OBJECTIVES: More than 12% of adult population in Poland (4 million people) are obese (BMI>30), with approximately 400 thousand  being extremely obese (BMI>40).  In Western Europe up to 4% of total expenditures on health are spent on managing obesity and obesity dependent chronic diseases including diabetes, cardiovascular diseases and cancer. The aim of this study was to estimate direct cost of managing obesity in Poland. METHODS: Direct costs of obesity treatment were measured from both public payer’s (National Health Fund, NHF) and patients perspective. Data regarding standard obesity care were prospectively collected in a population of 72 obese patients, treated in National Food and Nutrition Institute in Warsaw.  Data regarding bariatric surgery were provided by experts. Cost data were calculated based either on NHF data (public payer perspective) or current market prices (patients perspective). Values are presented in Euro (exchange rate: 1 Euro=4,50 PLN). RESULTS: We estimate annual cost of obesity care at 325 Euro per patient. with more than 63% representing direct medical costs. Based on number and sort of bariatric surgery performed in 2008 in Poland we estimate total cost of surgical treatment for more than €2.2 mln (all covered by public payer). Based on NHF data, we estimate less than 30 thousand obese patients being covered with specialized medical care. Given that, total annual cost of obesity treatment in Poland would be as low as €12 mln, representing about 0,07% of total expenditures on health in 2008. Direct medical cost covered by public payer were estimated at 4 mln Euro representing less than 0,05% of NHF expenditures in 2008. Approximately two-thirds of obesity therapy costs are covered by patients. CONCLUSIONS: Regarding annual cost of managing obesity dependent diseases estimated at €550 mln, obesity therapy expenditures seems to be rather  low in Poland.