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Rigorous estimates of preference‐based utilities are important inputs into economic evaluations of childhood obesity interventions, yet no published review currently exists examining utility by weight status in paediatric populations. A comprehensive systematic literature review and meta‐analysis was therefore undertaken, pooling data on preference‐based health state utilities by weight status in children using a random‐effects model. Tests for heterogeneity were performed, and publication bias was assessed. Of 3,434 potentially relevant studies identified, 11 met our eligibility criteria. Estimates of Cohen's d statistic suggested a small effect of weight status on preference‐based utilities. Mean utility values were estimated as 0.85 (95% uncertainty interval [UI] 0.84–0.87), 0.83 (95% UI 0.81–0.85), 0.82 (95% UI 0.79–0.84) and 0.83 (95% UI 0.80–0.86) for healthy weight, overweight, obese and overweight/obese states, respectively. Meta‐analysis of studies reporting utility values for both healthy weight and overweight/obese participants found a statistically significant weighted mean difference (0.015, 95% UI 0.003–0.026). A small but statistically significant difference was also estimated between healthy weight and overweight participants (0.011, 95% UI 0.004–0.018). Study findings suggest that paediatric‐specific benefits of obesity interventions may not be well reflected by available utility measures, potentially underestimating cost‐effectiveness if weight loss in childhood/adolescence improves health or well‐being.

Original publication




Journal article


Obesity Reviews



Publication Date





905 - 916


paediatric obesity, FFR, systematic review, health‐related quality of life, utility