Could your waistline be costing you thousands?

What does it really cost to be obese in America? Calculating the true cost of obesity can be tricky, but the most recent estimate for cost to the nation is about $147 billion per year in direct costs, according to the U.S. Centers for Disease Control and Prevention (CDC). This takes into account costs for diseases commonly associated with obesity, including type 2 diabetes, joint disorders and heart disease. 

Another estimate, which factors in indirect costs like lost wages, productivity and higher insurance costs puts the number at $190 billion. Either way you look at it, obesity is expensive—not all that surprising considering obesity has surpassed smoking as the leading cause of preventable illness in the U.S.

But that’s just a snapshot of obesity’s cost to the U.S. as a country—what about the cost to obese individuals themselves? Cost analysis estimates predict the average obese individual pays anywhere from $1,429 to $2,741 per year in medical expenses alone.

However, since medical charges vary between states, cities and even providers within the same city, an obese person might spend far more than that in any given year. On the other hand, some obese individuals may not have related illnesses or issues and will therefore spend much less. Even so, research now suggests that it is only possible to be fat and healthy for so long—chances are that obesity will catch up with you eventually and cause health problems down the road.

READ MORE: How to get in shape for free

Uncalculated factors
Many costs associated with obesity are well-known, while others fly under the radar or seem insignificant. Little costs, like extra pain medication for achy joints and the extra cost of clothing, are hardly ever factored in, but they do add up. Along those lines, many obese people pay more for life and health insurance without even knowing it, and excess premiums can reach hundreds of dollars per year. On top of that, obese people tend to take more time off work, which can result in lost income, productivity and job opportunities. Obesity is also strongly correlated with depression, which has huge economic costs of its own.

READ MORE: The impact of depression

Obesity also carries costs that are immeasurable in terms of dollars, including losses in quality of life or hypothetical savings that could come from long-term weight loss. Hypothetical savings might include money spent on transportation; fit people are more likely to walk or ride a bike to commute, while heavier people spend more on gas due to decreased fuel economy. Quality-of-life measures are easier to pinpoint: Along with depression, obesity has been linked to low self-esteem and anxiety disorders, all of which can interfere with daily life.

Medical costs
When discussing medical costs related to obesity, we can’t just tally the costs of certain diseases. Researchers have designed formulas to find the proportion of medical costs attributable to obesity, which they found to be about 21 percent. Common diseases used to determine costs are type 2 diabetes, heart disease, gallbladder disease, high blood pressure, colon cancer and postmenopausal breast cancer. By no means do these diseases represent the full scope of problems associated with obesity, so estimates may be conservative.

Knowing that medical costs can vary widely between localities, a recent study took a look at the average cost of obesity in each state and the District of Columbia. In order to do this, 2009 data on population, proportion of obese individuals and obesity spending was obtained for all 50 states and D.C. The national average in this analysis was on par with established averages ($1,429 to $2,741), coming in at $1,913. Here are the top 10 least and most expensive states for annual medical costs related to obesity, calculated per obese person residing there.

READ MORE: What does it cost to be obese in your state?

Least Expensive States to Be Obese
1. Arizona - $1,292
2. New Mexico - $1,341
3. Idaho - $1,435
4. Texas - $1,484
5. Arkansas - $1,517
6. Utah - $1,521
7. Wyoming - $1,535
8. Georgia - $1,541
9. Nevada - $1,580
10. Oklahoma - $1,582

Most Expensive States to Be Obese
1. District of Columbia - $3,739
2. Massachusetts - $2,512
3. Rhode Island - $2,477
4. Delaware - $2,450
5. Alaska - $2,416
6. Maine - $2,356
7. New York - $2,321
8. Connecticut - $2,294
9. New Jersey - $2,182
10. North Dakota - $2,148

READ MORE: The healthiest places in America

Lacie Glover writes for NerdWallet Health, a website that empowers consumers to find high quality, affordable health care and insurance.