The Economic Burden of Overweight and Obesity in Europe: A Systematic Literature Review
Author(s)
Raymond H. Henderson, BSc, MSc, PhD1, Sandra Redmond, BA, MA2, Colin Davenport, MB BCh BAO, PhD3, Órla Walsh, MSc, MB BCh BAO4, Séan Fennessy, MB BCh BAO, MRCPI5, Donal O'Shea, MB, BCh, BAO, MD, FRCPI, FRCP5.
1Senior HTA Manager, Salutem Insights Ltd, Portlaoise, Ireland, 2Salutem Insights Ltd, Enniscorthy, Ireland, 3Connolly Hospital Blanchardstown, Dublin, Ireland, 4Children’s Health Ireland (CHI) at Temple Street, Dublin, Ireland, 5St. Vincent's University Hospital, Dublin, Ireland.
1Senior HTA Manager, Salutem Insights Ltd, Portlaoise, Ireland, 2Salutem Insights Ltd, Enniscorthy, Ireland, 3Connolly Hospital Blanchardstown, Dublin, Ireland, 4Children’s Health Ireland (CHI) at Temple Street, Dublin, Ireland, 5St. Vincent's University Hospital, Dublin, Ireland.
OBJECTIVES: To assess and quantify the economic burden of overweight and obesity across European countries examining both direct healthcare costs and indirect productivity losses.
METHODS: A systematic literature review was conducted following PRISMA guidelines. We searched PubMed, Cochrane Library, Google Scholar, BASE and grey literature for English-language, peer-reviewed cost-of-illness studies published between 1 January 2014 and 20 January 2025. Two reviewers independently screened titles and abstracts, with four reviewers resolving discrepancies at the full-text stage. Data on study characteristics, direct cost items (inpatient, outpatient, primary care, emergency, diagnostics, drugs), indirect cost items (absenteeism, presenteeism, mortality, early retirement) and costing methods were extracted into Excel and summarised narratively.
RESULTS: Thirty‐one articles (covering 39 distinct studies) from 15 countries met inclusion criteria. Direct annual costs of obesity ranged from €108 million (Czech Republic) to €63 billion (Germany); per-capita direct costs varied between €13 for overweight (Czech Republic) and €1,642 for obese class III (England), while per-capita indirect costs reached up to €14,436 per individual (average for 5 largest European nations for obese class III) with obesity. Indirect costs—primarily productivity losses—accounted for 53-94% of total economic burden in most studies. Cardiovascular disease emerged as the predominant related complication driving costs, followed by musculoskeletal and metabolic disorders. Methodological approaches varied: 87% prevalence-based, 78% bottom-up, and 69% retrospective analyses.
CONCLUSIONS: Obesity imposes a substantial economic burden on European healthcare systems and societies, with indirect costs constituting the largest share. These findings underscore the urgent need for comprehensive multidisciplinary prevention and treatment strategies, and targeted policy interventions to mitigate both healthcare expenditures and productivity losses.
METHODS: A systematic literature review was conducted following PRISMA guidelines. We searched PubMed, Cochrane Library, Google Scholar, BASE and grey literature for English-language, peer-reviewed cost-of-illness studies published between 1 January 2014 and 20 January 2025. Two reviewers independently screened titles and abstracts, with four reviewers resolving discrepancies at the full-text stage. Data on study characteristics, direct cost items (inpatient, outpatient, primary care, emergency, diagnostics, drugs), indirect cost items (absenteeism, presenteeism, mortality, early retirement) and costing methods were extracted into Excel and summarised narratively.
RESULTS: Thirty‐one articles (covering 39 distinct studies) from 15 countries met inclusion criteria. Direct annual costs of obesity ranged from €108 million (Czech Republic) to €63 billion (Germany); per-capita direct costs varied between €13 for overweight (Czech Republic) and €1,642 for obese class III (England), while per-capita indirect costs reached up to €14,436 per individual (average for 5 largest European nations for obese class III) with obesity. Indirect costs—primarily productivity losses—accounted for 53-94% of total economic burden in most studies. Cardiovascular disease emerged as the predominant related complication driving costs, followed by musculoskeletal and metabolic disorders. Methodological approaches varied: 87% prevalence-based, 78% bottom-up, and 69% retrospective analyses.
CONCLUSIONS: Obesity imposes a substantial economic burden on European healthcare systems and societies, with indirect costs constituting the largest share. These findings underscore the urgent need for comprehensive multidisciplinary prevention and treatment strategies, and targeted policy interventions to mitigate both healthcare expenditures and productivity losses.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE702
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Mental Health (including addition), Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)