Estonia weighs drug compensation for obesity, doctor warns it treats symptoms, not causes
Excess weight and obesity cost Estonia roughly 120 million euros a year, and authorities are considering compensating obesity medications. Preventive medicine doctor Sergei Saadi warns the underlying causes also need addressing.
Estonia's Health Insurance Fund is considering compensating modern obesity medications, as excess weight and related illnesses cost the state more than 120 million euros annually. Currently, such compensation is available only to diabetes patients, and only after other treatments have already been tried — people diagnosed with obesity alone must pay full price. If a cost-benefit comparison report being prepared by the University of Tartu is ready by autumn, the benefit could take effect as early as next spring.
The system reacts to consequences instead of preventing them
Speaking on Radio 4, preventive medicine doctor Sergei Saadi said obesity cannot be explained simply by poor lifestyle choices or lack of willpower — the surrounding environment, including air quality, diet, stress and opportunities for physical activity, plays a major role. He argued it is overly simplistic to reduce excess weight to a matter of personal desire to live healthily.
The consequences of excess weight are especially costly for the state. According to Saadi, obesity is linked to numerous chronic conditions, including hypertension, infertility, arthritis, migraines and certain cancers. Treating obesity-related hypertension alone costs more than 26 million euros a year. Saadi noted that excess weight does not appear overnight but accumulates over 10-15 years, yet the healthcare system pays too little attention during that period — by the time it acts, patients often already have diabetes along with other chronic illnesses.
Drug compensation may help but is no universal fix
Saadi said one major gap is the lack of an effective early-support system for people who are just beginning to gain weight, even though that is precisely when a problem forms that will require far greater spending years later, both for the state and the patient. Existing treatments, such as bariatric surgery, injections, medication and dietitian consultations, are often only offered at advanced stages of obesity. He also pointed to a rising number of obesity cases among children and young people, noting that children of overweight parents are themselves more prone to excess weight and related health issues.
Estonia is discussing compensation for medications such as Wegovy, Ozempic and Mounjaro. Saadi cautioned that mass compensation could require unprecedented spending, and that these drugs do not provide lifelong results — about two-thirds of patients regain weight after stopping treatment. He also noted that without adequate protein intake and physical exercise, older patients using these drugs can lose significant muscle and bone mass. In his view, directing 100-200 million euros toward drug compensation alone will not be enough.
