Dáil Éireann Debate, Wednesday - 6 May 2026
934. Deputy Ken O'Flynn asked the Minister for Health whether her Department has conducted any updated economic modelling of the cost of overweight and obesity in Ireland since 2017; and if so, to provide the estimated annual cost to the public health service and the wider economy; and if she will make a statement on the matter. [32339/26]
View answer935. Deputy Ken O'Flynn asked the Minister for Health whether her Department has produced projections for obesity prevalence in Ireland to 2030 and 2040; and if so, to provide those projections in tabular form; and if she will make a statement on the matter. [32340/26]
View answer936. Deputy Ken O'Flynn asked the Minister for Health whether any modelling has been undertaken on the projected impact of overweight and obesity on acute hospital demand, primary care demand, and health service workforce requirements over the next 10 to 20 years; and if she will make a statement on the matter. [32341/26]
View answer937. Deputy Ken O'Flynn asked the Minister for Health whether the Department has assessed the potential cost savings associated with expanded access to evidence-based obesity treatments, including pharmacological interventions; if so, to provide details of any such assessments; and if she will make a statement on the matter. [32342/26]
View answer938. Deputy Ken O'Flynn asked the Minister for Health the timeline for the completion and publication of the next Obesity Policy and Action Plan; whether any interim measures are in place pending its publication; and if she will make a statement on the matter. [32343/26]
View answer939. Deputy Ken O'Flynn asked the Minister for Health the total annual expenditure by the HSE and her Department on obesity prevention, management, and treatment programmes for each year from 2020 to date in 2026, in tabular form; and if she will make a statement on the matter. [32349/26]
View answer940. Deputy Ken O'Flynn asked the Minister for Health whether a dedicated budget line exists for obesity-related services within the national health budget; if so, to provide the annual allocation for each year from 2020 to date in 2026; and if she will make a statement on the matter. [32350/26]
View answer945. Deputy Ken O'Flynn asked the Minister for Health whether outcome metrics are in place to evaluate the effectiveness of obesity-related programmes funded by the State; if so, to provide details of those metrics and any published results; and if she will make a statement on the matter. [32355/26]
View answerI propose to take Questions Nos. 934, 935, 936, 937, 938, 939, 940 and 945 together.
The current Obesity Policy and Action Plan (OPAP) was launched in September 2016 under the auspices of the Healthy Ireland Framework (Healthy Ireland: A Framework for Improved Health and Wellbeing 2013-2025).
OPAP covers a 10-year period up to 2025 and the overall aim is to reverse obesity trends, prevent health complications, and reduce the impact of overweight and obesity on health outcomes for individuals, families, the health system, and the wider society and economy. It recognises that obesity is a complex, multi-faceted problem and needs a multi-pronged solution, with every sector of society playing its part. OPAP is well aligned with the World Health Organisation in terms of the breadth of policy measures that have been introduced or are being considered in order to address the obesity epidemic.
Under OPAP, Ireland put in place a comprehensive, cross-Government strategy to address obesity and overweight. Since 2016 significant progress has been made in delivering on the Ten Step Programme of OPAP and to drive policy initiatives and actions, ranging from health promotion and education initiatives and obesity prevention measures through to establishing services to treat and manage obesity within the health care system.
While Ireland does not have official national projections of obesity prevalence to 2030 or 2040, international modelling indicates that many high income European countries are likely to experience either continued gradual increases or a levelling off in obesity prevalence over this period. Ireland’s observed data to date show a pattern of significant increases up to the early 2010s, followed by more recent stabilisation, albeit at persistently high levels. See references at the bottom of this response.
No standalone modelling has been undertaken on the projected impact of overweight and obesity on health service demand or workforce requirements in Ireland. The HSE has not produced a specific projection of the cost to the health service over the next ten years that is attributable solely to rising obesity prevalence. This is because obesity is a complex, chronic condition that contributes to healthcare demand across a wide range of diseases and service settings, rather than constituting a discrete, separately costed category of expenditure.
The primary national evidence base for future health service demand is the Health Service Capacity Review (2018) which projects healthcare utilisation and capacity requirements to 2031 across acute hospitals, primary care and community services. The report notes that obesity is associated with chronic illnesses such as diabetes, cardiovascular diseases, hypertension, high cholesterol, certain cancers, respiratory diseases (e.g., asthma), and arthritis. Rising obesity rates increase the prevalence of these chronic conditions, which in turn drives up demand for both acute and primary care services. The report notes that while Ireland's obesity rates are behind Australia and New Zealand, they are well ahead of the OECD average (19.5%) and higher than many European peers. The report models that a reduction in BMI by one unit across the population would result in 28 fewer cases of chronic disease per 1,000 people, including hypertension, raised cholesterol, lower back pain, osteoarthritis, diabetes, and asthma. The review cites research showing that lowering BMI at the population level can reduce chronic disease burden by about 4% for both men and women. If current trends continue, capacity requirements across acute and primary care will increase significantly by 2031 and recommends a 'whole of government' approach to deliver the Healthy Ireland strategy, with targeted interventions on obesity. Implementation of the HSE Model of Care for the Management of Overweight and Obesity, including appropriate resourcing of prevention, early intervention and structured management in general practice, is intended to mitigate future health service demand and costs by supporting timely, evidence-based care, reducing progression to more complex disease and limiting avoidable hospital utilisation over time.
Other system wide modelling includes: Sláintecare workforce and service planning analyses, which model future requirements across primary, community and acute care in response to increasing multimorbidity, long term condition management and demand for preventive and chronic care. Internationally, modelling approaches are similar:
• Global Burden of Disease (GBD) and NCD Risk Factor Collaboration (NCD RisC) models project future obesity related disease burden (e.g. diabetes and cardiovascular disease), but do not directly translate this into workforce or service capacity requirements.
• World Health Organization (WHO) and OECD analyses consistently warn that rising overweight and obesity prevalence will significantly increase demand for hospital care, primary care and health care professionals, but do not produce workforce planning models.
• UK NHS and other European systems also rely on system wide capacity and workforce modelling that incorporates obesity indirectly through chronic disease modelling rather than through obesity specific projections.
No comprehensive or system wide assessment has been undertaken in Ireland that quantifies the potential cost savings to the health service from expanded access across the full range of evidence-based obesity treatments, including prevention, behavioural interventions, pharmacological therapies and surgery.
International evidence indicates that bariatric surgery offers the strongest and most consistent cost-saving potential, behavioural and prevention interventions are highly cost-effective over time, and pharmacological treatments may be cost-effective for selected groups.
The Obesity National Clinical Programme (NCP) does not centrally collate an estimated annual cost of treating obesity and obesity-related conditions across the health service. Data on healthcare expenditure is held across a number of distinct systems and organisations. Costing and activity data for hospital care is compiled by the Healthcare Pricing Office (HPO), who may be in a position to advise on hospital activity associated with obesity-related conditions. Information relating to the cost of reimbursable medicines used in the management of obesity, falls under the remit of the HSE Medicines Management Programme (MMP).
There is no single dataset that provides a comprehensive breakdown of costs across hospital care, primary care, pharmaceuticals and community services attributable specifically to obesity for the period 2020 to date. Generating such an estimate would require the collation and analysis of data from multiple sources and is not currently available.
While the HSE cannot provide annual obesity-attributable treatment costs for the period requested, national research studies provide contextual estimates of the economic and healthcare costs of obesity in Ireland. Research commissioned by Safefood and undertaken by University College Cork estimated the annual economic cost of overweight and obesity in the Republic of Ireland at approximately €1.13 billion, based on 2009 data. Of this total, approximately 35% (€398 million) was attributable to direct healthcare costs, including hospital inpatient and outpatient care, general practice and pharmaceuticals. The remaining costs related to indirect impacts such as productivity losses and absenteeism. This study identified cardiovascular disease, type 2 diabetes, stroke and certain cancers as the primary drivers of direct healthcare costs attributable to obesity (link in references below).
Analysis presented at the Irish Endocrine Society Annual Meeting in 2025, using data from the 2022 Healthy Ireland Survey, estimated that the direct healthcare cost of overweight and obesity in Ireland was approximately €1.1 billion in 2025, representing around 3.2% of total healthcare expenditure for that year. The increased cost was primarily driven by a direct association between increased BMI and frequency of GP visits (C= 582.2 million) along with an increased healthcare resource utilisation at all levels of the healthcare system by individuals with Obesity Related Conditions (C= 515.0 million). However, this estimate does not provide a disaggregated breakdown across hospital, primary care, pharmaceutical and community service categories (link in references below).
Liraglutide (Saxenda®) has been reimbursed by the HSE since January 2023 under a Managed Access Protocol (MAP) administered by the HSE’s Medicines Management Programme (MMP). Reimbursement is restricted to a narrowly defined subgroup of patients and is subject to a two-phase approval process designed to ensure clinical appropriateness and cost containment. HSE analysis of Primary Care Reimbursement Service claims data indicates that expenditure on liraglutide under this Managed Access Protocol was approximately €3 million in 2023. Evidence from the Medicines Management Programme indicates that, in the absence of the MAP, expenditure could have been substantially higher (link included in references below). A dedicated budget line for obesity-related service does exist, please see below allocations the Department of Health has received from 2021 to 2026. Data for 2020 could not be found:
|
Budget 2021 |
€101,500 |
|
Budget 2022 |
€2,023,730 |
|
Budget 2023 |
€1,201,349 |
|
Budget 2024 |
€ 701,349 |
|
Budget 2025 |
€ 926,349 |
|
Budget 2026 |
€ 1,147,349 |
The new Obesity Policy & Action Plan is currently in development and is expected to be completed and published by the end of this year. As part of the development of the new OPAP, the Department will explore the need for further research to be integrated into the strategy, including research on the economic modelling of the cost of overweight and obesity in Ireland and other outcome-based metrics, as currently neither have been carried out.
Outcome metrics are in place to evaluate obesity-related programmes, but these operate at multiple levels rather than through a single, unified national outcomes framework. This reflects the cross-cutting nature of obesity services, which spans public health, primary care, community services and hospital-based care. At service level, local outcome metrics are routinely collected across obesity-related programmes. These local datasets typically include service activity (e.g. referrals, assessments, discharges), clinical outcomes (e.g. weight change, BMI, relevant comorbidity indicators), programme completion and attrition rates, and patient-reported outcomes where available. This information is used primarily for local service monitoring, clinical audit, and quality improvement, and is reported through internal governance and service-planning processes.
At national level, standardised metrics are collected for service activity and access aligned to the national Waiting Time Action Plan and Enhanced Community Care frameworks. These metrics support national oversight of access and equity, capacity planning, and monitoring of service delivery against agreed targets. Best Health community obesity management programme for adults is delivered within community based ECC Chronic Disease Hubs collect and report data on:
• patient engagement and attendance,
• programme completion,
• weight-related outcomes,
• functional, wellbeing and quality of life indicators
• relevant clinical risk factors.
An evaluation of Best Health in 2024 showed participants experienced an average weight loss of 3%, with 40% achieving a reduction of 5-10% within one year. Additionally, there was a 24% increase in WHO 5 Well-Being Index score, notable improvements in cardio-metabolic risk factors, and high programme satisfaction levels reported by service users (report available on request). National access metrics for hospital obesity services and bariatric surgery are published in the Waiting List Action Plan 2025. There is no single national annual outcomes report dedicated solely to obesity services, but obesity-related outcomes appear across multiple publications and programme-specific evaluations. To support more comprehensive and consistent evaluation of obesity-related programmes, the development of a robust, interoperable electronic health record is critical. Improved digital infrastructure would enable standardised outcome definitions, longitudinal tracking of patient outcomes, linkage across care settings, and stronger evaluation of the long-term impact of obesity interventions on health system demand.
References
Global Burden of Disease forecasting study (Lancet, 2025) (www.thelancet.com/journals/lancet/article/PIIS0140-6736%2825%2900355-1/fulltext)
NCD-RisC projections to 2040 (Obesity, 2025) (www.pmc.ncbi.nlm.nih.gov/articles/PMC12477102/)
Long-term European projections (Obesity Facts) (www.pmc.ncbi.nlm.nih.gov/articles/PMC12477102/)
World Obesity Atlas 2025 (WOF) (www.data.worldobesity.org/publications/world-obesity-atlas-2025-v7.pdf)
[Trends in the weight status of adults in Ireland 1990-2024] (www.link.springer.com/article/10.1007/s00394-025-03822-7)
www.safefood.net/professional/research/research-projects/the-cost-of-overweight-and-obesity-on-the-island-o
www.endocrine-abstracts.org/ea/0115/ea0115oc8
www.valueinhealthjournal.com/article/S1098-3015%2825%2902300-9/fulltext
