Vol.:(0123456789) Applied Health Economics and Health Policy https://doi.org/10.1007/s40258-020-00554-z ORIGINAL RESEARCH ARTICLE Preferences for Weight Loss Treatment Amongst Treatment‑Seeking Patients with Severe Obesity: A Discrete Choice Experiment Michelle Queally 1  · Edel Doherty 1  · Francis Finucane 2  · Ciaran O’Neill 3 © Springer Nature Switzerland AG 2020 Abstract Background Treatment options for weight loss vary considerably with regard to risks and benefts, but the relative importance of treatment characteristics in patient decision-making is largely unknown, particularly amongst patients with severe obesity. Developing such services requires insight into the preferences of recipients for service attributes. Objective The objective of this study was to quantify, using a discrete choice experiment, the preferences of treatment- seeking patients with severe obesity within the Irish population regarding diferent attributes of various obesity treatments. Methods Within a cohort of patients with severe obesity attending a hospital-based weight management programme, patients’ attitudes to and perceptions of three distinct treatment modalities were compared to those regarding not having treatment. The treatments included a structured lifestyle modifcation programme, lifestyle modifcation alongside weight loss medica- tion, and bariatric surgery. Results On average, patients with severe and complicated obesity who were attending a weight management programme were more enthusiastic about participating in a programme to help improve their diet and physical activity than they were about having surgery if the methods of treatment had equivalent results and costs. Conclusion The fndings provide insights into preferences that might assist the development of more appropriate treatments for severe obesity. Key Points for Decision Makers Adopting a singular therapeutic approach for individuals with severe obesity will not sufce. We estimated the overall mean willingness to pay for lifestyle modifcation to be signifcantly higher than that for bariatric surgery, other things being equal. 1 Introduction While the global prevalence of obesity is increasing [1], the rise in the number of patients with severe obesity (body mass index [BMI] > 40 kg/m 2 ) has been particularly dramatic [2]. Individuals who are severely obese have on average much more complex health issues and encounter very diferent challenges in the healthcare system than the majority of moderately obese individuals (BMI ≥ 30–35) [2]. Prejudice Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40258-020-00554-z) contains supplementary material, which is available to authorized users. * Ciaran O’Neill ciaran.oneill@qub.ac.uk Michelle Queally Michelle.queally@nuigalway.ie Edel Doherty Edel.doherty@nuigalway.ie Francis Finucane Francis.fnucane@hse.ie 1 Discipline of Economics, JE Cairnes School of Business and Economics, NUI Galway, Galway, Ireland 2 Bariatric Medicine Service, Galway Diabetes Research Centre and HRB CRF, NUI Galway, Galway, Ireland 3 Centre for Public Health, Queens University Belfast, Belfast, UK