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CUBA IS THE FUTURE FOR LATIN AMERICA AND PERHAPS THE WORLD

CUBA IS THE FUTURE FOR LATIN AMERICA AND PERHAPS THE WORLD On my way out of Cuba, from La Habana, on COPA airlines flight to Panama, I w...

dimanche 7 septembre 2014

COST OF LOOSING WEIGHT: 75 DOLLARS PER POUND WEIGHT LOST WITH WEIGHT WATCHERS TO 200 DOLLARS WITH MEDICATIONS

An interesting study had been published in the journal Obesity by Dr Eric Finkelstein who is with both Duke University and the National University of Singapore combined programme with Duke in Singapore. He has done extensive work in the field of weight loss economics and also invariably the psychology behind the weight loss economics.

Would paying money to people to loose weight work?
If you read the following study you can see that it costs a lot of money to loose weight and no one would be willing to pay that kind of incentive. But loosing ones own money is a good incentive, if you join Weight Watchers, you have to come up with the money and it is the best value for money there is. A drug, I think a combination of Phentermine and topiramate, is also effective coming in second. But if you take the Quality of Life measurement, it cost 34,000 dollars with Weight Watchers and 54,130 with the medication. Also weight watchers weight loss probably is longer lasting, is a lifestyle alteration, rather than a pharmaceutical modification, which is thus preferred.

Meta- and cost-effectiveness analysis of commercial weight loss strategies
.    Eric A. Finkelstein1,2,* and Eliza Kruger1
Article first published online: 24 JUN 2014

Objective
To estimate the incremental cost-effectiveness of clinically proven nonsurgical commercial weight loss strategies for those with BMIs between 25 and 40.
Methods
We performed a systematic literature review to identify randomized controlled trials of commercially available weight loss studies of at least 1 year in duration. Using the results of these trials and publicly available cost data, we quantified the incremental cost per kilogram of weight loss and per quality adjusted life year (QALY) gained. We then use probabilistic sensitivity analyses to quantify uncertainty in our results.
Results
Based on the literature review, two lifestyle programs (Weight Watchers and Vtrim), one meal replacement program (Jenny Craig), and three pharmaceutical products (Qsymia, Lorcaserin, and Orlistat) were included in the analysis. Average cost per kilogram of weight lost ranged from $155 (95% CI: $110-$218) for Weight Watchers to $546 (95% CI: $390-$736) for Orlistat. The incremental cost per QALY gained for Weight Watchers and Qsymia was $34,630 and $54,130, respectively. All other interventions were prohibitively expensive or inferior in that weight loss could be achieved at a lower cost through one or a combination of the other strategies.
Conclusions

Results suggest that, in the absence of other considerations and at current market prices, Weight Watchers and Qsymia represent the two most cost-effective strategies for nonsurgical weight loss.
HOW MUCH DOES IT COST TO PUT ON WEIGHT, FROM NORMAL WEIGHT TO AN UNHEALTHY WEIGHT?
GLOBALIZATION AND CONTEXT IS VERY IMPORTANT HERE
IN THE RICHER COUNTRIES, POOR AND MARGINALIZED PEOPLE TEND TO BE OBESE. IN THE POORER COUNTRIES IT IS THE PRIVILEGED CLASS THAT BECOMES OVERWEIGHT.

Also the weight in its absolute numbers or calculated as BMI Body Mass Index has different values for a Chinese from Singapore than for an European American from Minnesota, 22 or 23 kg/m2 would be considered the threshold for Normal Weight whereas in the west 25 kg/m2 is considered the normal. Also, abdominal accumulation of weight, however slight, as seen in the Asians, is much more metabolically dangerous than the steatopygia observed in Africa.

Even if my BMI is only 22.8 kg/m2 and my body fat is 17%, I plan to attend the lectures of the Weight Watchers in Miami, so that I can learn some wisdom to be able to help the group of I work with in America, who are 95% overweight or obese. The fact that it is not a progressive gain of weight, rather than a metabolic insult or inability to cope with a metabolic insult, in the group I work with, percentage wise, there are more Obese than Overweight people!

Good work, Dr Finkelstein..