Economic costs of obesity for Belgium estimated at €4.5 billion

Researchers from Belgium have reported that the annual estimated costs to cover the direct and indirect costs related to overweight and obesity at €4.5 billion, and have called for policies and interventions to reduce the prevalence of overweight and obesity to decrease these costs. The findings were reported in the paper, ‘Health care costs and lost productivity costs related to excess weight in Belgium’, published in BMC Public Health.

In 2018, the Belgian health examination survey (BHES) reported that more than half of the adult population was affected by overweight and 16% was affected by obesity. An earlier report in 2010 found that approximately €600 million was spent on medical care of obesity related pathologies. The researchers undertook their study to examine the current burden of excess weight including overweight and obesity, among the adult population on annual health care costs and lost productivity costs in Belgium.


Health care costs and costs of absenteeism were estimated using data from the Belgian national health interview survey (BHIS) 2013 linked with individual health insurance data (2013–2017). The average yearly health care costs and costs of absenteeism were assessed by body mass index (BMI) categories. In addition, healthcare costs were also analysed by type of cost. The cost attributable to excess weight and the contribution of various other chronic conditions to the incremental cost of excess weight were estimated using the method of recycled prediction (standardisation).

According to BHIS 2013, 34.7% and 13.9% of the Belgian adult population were respectively affected by overweight or obesity, mostly concentrated in the age-group 35–65 years. They also had significantly more chronic conditions compared to the normal weight population. Average total healthcare expenses for people with overweight and obesity were significantly higher than those observed in the normal weight population.


The adjusted incremental annual health care cost of excess weight in Belgium was estimated at €3,329,206,657 (€651 and €1,015 per capita for individuals with overweight and obesity respectively). Twenty out of twenty-three chronic conditions included in the regression model had a positive contribution to the incremental cost of overweight and obesity. Costs attributable to hypertension were by far the highest among all considered chronic conditions (Figure 1). The second highest relative cost was attributed to high cholesterol followed by serious gloom and depression.

Figure 1: Relative contribution of chronic conditions to incremental costs of overweight and obesity, Belgian population ≥ 18 years, BHIS 2013-IMA2013-2017

Mean annual incremental cost of absenteeism for overweight accounted for €242 per capita but was not statistically significant, people with obesity showed a significantly higher cost (p<0.001) compared to the normal weight population: €2,015 [per capita. The annual total incremental costs due to absenteeism of the population affected by overweight and obesity was estimated at €1,209,552,137. Arthritis, including rheumatoid arthritis and osteoarthritis, was the most important driver of the incremental cost of absenteeism in individuals with overweight and obesity, followed by hypertension and low back pain (Figure 1).


The average yearly total health care cost increased from €2,246 per capita in normal weight individuals to €3,475 and €4,288 per capita in individuals respectively with overweight and obesity. In individuals with underweight the average health care expenditure was €3,387 per capita per year. Ambulatory care was 58% of total health care cost while 30% of the costs were for hospital care and 9.5% for reimbursed medicines obtained through pharmacies.

“Our study provides valuable information on the extent of the societal impact that excessive weight status has in Belgium…”. They authors concluded. “Our findings are also important from a health policy perspective, in the planning of strategies for health care cost containment. From a public health perspective, a sustainable approach towards effective prevention of the most impactful diseases is a more affordable strategy.”

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