Mixed
Roux-en-Y gastric bypass (RYGB) and Health Behavior Intervention (HBI) are cost-effective strategies for managing class III obesity, whereas current-price pharmacotherapies (semaglutide and tirzepatide) are not cost-effective compared to no treatment or HBI.
For individuals with class III obesity, Roux-en-Y gastric bypass offers the best long-term health outcomes and cost-effectiveness. Health Behavior Intervention (13 counseling sessions) is also cost-effective. Current GLP-1/GIP medications are not cost-effective at current prices, though lower prices could change this.
RYGB and HBI are cost-effective for managing class III obesity. While RYGB provided the greatest health gains, access remains limited. Neither pharmacotherapy was cost-effective at current prices.
Why this rating
High-quality economic modeling based on published clinical trial data (STEP, SURMOUNT) and real-world adherence rates.
Source
A cost‐effectiveness analysis of behavioural, pharmacological, and surgical obesity treatments in Canada
Nisha Gupta et al. · Diabetes Obesity and Metabolism · 2025
DOI 10.1111/dom.16627
More from this paper
- Health Behavior Intervention (HBI) consisting of 13 dietician-led counseling sessions over 1 year is a cost-effective strategy for managing class III obesity compared to no treatment.Good
- Lower drug prices for semaglutide and tirzepatide could significantly improve their cost-effectiveness, potentially making them competitive with surgical and behavioral interventions.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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