Impact of Different Thresholds of Increasing or Decreasing Body Mass Index on Noncommunicable Diseases Through a Discrete Event Simulation Model
Author(s)
Cesar Victoria, Ph.D.1, Israel Rico Alba, Ph.D.2, Jorge Guzman Caniupan, MHE3, Adolfo Gabriel Hernandez, M.Sc., Sc.D., MD.4, Alberto Retana Guzman, M.B.A.2.
1AHS Health Consulting, CDMX, Mexico, 2Strategic Market Access, Novo Nordisk, Mexico, city, Mexico, 3AHS Health Consulting, Mexico city, Mexico, 4ADGH Health Consulting, Mexico City, Mexico.
1AHS Health Consulting, CDMX, Mexico, 2Strategic Market Access, Novo Nordisk, Mexico, city, Mexico, 3AHS Health Consulting, Mexico city, Mexico, 4ADGH Health Consulting, Mexico City, Mexico.
OBJECTIVES: To evaluate the number of Non-communicable diseases (NCDs) and Years of life lost (YLL) by different thresholds of Body mass index (BMI) at population level.
METHODS: A discrete event simulation model was implemented for a synthetic population based on official Mexican data. The model accounts for individual factors (BMI, age, sex) and simulates the increases or reductions in the number of NCD (e.g. cardiovascular diseases, diabetes and neoplasm) and YLL associated with obesity and overweight. For the model purposes each patient was cloned to compare their outcome under a no-intervention scenario versus an intervention that either increases or decreases BMI at 6 different thresholds (± 3, 9 and 15%). The model calculated the time required for the population to move from overweight or obesity to normal weigth.
RESULTS: The synthetic population had 362,341 new cases of NCDs and 1,145,601 YLL per million of people. Decreased 3, 9 and 15% of the BMI prevented 13.1%(n=47,389), 18.4%(n=66,508) and 19.5%(n=70,763) NCDs. In contrast, its increase raised it by 9.3%(n=33,838), 9.9%(n=35,966) and 10.0%(n=36,349), respectively. Reducing the BMI prevented 124,808 to 218,779 YLL, while increasing it generate 90,203 to 109,253 YLL. Interestingly, reducing the BMI obtained a linear benefit, albeit with `diminishing returns´; while increasing it >3% showed only marginal harms (0.6 and 0.1%). Finally, reductions of 3, 9 and 15% required 7.5, 2.8 and 1.9 years to cross the normal weight threshold. Conversely, increasing it needed less time: 5.1, 2.1 and 1.6 years, respectively.
CONCLUSIONS: Decreasing BMI at the population level reduced the NCDs and YLL. Importantly, reductions as small as 3% showed the greatest benefits in NCDs (-13.1%) and YLL (-10.9%). Unfortunately, it took 7.5 years to reach that benefit. Therefore, even with `diminishing returns´ in BMI reduction, interventions that achieve benefits in less time should be sought. As the 9% reduction in 2.82 years.
METHODS: A discrete event simulation model was implemented for a synthetic population based on official Mexican data. The model accounts for individual factors (BMI, age, sex) and simulates the increases or reductions in the number of NCD (e.g. cardiovascular diseases, diabetes and neoplasm) and YLL associated with obesity and overweight. For the model purposes each patient was cloned to compare their outcome under a no-intervention scenario versus an intervention that either increases or decreases BMI at 6 different thresholds (± 3, 9 and 15%). The model calculated the time required for the population to move from overweight or obesity to normal weigth.
RESULTS: The synthetic population had 362,341 new cases of NCDs and 1,145,601 YLL per million of people. Decreased 3, 9 and 15% of the BMI prevented 13.1%(n=47,389), 18.4%(n=66,508) and 19.5%(n=70,763) NCDs. In contrast, its increase raised it by 9.3%(n=33,838), 9.9%(n=35,966) and 10.0%(n=36,349), respectively. Reducing the BMI prevented 124,808 to 218,779 YLL, while increasing it generate 90,203 to 109,253 YLL. Interestingly, reducing the BMI obtained a linear benefit, albeit with `diminishing returns´; while increasing it >3% showed only marginal harms (0.6 and 0.1%). Finally, reductions of 3, 9 and 15% required 7.5, 2.8 and 1.9 years to cross the normal weight threshold. Conversely, increasing it needed less time: 5.1, 2.1 and 1.6 years, respectively.
CONCLUSIONS: Decreasing BMI at the population level reduced the NCDs and YLL. Importantly, reductions as small as 3% showed the greatest benefits in NCDs (-13.1%) and YLL (-10.9%). Unfortunately, it took 7.5 years to reach that benefit. Therefore, even with `diminishing returns´ in BMI reduction, interventions that achieve benefits in less time should be sought. As the 9% reduction in 2.82 years.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
SA52
Topic
Methodological & Statistical Research, Real World Data & Information Systems, Study Approaches
Topic Subcategory
Decision Modeling & Simulation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Oncology