Skip to main content
Log in

Health-economic burden of obesity in Europe

  • Review Paper
  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript


Although overweight and obesity have long been recognised as major risk factors for a number of chronic diseases, lifestyle developments have led to substantial increases in bodyweight worldwide. In addition to their negative effects on health and quality of life, obesity and associated comorbidities may have a considerable impact on healthcare expenditures. The aim of this systematic review was to summarise cost estimates and compare costs attributable to obesity across different European countries. A structured search in MEDLINE, EMBASE, and all EBM Reviews was conducted to identify relevant literature. Two researchers independently assessed publications according to pre-defined inclusion criteria and with regard to study methodology. Costs attributable to obesity were extracted from the included studies and calculated relative to country-specific gross domestic income. Out of 797 publications that met our search criteria, 13 studies investigating 10 Western European countries were determined to be relevant and included in our review. Obesity-related healthcare burdens of up to 10.4 billion euros were found. Reported relative economic burdens ranged from 0.09% to 0.61% of each country’s gross domestic product (GDP). Obesity appears to be responsible for a substantial economic burden in many European countries, and the costs identified in the available studies presumably reflect conservative estimates. There remains a great need for prospective and standardised studies to provide more accurate estimates of costs for all European countries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others



Between-group differences


Body mass index


Swiss francs


Dutch gulden


European Union


French francs


Gross domestic product


International Classification of Disease


International Association for the Study of Obesity


Medical subject heading


Not available


Not significant


Swedish crowns


United Kingdom




  1. Popkin BM, Kim S, Rusev ER, Du S, Zizza C. Measuring the full economic costs of diet, physical activity and obesity-related chronic diseases. Obes Rev. 2006;7(3):271–93.

    Article  PubMed  CAS  Google Scholar 

  2. Ezzati M, Lopez AD, Rodgers A, Vander HS, Murray CJ. Selected major risk factors and global and regional burden of disease. Lancet. 2002;360(9343):1347–60.

    Article  PubMed  Google Scholar 

  3. Haslam DW, James WP. Obesity. Lancet. 2005;366(9492):1197–209.

    Article  PubMed  Google Scholar 

  4. International Association for the Study of Obesity. Global Obesity Prevalence in Adults. 2006 September 1;Available from: URL:

  5. Fry J, Finley W. The prevalence and costs of obesity in the EU. Proc Nutr Soc. 2005;64(3):359–62.

    Article  PubMed  Google Scholar 

  6. Martinez JA, Kearney JM, Kafatos A, Paquet S, Martinez-Gonzalez MA. Variables independently associated with self-reported obesity in the European Union. Public Health Nutr. 1999;2(1A):125–33.

    Article  PubMed  CAS  Google Scholar 

  7. Federal Statistical Office. Federal Health Monitoring Information Services. Federal Statistical Office Germany, Wiesbaden 2007. Available from: URL:

  8. Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res. 1998;6(2):97–106.

    PubMed  CAS  Google Scholar 

  9. Thompson D, Edelsberg J, Kinsey KL, Oster G. Estimated economic costs of obesity to U.S. business. Am J Health Promot. 1998;13(2):120–7.

    PubMed  CAS  Google Scholar 

  10. European Central Bank . Fixed euro conversion rates. 2007. Available from: URL: Accessed 2007.

  11. FXHistory: historical currency exchange rates. Oanda com—The currency site 2007. Available from: URL:

  12. European gross domestic product in billion US-Dollars. International Monetary Fund. 2007. Available from: URL:

  13. Borg S, Persson U, Odegaard K, Berglund G, Nilsson JA, Nilsson PM. Obesity, survival, and hospital costs-findings from a screening project in Sweden. Value Health. 2005;8(5):562–71.

    Article  PubMed  Google Scholar 

  14. Narbro K, Jonsson E, Larsson B, Waaler H, Wedel H, Sjostrom L. Economic consequences of sick-leave and early retirement in obese Swedish women. Int J Obes Relat Metab Disord. 1996;20(10):895–903.

    PubMed  CAS  Google Scholar 

  15. Narbro K, Agren G, Jonsson E, Naslund I, Sjostrom L, Peltonen M. Pharmaceutical costs in obese individuals: comparison with a randomly selected population sample and long-term changes after conventional and surgical treatment: the SOS intervention study. Arch Intern Med. 2002;162(18):2061–9.

    Article  PubMed  Google Scholar 

  16. von Lengerke T, Reitmeir P, John J. Direct medical costs of (severe) obesity: a bottom-up assessment of over- vs. normal-weight adults in the KORA-study region (Augsburg, Germany). Gesundheitswesen. 2006;68(2):110–5.

    Article  Google Scholar 

  17. Sander B, Bergemann R. Economic burden of obesity and its complications in Germany. Eur J Health Econ. 2003;4(4):248–53.

    Article  PubMed  Google Scholar 

  18. Schneider R. Relevanz und Kosten der Adipositas in Deutschland (Relevance and cost of obesity in Germany). Ernährungs-Umschau. 1996;43(10):369–74.

    Google Scholar 

  19. Detournay B, Fagnani F, Phillippo M, Pribil C, Charles MA, Sermet C, et al. Obesity morbidity and health care costs in France: an analysis of the 1991–1992 Medical Care Household Survey. Int J Obes Relat Metab Disord. 2000;24(2):151–5.

    Article  PubMed  CAS  Google Scholar 

  20. Levy E, Levy P, Le PC, Basdevant A. The economic cost of obesity: the French situation. Int J Obes Relat Metab Disord. 1995;19(11):788–92.

    PubMed  CAS  Google Scholar 

  21. Report by the Comptroller and Auditor General. Tackling Obesity in England. 2001. HC 220 Session 2000–2001; 2001 Feb 15.

  22. Esposti ED, Sturani A, Valpiani G, Di MM, Ziccardi F, Rita CA, et al. The relationship between body weight and drug costs: an Italian population-based study. Clin Ther. 2006;28(9):1472–81.

    Article  PubMed  Google Scholar 

  23. Schmid A, Schneider H, Golay A, Keller U. Economic burden of obesity and its comorbidities in Switzerland. Soz Praventivmed. 2005;50(2):87–94.

    Article  PubMed  Google Scholar 

  24. Golay A, Masciangelo ML. Burden of obesity: from epidemic to costs. Rev Med Suisse. 2005;1(12):807–10,813.

    PubMed  CAS  Google Scholar 

  25. Seidell JC. The impact of obesity on health status: some implications for health care costs. Int J Obes Relat Metab Disord. 1995;19(Suppl 6):S13–6.

    PubMed  Google Scholar 

  26. James WPT, Jackson-Leach R, Ni Mhurchu C. Overweight and obesity (high body mass index). In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. vol 1. Geneva: WHO; 2004.

    Google Scholar 

  27. Birmingham CL, Muller JL, Palepu A, Spinelli JJ, Anis AH. The cost of obesity in Canada. CMAJ. 1999;160(4):483–8.

    PubMed  CAS  Google Scholar 

  28. Katzmarzyk PT, Janssen I. The economic costs associated with physical inactivity and obesity in Canada: an update. Can J Appl Physiol. 2004;29(1):90–115.

    PubMed  Google Scholar 

  29. Swinburn B, Ashton T, Gillespie J, Cox B, Menon A, Simmons D, et al. Health care costs of obesity in New Zealand. Int J Obes Relat Metab Disord. 1997;21(10):891–6.

    Article  PubMed  CAS  Google Scholar 

  30. Colditz GA. Economic costs of obesity and inactivity. Med Sci Sports Exerc. 1999;31(11 Suppl):S663–7.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Falk Müller-Riemenschneider.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Müller-Riemenschneider, F., Reinhold, T., Berghöfer, A. et al. Health-economic burden of obesity in Europe. Eur J Epidemiol 23, 499–509 (2008).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: