Overweight and obesity are associated with a higher risk of cardiovascular disease and noncardiovascular disease morbidity and mortality, and shorter life expectancy. Despite declines in prevalence of other key major cardiovascular disease risk factors, the prevalence of overweight and obesity has reached epidemic proportions and it continues to rise. This has implications for future Medicare expenditures. Recent findings indicate that irrespective of interim changes in weight, being overweight or obese in young adulthood and middle age is significantly and positively associated with higher average annual and cumulative cardiovascular disease-related and total Medicare charges in older age. However, the prevention and control of overweight and obesity has proven difficult due to overconsumption of calorie-dense foods, sedentary lifestyles, and insufficient and ineffective treatment options. Clinicians should emphasize weight management strategies for all patients and public health authorities should implement policies that promote maintenance and achievement of healthy weight through systemic environmental changes. Emphasis on the primary prevention of weight gain from early life onwards by adoption of healthy lifestyles, and prevention and control of excess weight at all ages are urgently required to contain and end the obesity epidemic and to reduce healthcare costs incurred by older people.