Objective: To examine literature published during the past ten years describing the impact of obesity and obesity-related disease on direct and indirect costs in Australia, Canada, France, Germany, Italy, Spain, Sweden, the UK, and the US. Methods: A review of the medical literature published from 1997 to 2007 was conducted, including MEDLINE, EMBASE, Current Contents Connect, and International Pharmaceutical Abstracts databases; ISPOR abstracts; and data published by relevant governmental agencies. Results: A substantial portion of direct costs related to obesity derive from treating comorbidities associated with the condition (e.g., type 2 diabetes, cardiovascular disease). Indirect costs, including those associated with reduced work productivity, increased absenteeism, and premature death, are significant, with the majority arising from comorbid conditions. Direct costs were greater for obese patients than for normal-weight patients; morbid obesity was associated with dramatic cost increases. Estimates of direct costs as a percentage of national health care expenditures were 5.7% for the US, and ranged from 2% to 2.6% for Australia, Canada, Sweden, and the UK. No estimates of indirect costs as a percentage of national health care costs were identified. No studies involving direct or indirect cost data collected since 1995 were identified for France, Italy, or Spain. Conclusion: Obesity has a substantial economic impact because of its high prevalence, association with multiple chronic diseases, and increased levels of disability and absenteeism. The lack of recent direct or indirect cost estimates in several countries highlights the need for further work to describe the global economic burden of obesity.