Cost-Effectiveness of a Weight Loss Intervention: An Adaptation of the Look AHEAD Lifestyle Intervention in the US Military

Karina C. Manz, Teresa M. Waters, Hannah E. Clifton, Mehmet Kocak, Robert C. Klesges, G. Wayne Talcott, Rebecca A. Krukowski

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: This study aimed to assess whether a counselor-initiated (CI) adaptation of the Look AHEAD (Action for Health in Diabetes) intensive lifestyle intervention in a military setting was cost-effective relative to a self-paced (SP) adaptation. Methods: A cost-effectiveness analysis from a payer perspective was performed alongside a 2014-2017 randomized behavioral weight loss trial among 248 active-duty military personnel stationed at a US Air Force base in Texas. Incremental cost-effectiveness ratios were calculated for weight loss, reductions in waist circumference, and quality-adjusted life-years (QALYs). Results: After 12 months, the CI adaptation cost more per participant compared with the SP adaptation ($1,081 vs. $120) but achieved greater weight loss (1.86 kg vs. 0.06 kg), greater reductions in waist circumference (1.85 cm vs. 0.48 cm), and more QALYs (0.871 vs. 0.856). The incremental cost-effectiveness ratio for the CI adaptation relative to the SP adaptation was $61,268 per additional QALY. At willingness-to-pay thresholds of $50,000 and $100,000 per QALY, the CI adaptation was 45% and 49% likely to be cost-effective, respectively. Conclusions: The CI delivery of the Look AHEAD Intensive Lifestyle Intervention may offer a cost-effective approach to tackle excess weight in the US military.

Original languageEnglish
Pages (from-to)89-96
Number of pages8
Issue number1
StatePublished - Jan 1 2020

Bibliographical note

Funding Information:
agencies: The study was funded by the NIDDK (RO1 DK097158) of the NIH under the title “Dissemination of the Look AHEAD Weight Management Treatment in the Military” (principal investigators: RCK and RAK). The research represents a Collaborative Research and Development Agreement with the US Air Force (CRADA #13-168-SG-C13001). The opinions expressed in this document are solely those of the authors and do not represent an endorsement by or the views of the US Air Force, the US Department of Defense, or the US Government.We would like to thank the participants and the research team for their dedication to the research and the Look AHEAD study team for sharing the intervention materials. We gratefully acknowledge the donation of some of the meal replacements and snacks from ConAgra Foods, Inc., and the partnerships with the Lose It! application and website and BodyTrace. The individual participant data collected during the trial are available, after deidentification (upon request to the corresponding author).

Publisher Copyright:
© 2019 The Obesity Society.

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics


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