America has an obesity problem: According to the current diagnostic criteria—body mass index—nearly three-quarters of adults in the United States are either overweight or obese. And the most recent World Health Organization data ranks the U.S. (with a 42.9 percent obesity rate) at No. 18 on the list of the most obese countries in the world. So what does zooming further into the map—and looking at the breakdown of the least and most obese U.S. states—tell us? In short these rankings are a better indicator of quality healthcare (or lack thereof) than individual health.
“We know that states that have fewer services for families, higher income disparities, and less access to food and safe places to exercise, often correlate with larger body size,” says Lisa Erlanger, M.D., a board-certified family physician, clinical professor of family medicine at the University of Washington School of Medicine in Seattle, and founding president of the Association for Weight and Size-Inclusive Medicine. And “if we make all those larger people smaller—with medications, for example—we don’ fix those other problems which have a much more direct impact on health, wellbeing, and longevity.”
So living in the most obese state (spoiler alert, it’s West Virginia, with a 41.2 percent obesity rate) doesn’t mean you’re an inherently “unhealthy” person—it means your access to quality healthcare and healthy foods are more likely to be limited. (Indeed, West Virginia ranks #49 in overall healthcare quality, #50 in public health outcomes, and #30 in access to healthcare according to an analysis by U.S. News and World Report. And one study places West Virginia #45 on the state-by-state Healthy Diet Index list, which is determined by factors like food insecurity and fruit and vegetable consumption.)
So how does your state stack up?
The Most Obese States in the U.S.
Here’s an alphabetical list that includes every U.S. state—plus, D.C. and three U.S. territories (Guam, Puerto Rico, and the U.S. Virgin Islands)—and the obesity rate in each, based on the most recent data from the Centers for Disease Control. (A missing obesity rate indicates that insufficient data was shared.) The numbers are based on the Behavioral Risk Factor Surveillance System (BRFSS), which is an ongoing, survey conducted by CDC and state health departments using self-reported data.
| Alabama | 39.2 |
| Alaska | 35.2 |
| Arizona | 31.9 |
| Arkansas | 40 |
| California | 27.7 |
| Colorado | 24.9 |
| Connecticut | 29.4 |
| Delaware | 35.7 |
| District of Columbia | 23.5 |
| Florida | 30.1 |
| Georgia | 35 |
| Guam | 35.4 |
| Hawaii | 26.1 |
| Idaho | 31 |
| Illinois | 36 |
| Indiana | 37.8 |
| Iowa | 37.8 |
| Kansas | 35.9 |
| Kentucky | Insufficent data |
| Louisiana | 39.9 |
| Maine | 32.6 |
| Maryland | 34.1 |
| Massachusetts | 27.4 |
| Michigan | 35.4 |
| Minnesota | 33.3 |
| Mississippi | 40.1 |
| Missouri | 35.3 |
| Montana | 30.5 |
| Nebraska | 36.6 |
| Nevada | 30.8 |
| New Hampshire | 32.8 |
| New Jersey | 28.9 |
| New Mexico | 35.3 |
| New York | 28 |
| North Carolina | 34 |
| North Dakota | 35.6 |
| Ohio | 36.4 |
| Oklahoma | 38.7 |
| Oregon | 33.6 |
| Pennsylvania | Insufficent data |
| Puerto Rico | 36 |
| Rhode Island | 31.6 |
| South Carolina | 36 |
| South Dakota | 36 |
| Tennessee | 37.6 |
| Texas | 34.4 |
| Utah | 30.2 |
| Vermont | 28.8 |
| Virgin Islands | 32.1 |
| Virginia | 34.3 |
| Washington | 30.6 |
| West Virginia | 41.2 |
| Wisconsin | 35.9 |
| Wyoming | 33.3 |
So, what does this mean for you?
Regardless of where you live, Erlanger encourages patients to seek out weight-inclusive medical experts. The right healthcare team will focus on your overall health—and preventing and treating disease—rather than making weight-loss the be-all and end-all. She also suggests prioritizing movement: “Regardless of its impact on weight, recreational physical activity has a very direct impact on health, wellbeing, and longevity,” Erlanger says.