Do Step-Down Transformers Increase Total Power Consumption?
You didn't bring up something else -- frequency. You don't mention the country, but I suspect that if they are supplying a mains voltage of \$220\:\textrm{V}_\textrm{AC}\$ then it's probably also \$50\:\textrm{Hz}\$. Just using a transformer alone to drop the voltage to US levels doesn't change the frequency and not all devices work properly (or well) on the wrong AC frequency. (I'm assuming here that you are using a transformer designed for the operating frequency of your country's main supply.) So that will be one consideration. You need to make sure that if you buy the cheaper US rated devices that they will still do okay on the different frequency. Electric water and space heaters are probably just fine (though I can't speak for the fancy ones with electronic panels in them.) But just be aware that a vacuum cleaner's motor might not work the same or as well, even with the voltage right.



Regarding efficiency, all transformers are imperfect and will sustain some losses. Also, the lower voltage implies a higher current for the same power. And this implies the need for more expensive wire. Perhaps a lot more expensive. Keep in mind that losses in the wire are equal to \$I^2 R_{wire}\$ and that if you double the current (as required for the same power at the device) that the losses go up by a factor of 4 (if you leave the wire alone.) Also, the voltage drop across the wire is \$I R_{wire}\$ and this means more of a drop, too (again if you leave the wire alone.) All this together means that you need a lower \$R_{wire}\$ value for similar results and that if you truly want the exact same losses in the wire then you need wire with \$\frac{1}{4}\$ the resistance since the current will be twice as high.



Just be thoughtful about each choice and make sure you have adequate wiring for the US voltage devices. Consider the implications of frequency, of wiring and transformer losses, wiring voltage drop to the device, and what wiring you have installed to get to the device, when making a choice between the two options.

Also, you might consider limitations of your breakers and US devices, generally. For example, a skillet in the US will top out at about \$1500-1800\: \textrm{W}\$ because most US breakers are set for \$15\:\textrm{A}\$ rating. However, that's not true for many European skillets, which have the advantage of higher voltages. There are times when you actually would like to have a higher wattage skillet for cooking larger quantities of food.

So think about all the details. But you've got options, it seems. So I think that puts you in a better circumstance than not having the US voltage available. You can pick and choose, at least. Just be aware while doing so.