Based on a regional US claims dataset, positive associations between total healthcare costs and BMI levels were observed within each glycemic stage. Overweight and obese subjects (BMI ≥25 kg/m2) had higher costs than those with normal BMI in both the normal glycemic stage and the type 2 diabetes (T2D) stage, while during the pre-diabetes (PreD) stage, subjects with extreme obesity (BMI ≥40 kg/m2) had higher costs.

The costs of being overweight and obese, relative to normal BMI (18.5–24.9 kg/m2), were much higher among subjects with T2D than those with normal glycemic levels. Extreme obesity had a noticeable impact on healthcare costs within each glycemic stage.

Targeted weight-control programs aimed at people with PreD, or at-risk normal glycemic subjects, as well as those with frank T2D, should be able to generate a significant return on investment by effectively reducing the economic burden of overweight and obesity in the US.