Weight Of The Nation: A Look At The Most (And Least) Obese States In America

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Overweight and obesity have become the new normal in the United States, according to Monday’s “State of Obesity” report. Though only five states saw increases in adult obesity last year, researchers noted little overall improvement in the nation’s weight crisis: The average American adult is 24 pounds heavier than in 1980, when obesity rates were less than half of their current levels.

The findings of the report, published annually by Trust for America’s Health and the Robert Wood Johnson Foundation, come from an analysis of the Centers for Disease Control and Prevention’s Behavior Risk Factor Surveillance System, which collects self-reported data on a variety of health indicators. Obesity was measured by calculating each participant’s Body Mass Index (BMI), a ratio of a person’s weight to height.

Using these calculations, the researchers found that more than one-third of adults in the U.S. — an estimated 78.6 million people — are obese, and two-thirds are either obese or overweight. And because the study used self-reported data, the researchers say these figures likely underestimate actual obesity rates.

While adult obesity rates are high across the country, the analysis found that the highest rates are concentrated in two regions, with 23 of the 25 states with the highest rates located in the South and Midwest. The geographical clustering of obesity is clear on the map below, which shows each state’s obesity rate:

State of Obesity_every state map

In a state-by-state analysis, Arkansas, West Virginia and Mississippi were the states with the highest adult obesity rates. Hawaii, the District of Columbia and Colorado had the lowest rates. Here are the full rankings of the top and bottom ten states:

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Trends in obesity rates

Obesity rates have been steadily rising since the late 1980s and early 1990s. In 1980, not a single state in the country had an adult obesity rate higher than 15 percent; in 1991, no state was over 20 percent; in 2000, no state was over 25 percent; and, in 2007, only Mississippi was above 30 percent. Today, every state is above 20%, 45 states are above 25%, and 22 states have obesity rates above 30%. And in 2013, Mississippi and West Virginia became the first two states to ever report more than 35% of their adult population as obese. These maps show the rapid increase in obesity rates since the mid-1980s:

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Racial disparities in obesity

Although the population has become heavier as a whole, the burden of overweight and obesity disproportionately impact racial and ethnic minority groups — a disparity that continues to worsen. According to the report, obesity rates are significantly higher among black (48%) and Latino (43%) adults than white adults (32%). But while the obesity rate has nearly leveled off among whites, it continues to rise among blacks and Latinos, which the researchers attribute to a variety of socioeconomic, environmental, and societal inequities.

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Obesity-related diseases

Obesity increases the risk of many serious chronic diseases, including heart disease, stroke, type 2 diabetes and some forms of cancer, leading to about $147 billion in obesity-related medical costs each year in the United States.  Unsurprisingly, the report found a significant degree of crossover between the 10 states with the highest adult obesity rates and the 10 states with the highest rates of adult diabetes. Seven states appear on both lists: Arkansas, West Virginia, Mississippi, Alabama, Oklahoma, Ohio and South Carolina.

State of Obesity_diabetes

A similar pattern was seen for hypertension (high blood pressure), which is a precursor to stroke, heart disease, and other cardiovascular problems. The 10 states with the highest rates of hypertension were in the South, according to the report, and West Virginia — the most obese state — had the highest rate at 41 percent.

State of Obesity_hypertension

Focus on childhood obesity

The report identifies preventing obesity among children as key to fighting the obesity epidemic, stating that it is easier to help children maintain a healthy weight than it is to reverse obesity in adulthood. Childhood obesity rates have more than tripled since 1980, the report says, but recent efforts to combat the problem seem to paying off, as obesity rates have stabilized and even dropped among children in some age-groups. Still, obesity remain a major public health problem among children and teens (aged 2 to 19 years), particularly among racial/ethnic minorities, with 22.5 percent of Latino youth, more than 20 percent of black youth, and 14.1 percent of white youth currently classified as obese.

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Obesity prevention: Policies & programs

The report concludes with a review of key programs that can help prevent and address obesity by focusing on the environmental factors that influence obesity risk. These include initiatives aimed at improving nutrition in schools, child care and food assistance programs; increasing opportunities for physical activity before, during and after school; expanding healthcare coverage for preventing and treating obesity and related conditions; making healthy affordable food and safe places to be active more accessible in neighborhoods, such as through Complete Streets and healthy food financing initiatives; and increasing healthy food options via public-private partnerships.