A study conducted by researchers at RTI International, Duke University, and the Agency for Healthcare Research and Quality, updates 2004 state-by-state estimates of obesity-attributable medical expenses. In 2009 dollars, the costs ranged from a low of $203 million in Wyoming to $15.2 billion in California.

The study, published on-line in the journal Obesity, also provides rough estimates of the share of obesity expenditures in each state that are funded by taxpayers through Medicare and Medicaid.

“This evidence clearly indicates that obesity imposes high annual total and public sector medical costs on state budgets,” said Justin Trogdon, a health economist at RTI and the study’s lead author. “The high costs emphasize the need to prevent and control obesity as a way to manage those costs.”

The study showed that obesity-attributable Medicaid expenditures ranged from $38 million in Wyoming to $4 billion in New York, and Medicare expenditures ranged from $35 million in Wyoming to $3.4 billion in California. In addition, it showed that total annual medical estimates attributable to obesity are 10% or higher in Alabama, Alaska, Indiana, Louisiana, Michigan, Mississippi, Ohio, South Carolina and Tennessee. Colorado had the lowest percentage of annual medical estimates attributable to obesity at 7%, followed by Hawaii at 7.2%.

“This study shows that the toll that obesity takes goes beyond impairing the health of individuals to imposing a major burden on the entire health care system,” said Carolyn M. Clancy, A.H.R.Q. director. “Reducing the prevalence of obesity and its complications is an important priority for the nation and requires focused and constant attention.”

The percentage of annual Medicare expenditures in each state ranged from 5.2% in Hawaii to 10.2% in Ohio. For Medicaid recipients, the percentages were higher, ranging from 6.8% in Virginia to 17% in Arizona. The higher percentage of Medicaid expenditures attributed to obesity results from the higher prevalence of obesity among Medicaid recipients.

The study’s results confirm earlier findings that obesity accounts for a significant, and preventable, portion of the nation’s medical bill, and highlight the role of the states in financing these costs, according to the authors, but they cautioned that the estimates should not be used to make cost comparisons across states or between payers because the state-level estimates are associated with large standard errors influenced by variables within each state.

The study was based on the 2006 Medical Expenditure Panel Survey which was used to generate an equation to predict annual medical expenditures as a function of obesity status.