As the prevalence of obesity increases, its economic consequences must be understood. This review summarizes published literature on the costs and resource use associated with obesity in the workplace. A Medline literature search was conducted for English-language publications. References from identified articles were also reviewed for relevance. The identified studies evaluated several cost components, including absenteeism, sick leave, disability, injuries, and claims data. Overall, overweight or obese employees had higher sick leave or disability use. Workplace injuries were higher among overweight or obese employees. Health care costs, based on claims data analyses, were also consistently higher for employees with higher body mass indices. Obesity is an important driver of costs in the workplace. These findings quantify the costs and can help employers consider whether to introduce workplace interventions or provide coverage for weight loss programs.