Cost‐Effectiveness of Personalized Lifestyle Interventions in Adults With Overweight/Obesity: A Systematic Review

OBJECTIVES: Obesity and overweight pose a global health and economic burden. Lifestyle interventions are recommended as first-line treatment. Given their individual complexity, personalized lifestyle interventions may be more effective than one-size-fits-all approaches. This review assessed the methodology, findings and reporting quality of cost-effectiveness analyses evaluating personalized lifestyle interventions in adults with overweight or obesity. METHODS: MEDLINE, Embase, Web of Science, and Scopus were searched in March 2025, with backward reference tracking. Full economic evaluations were included without date restrictions. Studies were categorized by highest applicable personalization level: behavioral (Level 1), phenotype-based (Level 2), or omics-based (Level 3). Reporting quality was assessed using the CHEERS 2022 Checklist. RESULTS: From 15,385 records screened, 18 studies were included. Fourteen evaluated Level 1 interventions and two each evaluated Levels 2 and 3. Thirteen were cost-utility analyses: seven reported cost-effective or dominant findings, four reported not cost-effective findings, and two reported unclear or mixed results. Ten studies reported cost-effectiveness using clinical outcomes: eight showed favorable findings for at least one outcome, and two reported unclear findings. Heterogeneity in intervention design and methods between studies precluded robust conclusions. Findings for level 1 were mixed, evidence for levels 2 and 3 was limited, with favorable and inconsistent findings, respectively. CONCLUSIONS: Evidence on the cost-effectiveness of personalized lifestyle interventions was mixed and predominantly behavioral personalization. The scarcity of economic evaluations evaluating more advanced personalized lifestyle interventions remains a key evidence gap. Future research should evaluate their added value to inform resource allocation in obesity management.