12 Worst States for Obesity: 2023

The U.S. has an overweight problem, and this has drastic implications for Americans’ health and for the country’s health care system, according to a new report by WalletHub, a personal finance website.

Based on data collected by the Centers for Disease Control and Prevention between 2017 and 2020, 41.9% of Americans 20 and older have obesity, up from 35% in the 1999-to-2000 period.

Among children and teenagers, the same data set showed that 14.7 million, or 19.7%, have obesity:

12.7% among 2- to 5-year-olds
20.7% among 6- to 11-year-olds
22.2% among 12- to 19-year-olds.

Childhood obesity is also more common among certain populations, according to the CDC.

The CDC uses Body Mass Index as a screening tool for overweight and obesity. This is a person’s weight in kilograms divided by the square of height in meters. A high BMI can indicate high body fatness.

The CDC estimates that the annual medical cost of obesity in the U.S. during the latest study period was $173 billion in 2019 dollars. The costs for adults who had obesity were $1,861 higher than those for people with healthy weight.

Health insurers, meanwhile, are not allowed to charge higher premuims for obese policyholders. Under the Affordable Care Act, most plans are required to cover obesity screening and counseling.

One of the main causes of obesity is lack of physical activity. WalletHub, citing findings by the Physical Activity Council, said some 69 million Americans 6 and older were completely inactive in 2022.

Obesity is a much more serious problems in some parts of the country than others. In order to determine the most overweight and obese states in the U.S., WalletHub compared the 50 states and the District of Columbia across three key dimensions:

Obesity and overweight prevalence, including share of obese adults, teenagers and children; and projected obesity rate
Health consequences, including share of adults with high cholesterol, type-2 diabetes and hypertension; and heart disease rate
Food and fitness, including healthy food access and comprehensiveness of school nutrition and physical activity policies

Researchers evaluated those dimensions using 31 relevant metrics, ranking the states from 1 (worst) to 51 (best). To create the overall ranking, they rated each state on a 100-point scale, with a score of 100 representing the most overweight state.

See the gallery for the 12 worst states for obesity, according to WalletHub. The adult obesity rate data prsented here is from the CDC.