Clinical, Economic, and Patient-Reported Impact of Obesity in Selected European Countries: A Systematic Review

OBJECTIVES: To describe the clinical, economic, and patient-reported impact of obesity in selected European countries.

METHODS: Using PRISMA guidelines, a multi-region systematic literature review (SLR) review was performed to report the clinical, economic, and patient-reported impact of obesity in selected European and Asia-Pacific countries, and Canada from 2018 to 2023. Here we report results for Europe from multi-country and country-specific studies (France, Germany, UK, Italy, Spain). Obesity was defined using the WHO body mass index (BMI); BMI ≥30 was used for all countries. Original articles, conference abstracts, and grey literature, published in English or local languages, were eligible for inclusion.

RESULTS: From 220 publications in the global SLR, 107 publications reporting on 93 studies were identified for Europe (Germany, n=30; UK, n=38; Italy, n=26; Spain, n=34; France, n=19; Europe, n=2; non-mutually exclusive). The prevalence of obesity ranged from 5%-35.7% with the highest estimates seen in Spain (35.7%) and the UK (26.0%). Diabetes, hypertension, heart-related complications, depression, and dyslipidaemia were the most frequently reported comorbidities. Studies illustrated health-related quality of life, depression, eating behaviors, anxiety, and body image as the most reported patient- reported outcomes. Total direct and indirect patient-specific costs were high, with the main patient-specific costs including healthcare professional visits, hospitalization, prescription medication, out-of-pocket costs, and productivity loss caused by presenteeism and absenteeism.

CONCLUSIONS: Obesity is prevalent in European countries and accompanied by weight-related metabolic, cardiovascular, and psychological comorbidities. Obesity significantly affects the psychosocial sphere and HRQoL in people with obesity and is associated with significant use of resources.