OBJECTIVES: To identify the factors associated with high healthcare expenditure among obese individuals in the United States.  METHODS: Analytical sample consisted of obese adults 20 years or older with (BMI≥30). Total yearly expenditures for obese adults were obtained from 2007 Medical Expenditure Panel Survey data. Observations with total yearly healthcare expenditure greater than 90th percentile were classified as high healthcare expenders and coded yes/no to be used as the dependent variable. Independent factors selected according to the Anderson’s Behavioral Model were age, gender, race, MSA, region, education, poverty category, source of payment, usual source of care, MSA, education, general health status, mental health status and mortality risk status.  ‘Surveylogistic’ regression was used to determine the predictors of high expenditures. RESULTS: Descriptive analysis show that adults with high healthcare expenditure were whites (74.23%), had mid-school education (60%), lived in MSA (79%), had usual care provider (95%), private insurance (67%) and belonged to very high mortality risk group (46%).  In adjusted analysis, age (OR: 1.019 CI: 1.009-1.029), usual source of care (OR: 1.901 CI: 1.196-3.020), private (OR: 3.609 CI: 1.992-6.539) and public insurance (OR: 3.251 CI: 1.781-5.936), very high (OR: 3.342 CI: 2.327-4.798) and high (OR: 2.213 CI: 1.666-2.938) mortality risk and general health status (OR: 2.493 CI: 2.148-2.893) were associated with high healthcare expenditure.  CONCLUSIONS: Several enabling and need factors seem to be associated with high healthcare expenditure. Both private and public health insurance have a significant burden of healthcare expenditure associated with obesity.  Individuals with usual source of care are more likely to incur high healthcare expenditure. Comorbidities have a significant impact on healthcare expenditure among obese individuals and highlight the need to deliver comprehensive disease state management. The findings from this study can have important implications in understanding increased utilization of health services among obese adults in United States.