Presentation (CTI)

OBJECTIVES: Overweight and obesity represent a rapidly growing public health challenge in Colombia, generating substantial indirect costs through productivity losses, disability, and premature mortality. . While international evidence on the indirect economic burden of obesity is extensive, its applicability to Latin American health systems and economic evaluations remains limited, constraining informed decision-making. The aim was to synthesize the evidence on indirect costs associated with adult overweight and obesity to inform policy and economic modeling in Colombia.
METHODS: A systematic review was conducted in accordance with Cochrane standards, with the protocol registered in PROSPERO (CRD420251158197). Searches were performed in MEDLINE, Embase, Cochrane Library, DARE/NHS EED, LILACS, and gray literature up to October 14, 2025. Eligible studies included observational designs and cost-of-illness analyses reporting indirect costs attributable to adult overweight or obesity. Two reviewers independently screened studies, extracted data, and assessed methodological quality.
RESULTS: Twenty-three studies were included, predominantly cost-of-illness (36%) and cohort studies (27%), mainly from high-income countries; only three studies were conducted in Colombia. Absenteeism was the most frequently reported outcome (82%). Compared with individuals of normal weight, adults with obesity experienced approximately 2-10 additional lost workdays per year, translating into annual per-person indirect costs ranging from approximately USD 200 to over USD 7,000. Presenteeism contributed substantially to productivity losses, with reported reductions ranging from 0.3% to 30% and annual per-person costs between approximately USD 180 and USD 4,000. Disability and premature mortality were major cost drivers, jointly accounting for more than 50% of total indirect costs in several studies
CONCLUSIONS: Overweight and obesity impose a substantial indirect economic burden, driven primarily by productivity losses, disability, and premature mortality. Despite methodological heterogeneity, findings consistently indicate high societal costs. Incorporating indirect costs into economic evaluations and HTA-informed decision frameworks is essential to support value-based obesity management policies in Colombia and similar middle-income settings.