The economic burden of obesity and diabetes

economic burden of obesity
At the end of last week, the Milken Institute, a non-profit, non-partisan think tank, released a report on the real economic costs of obesity and overweight in the United States. This report, unlike many estimates, includes both direct health care costs that are caused by obesity and overweight and indirect costs associated with lost productivity borne by patients and their employers. The total number is staggering: $1.72 trillion dollars each year.

Ars Technica: A new, eye-wateringly high estimate of the cost of obesity in the US

Like all estimates of this sort, this figure is undoubtably wrong, as it is built on many assumptions and imperfect underlying data. However, its scale should serve as a wake-up call to health policymakers, especially those in a position to invest in preventative public health initiatives.

In the report’s executive summary, the Milken Institute’s authors write:

Because obesity and overweight are major risk factors for a broad range of chronic diseases, the increase in their prevalence across the nation has major implications for the health and wellbeing of the population. The burden of obesity, and the chronic diseases for which it is a contributing factor, has reached record economic heights. In 2016, chronic diseases driven by the risk factor of obesity and overweight accounted for $480.7 billion in direct health care costs in the U.S., with an additional $1.24 trillion in indirect costs due to lost economic productivity. The total cost of chronic diseases due to obesity and overweight was $1.72 trillion — equivalent to 9.3 percent of the U.S. gross domestic product (GDP). Obesity as a risk factor is by far the greatest contributor to the burden of chronic diseases in the U.S., accounting for 47.1 percent of the total cost of chronic diseases nationwide.

According to the report, obesity-driven costs from the top five contributors are as follows:

Diabetes (type 2)
Chronic back pain
Alzheimer’s and vascular dementia
Top 5 total
Annual cost (in billions)

How accurate are these numbers? If we look at just one chronic disease affected by overweight and obesity — diabetes — we see that the Milken estimate of $335 billion in obesity-related total costs each year is higher than the American Diabetes Association’s estimate of $327 billion of annual economic cost for all Americans with diabetes. So the Milken Institute estimate is relatively high. We suspect the point of its report is not precision; rather, it is to paint a picture of the scale of the problem.

Separately, but also last week, healthcare policy analyst Dr. Paul H. Keckley authored a report entitled “The cost and impact of type 2 diabetes: policy recommendations for a growing public health epidemic.” (Note that this report was funded by Atkins Nutritionals, Inc., so it must be interpreted with caution.) The report states:

If 20% of the 30 million U.S. [type 2 diabetes] sufferers made this dietary change [to a low-carb diet] resulting in a HbA1c reduction of 1%, savings to the U.S. healthcare system would be at least $10.2 billion annually.

See the simple infographic, here.

In terms of policy imperatives, Keckley recommends low-carb-friendly changes to the Dietary Guidelines, as well as a public health education campaign designed to make citizens aware of “nutrition therapies that address diverse populations including pre-diabetics… and equip them to avoid nutritional advice that is misleading, contradictory and confusing.”

Now that sounds promising!

While we wait for policymakers to change official guidelines, feel free to share our site with friends and family. Our goal at Diet Doctor is to empower people everywhere to revolutionize their health.

Milken Institute: America’s obesity crisis: The health and economic costs of excess weight

Paul Keckley: The cost and impact of type 2 diabetes: policy recommendations for a growing public health epidemic


Dr. Ludwig in the NYT: The toll of America’s obesity

How to worsen diabetes: follow the ADA and CDA advice


A ketogenic diet for beginners

How to reverse type 2 diabetes

Type 2 diabetes

Weight loss


Intermittent fasting


  1. Shawheen
    IMHO, the true number is much higher. Why? What is the human suffering really worth? There are numerous million dollar lawsuits settlements for health damage from medications. Just paying damages for people with diabetes for amputations, loss of eyesight, kidney failure, etc due to flawed dietary guidelines and industry practices alone will push the total cost to the skies.
  2. Bovi
    Great post
  3. Eileen
    Whenever I read something like this, I wonder, "Whose cost? What counts as a cost?" My family and I pay the direct costs of my disease, not the government. I don't see an allopathic doctor, nor do I take allopathic medications, so I do not use traditional insurance. I won't go to the hospital. The only cost the government suffers are the taxes I don't pay on the work I can't do while sick.

    Two major diseases affect me and are definitely tied to obesity. One I have studied all my life, but the other one has had my full attention for the last six months. The cure for diabetes is right here on the Diet Doctor website. The ketogenic diet, intermittent fasting, and extended fasting are doing wonders to eliminate the effects of diabetes. Cancer elimination has been somewhat slower, but let me assure you that the pain and suffering that disease produces has been reduced greatly with various types of fasting and a natural substance that is legal even in Texas.

    While I understand how the wrong information about diet has lead to the Obesity Crisis and associated diseases, I tend to view studies like this with a jaded eye. Most people use them to push an agenda, but there is little in the article to say how the researchers gathered the data, nor what the individual can do about it. DON'T GET ME WRONG, I appreciate the massive amounts of work ya'll do to get the word out about how wrong the guidelines have been for the last sixty years, or the totality of my life! With the information you put out there, my grandchildren need not suffer the frustrating weight gain and diseases that my children and I have had to face because of what has been pushed on us by "experts".

    Reply: #4
  4. Eileen

    but there is little in the article to say how the researchers gathered the data, nor what the individual can do about it.

    On a second reading, I see that I was hasty in suggesting that the assigning of cost was too nebulous, however, no one is the "average" person. I am not angry with whomever posted this as much as disappointed in our society's dependence on such studies.

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