Presentation (CTI)

OBJECTIVES: Obesity is a significant global health challenge, recognized as a major public health epidemic. Despite its increasing prevalence, it is often underdiagnosed and undertreated in Bulgaria. The most recent estimates show obesity affects 16.38% of the adult population (approximately 875,061 people). Of those, only 40% have an official diagnosis, and just 1.3% of the diagnosed patients receive pharmacological treatment (paid out of pocket). As a result, obesity-related complications lead to substantial direct medical costs and reduced workforce productivity.
METHODS: This analysis estimated the total annual economic burden of obesity in Bulgaria, considering both direct healthcare costs and indirect costs due to productivity loss. National prevalence data, treatment rates, and productivity metrics were used. Health loss was quantified using disability-adjusted life years (DALYs). Economic values were based on 2023 Bulgarian GDP data and healthcare cost estimates.
RESULTS: The total annual economic burden of obesity was estimated at BGN 6,484,447,995, or 3.5% of the national GDP for 2023. Direct healthcare costs amounted to BGN 668,918,648, of which BGN 589,694,645 were due to complications and comorbidities—costs potentially reducible with timely intervention. Indirect costs represented over 89% of the total burden, driven by substantial productivity loss (17% impaired productivity and 10 workdays lost per patient annually). The resulting GDP loss from reduced productivity was BGN 5,815,519,352 per year. Additionally, annual health loss was quantified at 67,723 DALYs.
CONCLUSIONS: Our findings demonstrate that investment in early diagnosis, multidisciplinary care, and innovative treatment options can yield substantial health and economic benefits. The results should inform policy decisions aimed at improving access to obesity treatment in Bulgaria. Recognizing obesity as a strategic health and economic priority is essential for mitigating its long-term societal impact.