Goettler Andrea, Grosse Anna, Sonntag Diana
Mannheim Institute of Public Health, Social and Preventive Medicine, University Medicine Mannheim, Heidelberg University, Mannheim, Germany.
Department of Health Sciences, University of York, York, UK.
BMJ Open. 2017 Oct 5;7(10):e014632. doi: 10.1136/bmjopen-2016-014632.
The increasingly high levels of overweight and obesity among the workforce are accompanied by a hidden cost burden due to losses in productivity. This study reviews the extent of indirect cost of overweight and obesity.
A systematic search was conducted in eight electronic databases (PubMed, Cochrane Library, Web of Science Core Collection, PsychInfo, Cinahl, EconLit and ClinicalTrial.gov). Additional studies were added from reference lists of original studies and reviews. Studies were eligible if they were published between January 2000 and June 2017 and included monetary estimates of indirect costs of overweight and obesity. The authors reviewed studies independently and assessed their quality.
Of the 3626 search results, 50 studies met the inclusion criteria. A narrative synthesis of the reviewed studies revealed substantial costs due to lost productivity among workers with obesity. Especially absenteeism and presenteeism contribute to high indirect costs. However, the methodologies and results vary greatly, especially regarding the cost of overweight, which was even associated with lower indirect costs than normal weight in three studies.
The evidence predominantly confirms substantial short-term and long-term indirect costs of overweight and obesity in the absence of effective customised prevention programmes and thus demonstrates the extent of the burden of obesity beyond the healthcare sector.
劳动力中超重和肥胖水平日益升高，同时因生产力损失带来了隐性成本负担。本研究回顾了超重和肥胖的间接成本程度。
在八个电子数据库（PubMed、Cochrane图书馆、科学网核心合集、PsychInfo、Cinahl、EconLit和ClinicalTrial.gov）中进行了系统检索。从原始研究和综述的参考文献列表中补充了其他研究。如果研究发表于2000年1月至2017年6月之间，且包含超重和肥胖间接成本的货币估计，则这些研究符合纳入标准。作者独立回顾了各项研究并评估其质量。
在3626条检索结果中，有50项研究符合纳入标准。对所回顾研究的叙述性综合分析显示，肥胖工人因生产力损失产生了巨大成本。尤其是旷工和出勤不出力导致了高昂的间接成本。然而，方法和结果差异很大，特别是关于超重成本，在三项研究中，超重甚至与比正常体重更低的间接成本相关。
证据主要证实了在缺乏有效的定制化预防计划的情况下，超重和肥胖会带来巨大的短期和长期间接成本，从而证明了肥胖负担超出医疗保健部门的程度。
