OBJECTIVES: The aim of this study was to investigate the annual use of medical resources (outpatient visits and current drug use) and lost productivity (days off work) for people with T2D with increasing BMI. METHODS: A retrospective analysis was conducted in United States based on a sample of T2Ds from the Adelphi Metabolic Syndrome Disease Specific Programme (a large cross sectional study) in 2006 with 643 people diagnosed with T2D, aged between 35 to 64 years and a BMI°Ý 20 kg/m2 (based on physician reported height and weight). People were stratified according to their BMI; normal/overweight (20-29.99 kg/m2; n=110), obese (30-34.99 kg/m2; n=178)); very obese (35-39.99 kg/m2; n=170) and morbidly obese (>39.99 kg/m2; n=185). The cohort had an average age of 53 years, 58% male, and 69% Caucasians. RESULTS: For people with T2D who was normal/overweight, mean number of total drugs used for any condition was 4.7. The number of annual visits to health professionals (PCP, cardiologist, diabetes specialist, diabetes nurse, other doctor/nurse) was 5.9. The rate ratio i.e. the mean resource utilization relative to the utilization in the normal/overweight group for people with T2D who was obese, very obese and morbidly obese, respectively, were 1.08, 1.15, and 1.32 for total drug use, 1.75, 2.37, and 3.37 for percentage of people using more than 2 diabetes drugs, and 1.21, 1.31, and 1.39 for annual number of visits to health professionals. People not retired had an average annual number of days off work due to CV or diabetes complications of 1.5 for the normal/overweight group, with 3.2 for the obese group. CONCLUSION: These findings suggest a positive correlation between BMI and medical resources. The impact of obesity on resource use is particularly evident in people with T2D in the high obesity groups.