New Analysis Links Obesity and Multiple Chronic Conditions to Unsustainable Spending Growth Across Insurance Programs

January 14, 2026 (Washington, D.C.) The Partnership to Fight Chronic Disease (PFCD) today released a new research report, “The Association of Obesity and Chronic Conditions Treated as it Relates to the Growth in Health Care Spending by Source of Insurance, 2011–2022,” by PFCD Chair Kenneth E. Thorpe and Peter J. Joski. The report finds that the increasing prevalence of obesity and multiple chronic conditions is the dominant force behind rising health care spending across Medicare, Medicaid, and private insurance.

Health care spending is increasingly concentrated among a small share of patients with complex, obesity-related illnesses. The report highlights that obesity, now affecting four in 10 U.S. adults, plays a central role in this trend.

• Obesity rates increased across all insurance types and chronic disease categories from 2011 to 2022, coinciding with rapid spending growth among patients managing multiple conditions.

• Among privately insured individuals with three chronic conditions, per-person spending rose 31% over the study period, while just 26% of patients now account for nearly 60% of private insurance spending.

• Among Medicaid beneficiaries with 4+ chronic conditions, 51.2% also had obesity.

Thorpe’s analysis finds that policy approaches focused on limiting coverage, increasing reimbursement barriers, or imposing blunt price controls do not prevent disease or slow long-term cost growth. Instead, meaningful cost containment requires policies that reduce the burden of chronic disease itself, by preventing onset, slowing progression, and addressing obesity as a root cause across populations and insurance programs.

“Our analysis shows that chronic disease, particularly obesity-related conditions, is now the dominant driver of U.S. health care spending growth, with the vast majority of new Medicare and Medicaid dollars going to patients managing multiple chronic conditions. These findings make clear that slowing cost growth will require sustained investments in prevention and better chronic disease management, not blunt price controls, so we can improve outcomes while reducing the long-term cost burden on patients and the health system,” said PFCD’s Ken Thorpe.

The full paper can be found HERE, and a related one pager HERE.

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The Partnership to Fight Chronic Disease (PFCD) is an internationally-recognized organization of patients, providers, community organizations, business and labor groups, and health policy experts committed to raising awareness of the number one cause of death, disability, and rising health care costs: chronic disease.