Cent Eur J Public Health 2026, 34(2):72-79 | DOI: 10.21101/cejph.a8761

Economic cost of excess body weight among adults in Estonia

Johann Saavaste, Aleksei Baburin, Mall Leinsalu, Rainer Reile
Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia

Objectives: High disease burden related to excess body weight (EBW) poses a substantial burden to healthcare systems globally. This study aims to assess the economic impact of EBW in Estonia, where over 60% of adult population are overweight or obese.

Methods: Using population attributable fraction approach, this cost-of-illness study included 29 health conditions associated with overweight and obesity. The annual costs were calculated from the health care/government perspective for the year 2021 using individual level and administrative data. The direct costs were defined as a sum of treatment and medication costs, sickness benefits and care leave, while indirect costs were viewed as tax revenue lost due to premature death or incapacity for work. One-way sensitivity and scenario analyses were carried out to assess the robustness of the results.

Results: The annual direct costs associated with EBW were €112.7 million, of which €107.2 million (95%) were treatment costs. Cardiovascular diseases (€58 million) had the highest treatment costs. Indirect costs of EBW were estimated at €12 million. The total annual cost of EBW among adults was €125 million (€116 per adult), from which €50.3 million was attributable to overweight and €74.4 million to obesity. Depending on assumptions and input data, the estimated total costs reached €226 million in the sensitivity analysis.

Conclusions: The estimated direct costs of EBW comprise 6.9% of national health expenses in Estonia. EBW among adults is thus not only an important public health challenge but also a considerable burden for national healthcare system.

Keywords: overweight, obesity, cost of illness, population attributable fraction, Estonia

Received: August 18, 2025; Revised: May 13, 2026; Accepted: May 13, 2026; Published: June 30, 2026  Show citation

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Saavaste J, Baburin A, Leinsalu M, Reile R. Economic cost of excess body weight among adults in Estonia. Cent Eur J Public Health. 2026;34(2):72-79. doi: 10.21101/cejph.a8761.
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