Research
Mixed
Markov models are the dominant methodological framework for economic evaluations of obesity interventions, with 85% of reviewed studies utilizing state-transition models.
When evaluating the long-term cost-effectiveness of obesity treatments, decision-makers should expect and look for Markov modeling. This is the standard approach for comparing interventions like bariatric surgery, pharmacotherapy, and lifestyle changes over a patient's lifetime.
GoodSupportsHIGH confidence
a review by Bjoern Schwander et al provided a comprehensive overview of published decision models for health economic assessments related to obesity, various methodological approaches were identified and Markov models dominated (85% of studies).
Why this rating
Based on a systematic review of 21 unique Markov models from 34 publications.
Source
Critical Analysis of Markov Modeling for the Economic Evaluation of Obesity Interventions: A Systematic Review
Qiucen Lin et al. · Risk Management and Healthcare Policy · 2025
DOI 10.2147/rmhp.s528064
systematic_reviewCited 2×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Current Markov models for obesity interventions exhibit significant methodological heterogeneity, particularly in how they model the progression of obesity and its impact on costs and utilities.Good
- Diabetes mellitus (DM) and cardiovascular disease (CVD) are the most frequently modeled obesity-related complications in Markov models, with DM appearing in 15/15 models focusing on complications and CVD in 14/15.Good
- Validation practices in Markov models for obesity interventions are inconsistently reported, with only 43% of models reporting validation, limiting the reliability and comparability of these evaluations.Good
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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