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

BACKGROUND: Obesity represents an important public health issue. An assessment of\r\nits costs would be useful to provide recommendations for policy and\r\ndecision-making strategies. The aims of our study were to carry out a systematic \r\nreview to assess the economic burden of adult obesity in terms of direct and\r\nindirect costs and to perform a quality appraisal of the analysed studies.\r\nMETHODS: A literature search was carried out on PubMed, Scopus and Cochrane\r\nLibrary to retrieve cost-of-illness (COI) analyses focused on adult (aged 18\r\nyears or more) overweight or obese people and published up to 2013. COI analyses \r\nthat considered direct and indirect costs were included. Each included manuscript\r\nwas independently appraised by three groups of researchers on the basis of the\r\nBritish Medical Journal Drummond's checklist.\r\nRESULTS: Approximately 2044 articles were initially retrieved, and 17 were\r\nincluded in the current review. The included studies showed a medium-high-quality\r\nlevel. The available studies seemed to be heterogeneous both in terms of\r\nmethodology and results reporting. However, as many studies have been conducted\r\nfrom the payer perspective, just direct medical costs can be considered\r\nexhaustive. As only three studies included considered also indirect costs, there \r\nis no strong evidence to give a comprehensive picture of this phenomenon also\r\nfrom the societal perspective.\r\nCONCLUSION: The review confirmed that obesity absorbs a huge amount of\r\nhealth-care resources. Further research is therefore needed to better understand \r\nthe economic impact and to identify and promote public health strategies to\r\ntackle obesity.