A new report estimates that elevated body mass index (BMI) is associated with 278,000 deaths and almost eight million years of healthy life lost annually across eight European countries.
The Economic Burden of Overweight and Obesity in Europe, published by the Office of Health Economics (OHE), examines the health and economic impact in France, Germany, Greece, Ireland, Italy, Romania, Spain and the United Kingdom. The report was commissioned and funded by the European Federation of Pharmaceutical Industries and Associations (EFPIA).
A growing challenge for Europe
In 2024, an estimated 26% of adults in Europe were living with obesity, while a further 30% were living with overweight. Almost one-third of children in Europe are also living with overweight or obesity.
Across the eight countries studied, elevated BMI was associated annually with:
- 278,000 deaths
- Almost eight million disability-adjusted life years, or DALYs
- Economic costs equivalent to between 0.7% and 1.4% of national economic output
DALYs measure the combined effect of premature death, illness and disability and can be understood as years of healthy life lost.
The estimated annual economic costs in the countries studied were:
| Land | Annual cost | Share of economic output |
|---|---|---|
| Deutschland | €55.2 billion | 1.3% |
| Vereinigtes Königreich | €43.2 billion | 1.4% |
| Frankreich | €23.3 billion | 0.8% |
| Italien | €20.3 billion | 0.9% |
| Spanien | €19.6 billion | 1.2% |
| Griechenland | €3.4 billion | 1.4% |
| Irland | €3.2 billion | 1.1%* |
| Rumänien | €2.5 billion | 0.7% |
For Ireland, the percentage is expressed as a share of modified gross national income rather than GDP.
These figures include direct healthcare expenditure and indirect costs associated with economic inactivity, absence from work, reduced productivity while at work, premature mortality and unpaid caregiving.
Indirect costs represented between 18% and 58% of the overall economic burden, demonstrating that the impact extends well beyond healthcare systems.
The human impact behind the figures
Economic estimates cannot fully represent the experiences of people living with obesity.
People across Europe continue to encounter delayed diagnosis, limited treatment options, unequal access to care and weight-related stigma. These barriers can affect physical and mental health, education, employment and participation in society.
The report also highlights the association between elevated BMI and other non-communicable diseases. Across the countries studied, elevated BMI was implicated in almost 60% of the health loss caused by type 2 diabetes, 45% of that caused by digestive diseases and 32% of that caused by chronic kidney disease.
BMI must be considered carefully
The analysis uses elevated BMI as a population-level proxy for excess body fat. However, BMI cannot distinguish between body fat and other tissue and may overestimate or underestimate adiposity at an individual level.
BMI should therefore not be used in isolation to define a person’s health, diagnose obesity or determine the care they receive. Assessment and treatment must be individualised, evidence-based and undertaken without judgement or stigma.
Putting people at the centre of policy
The findings strengthen the case for recognising obesity as a chronic, complex and relapsing disease—not a lifestyle choice or personal failure.
The report calls for:
- Formal recognition of obesity as a disease
- Action to address weight-related stigma and bias
- Better access to the full continuum of prevention, treatment and long-term care
- Evidence that reflects health, employment and wider societal outcomes
- Stronger integration of obesity policy within European strategies for cardiovascular disease and other non-communicable diseases
For ECPO, meaningful progress also requires the active involvement of people living with obesity. Policies, services and research must be developed with patients, not simply for them.
Every person living with obesity deserves respect, dignity and equitable access to appropriate support and care, regardless of where they live in Europe.
Read the OHE publication summary, download the full report or read the EFPIA announcement.