GLOBAL ECONOMIC BURDEN OF OBESITY IN ADULTS: AN UMBRELLA REVIEW OF SYSTEMATIC REVIEWS AND META-ANALYSES
Author(s)
Daria Tsapko1, Andrey Yurievich Kulikov, PhD, MD2, Roza Yagudina, PhD3.
1Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow Stat, Moscow, Russian Federation, 2First Moscow State Medical University (Sechenov Univerity), Moscow, Russian Federation, 3First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
1Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow Stat, Moscow, Russian Federation, 2First Moscow State Medical University (Sechenov Univerity), Moscow, Russian Federation, 3First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
OBJECTIVES: To synthesise evidence from published systematic reviews and meta-analyses on the economic burden of obesity in adults.
METHODS: We followed PRISMA 2020 and PRIOR guidelines; the protocol was prospectively registered on PROSPERO (CRD420261351619). PubMed/MEDLINE, Scopus, and Web of Science were searched from January 2010 to March 2026 (English only). Eligible reviews covered adults aged 18 years or older with overweight or obesity defined by BMI and reported direct or indirect costs. Two investigators screened independently, extraction was double-checked on a 20% random sample. . Methodological quality was appraised with AMSTAR 2, and overlap of primary studies with the corrected covered area. Where reviews reported internally standardised per-person estimates, these were expressed in 2024 purchasing power parity US dollars. Findings were synthesised narratively.
RESULTS: Sixteen systematic reviews drawing on 273 unique primary studies met the selection criteria. Overlap between reviews was 3.54%. Cost scope differed across the set: 5 reviews reported direct costs only, 1 indirect only, and 10 both. Costing methods, currencies, and reference years also varied. Cost as a share of GDP ranged from 0.6% to 3.1%. Excess direct medical cost per person for obesity ranged widely across settings, from US$370 (2024 PPP, Taiwan) to US$2,519 (2024 PPP, United States). Coverage concentrated in the Region of the Americas (13/16) and high-income countries (15/16). Two reviews included lower-middle-income countries, none included low-income countries.
CONCLUSIONS: In this first umbrella review of cost-of-illness research on adult obesity, absolute cost estimates varied widely across countries, diverging with costing method, currency, and cost boundary, while relative measures such as the cost premium over normal weight were more consistent across reviews. Cross-review synthesis is therefore more dependable when built on relative measures than on absolute figures. Broader coverage of underrepresented regions and low-income countries is needed before a genuinely global account can be drawn.
METHODS: We followed PRISMA 2020 and PRIOR guidelines; the protocol was prospectively registered on PROSPERO (CRD420261351619). PubMed/MEDLINE, Scopus, and Web of Science were searched from January 2010 to March 2026 (English only). Eligible reviews covered adults aged 18 years or older with overweight or obesity defined by BMI and reported direct or indirect costs. Two investigators screened independently, extraction was double-checked on a 20% random sample. . Methodological quality was appraised with AMSTAR 2, and overlap of primary studies with the corrected covered area. Where reviews reported internally standardised per-person estimates, these were expressed in 2024 purchasing power parity US dollars. Findings were synthesised narratively.
RESULTS: Sixteen systematic reviews drawing on 273 unique primary studies met the selection criteria. Overlap between reviews was 3.54%. Cost scope differed across the set: 5 reviews reported direct costs only, 1 indirect only, and 10 both. Costing methods, currencies, and reference years also varied. Cost as a share of GDP ranged from 0.6% to 3.1%. Excess direct medical cost per person for obesity ranged widely across settings, from US$370 (2024 PPP, Taiwan) to US$2,519 (2024 PPP, United States). Coverage concentrated in the Region of the Americas (13/16) and high-income countries (15/16). Two reviews included lower-middle-income countries, none included low-income countries.
CONCLUSIONS: In this first umbrella review of cost-of-illness research on adult obesity, absolute cost estimates varied widely across countries, diverging with costing method, currency, and cost boundary, while relative measures such as the cost premium over normal weight were more consistent across reviews. Cross-review synthesis is therefore more dependable when built on relative measures than on absolute figures. Broader coverage of underrepresented regions and low-income countries is needed before a genuinely global account can be drawn.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE17
Topic
Economic Evaluation, Health Policy & Regulatory, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas