Economic impact of adult obesity on health systems: a systematic review [Poster]

Background Obesity is one of the biggest public health challenges of the 21st century. Excess weight and obesity are major public health issues in high income countries but are increasing also in developing countries. Obesity has been demonstrated to have important social and economic consequences, so an assessment of its economic burden is required. The main aim of this study was to assess the economic burden of adult obesity and overweight in terms of direct and indirect costs. A secondary purpose was to provide a quality appraisal of the reviewed studies. Methods A systematic review of the economic impact of adult obesity was performed on PubMed by developing a specific algorithm, in order to find out articles on the economic evaluation of adult obesity impact. Cost-of-illness (COI) analyses of overweight or obese people aged 18 years or more published up to May 2013 were considered. Furthermore, with the aim to appraise the quality of the included studies, each of the included COI analyses was assessed on the basis of the British Medical Journal Drummond’s checklist. Results About 1,052 COI analyses were initially found and 16 were finally considered in the current review, of which 7 have been carried out in the US, 2 in Brasil, 2 in Germany, 1 in Japan, 1 in United Kingdom, 1 in Australia, 1 in Korea and 1 in China. Twelve studies were carried out from the Payer’s perspective, 2 from both societal and Payer’s perspective and 1 only from the societal perspective. The type of costs mostly considered were direct medical costs, 3 studies included also indirect costs and 1 study took into account also direct non-medical costs. Total direct medical costs due to overweight and obesity ranged from US$ 2,152 billion in Brazil to US$ 2.74 billion in China to US$ 8,56 billion in United Kingdom. The average quality of the included analyses was medium-high. Conclusions The analysis confirmed that obesity absorbs a huge amount of health care resources and heterogeneity among available studies. However, as many studies have been conducted from the Payer’s perspective, just direct medical costs can be considered exhaustive. Therefore strong evidence is not available in order to give a comprehensive picture of this phenomenon also from the societal perspective. Key messages Further research should be promoted in the field of adult obesity with the aim to increase commitment and awareness among the community. To decrease adult obesity economic burden and incidence, prevention strategies should be intensified by promoting positive lifestyles/behaviours, and targeted services should be planned and provided.