Both the studies and the article are too narrow. The point is, I don't care how much health care for fat people costs, I only care how much health care for fat people costs me. Of course health care costs more for people who live longer, but they are also contributing more productivity over the course of those long lives. There is an implicit assumption in these studies that the public share of health care costs is roughly equal for all groups, but I'm not convinced that is the case. Let's see some studies showing how much of fat people's lifetime earnings are devoted to health care vs. skinny people's, and how much of each group's health care expenditure is borne by government programs. What we need is more discrimination, not less. No ivory-tower academic or governement bureaucrat could be better at quantifying costs than a competitive marketplace. The best way to identify the costs of fatness (as well as provide incentives to reduce it, if it turns out to be a societal good) is to make the fat people themselves pay their way. Let insurance companies charge higher premiums to fat people who refuse to change their behavior, and they'll quickly learn how much it costs.