The Macroeconomic Cost of Obesity and Overweight in European Countries: A Systematic Review and Methodological Quality Analysis.

Abstract

The aim for this study is to systematically review cost-of-illness (COI) studies of costs attributable to obesity and overweight (OAO) at the country level for European Union (EU) countries, Northern European countries, the United Kingdom, and Switzerland. PubMed, Scopus, and HTA Database were searched from 2014 to 2024. This study adhered to PRISMA guidelines. A COI checklist was used to assess methodological quality. Outcome measures were cost as a percentage of GDP and percentage of direct costs. Eight studies were included. Only one study did not use the population attributable fraction approach. Important heterogeneity among studies was observed for BMI categories, for the population age range included, for the range of diseases attributed to OAO, and for the discount rate. Included costs varied among studies, especially indirect costs. More than half of the results for the highest observation for each country, including obesity and overweight global costs, showed results above 2% of GDP (14 out of 26 countries). The results of the regression models showed the decreasing trend of the proportion of GDP attributed to OAO as per capita GDP increases. The majority of studies showed a proportion of costs above 1.5% of GDP; more than half of the 26 European countries showed a cost above 2% of GDP. Total cost at the country level attributed to OAO as a proportion of GDP decreases as GDP per capita increases.