Economic evaluation of a weight control program with e-mail and telephone counseling among overweight employees: a randomized controlled trial: a randomized controlled trial

M.F. van Wier, J.C. Dekkers, J.E. Bosmans, M.W. Heijmans, I.J.M. Hendriksen, N.P. Pronk, W. van Mechelen, M.W. van Tulder

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BACKGROUND: Distance lifestyle counseling for weight control is a promising public health intervention in the work setting. Information about the cost-effectiveness of such interventions is lacking, but necessary to make informed implementation decisions. The purpose of this study was to perform an economic evaluation of a six-month program with lifestyle counseling aimed at weight reduction in an overweight working population with a two-year time horizon from a societal perspective.

METHODS: A randomized controlled trial comparing a program with two modes of intervention delivery against self-help. 1386 Employees from seven companies participated (67% male, mean age 43 (SD 8.6) years, mean BMI 29.6 (SD 3.5) kg/m2). All groups received self-directed lifestyle brochures. The two intervention groups additionally received a workbook-based program with phone counseling (phone; n=462) or a web-based program with e-mail counseling (internet; n=464). Body weight was measured at baseline and 24 months after baseline. Quality of life (EuroQol-5D) was assessed at baseline, 6, 12, 18 and 24 months after baseline. Resource use was measured with six-monthly diaries and valued with Dutch standard costs. Missing data were multiply imputed. Uncertainty around differences in costs and incremental cost-effectiveness ratios was estimated by applying non-parametric bootstrapping techniques and graphically plotting the results in cost-effectiveness planes and cost-effectiveness acceptability curves.

RESULTS: At two years the incremental cost-effectiveness ratio was €1009/kg weight loss in the phone group and €16/kg weight loss in the internet group. The cost-utility analysis resulted in €245,243/quality adjusted life year (QALY) and €1337/QALY, respectively. The results from a complete-case analysis were slightly more favorable. However, there was considerable uncertainty around all outcomes.

CONCLUSIONS: Neither intervention mode was proven to be cost-effective compared to self-help.

Original languageEnglish
Article number112
Journalinternational journal of behavioral nutrition and physical activity
Publication statusPublished - 11 Sept 2012


  • Adult
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Counseling
  • Electronic Mail
  • Female
  • Health Behavior
  • Health Promotion
  • Humans
  • Journal Article
  • Life Style
  • Male
  • Middle Aged
  • Overweight
  • Quality-Adjusted Life Years
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Telephone
  • Weight Reduction Programs

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