Special Report

States With the Highest Obesity

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Obesity has been associated with some of the nation’s biggest killers — cancer, heart disease and diabetes. All have been closely linked to obesity. According to the National Cancer Institute, in some cases, obesity can cut a person’s lifespan more than smoking. The obesity epidemic afflicts every part of the country to some degree. At least one in five adults are obese in every state. In five states, at least one in three adults are obese.

24/7 Wall St. reviewed the percentage of adults who are obese in every state. Nine of the 10 states with the highest obesity rates are located in the South. Mississippi leads the nation with an obesity rate of 35.3%, in contrast with Colorado’s obesity rate of 20.1%.

Obesity is a complex health issue. While a balanced diet and exercise can help a person lose weight, many other factors influence obesity. Factors such as poverty, and low educational attainment rates are linked to higher obesity rates. In addition, genetic predisposition and community influences can impede efforts to combat obesity.

Click here to see the states with the highest obesity.

The Physical Activity Guidelines from the U.S. Department of Health and Human Services recommends 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity a week for adults. Many Americans, however, fall short of this recommendation. In Mississippi, the state with the highest obesity rate, one in three adults do not exercise, the highest rate in the nation.

Obesity increases the risk of many negative health outcomes that can lower quality of life. Obesity is a risk factor in a range of preventable illnesses, including diabetes, heart disease, and stroke. Also, obese individuals are far more likely to report mental illnesses such as clinical depression and anxiety. In the 10 states with the highest obesity rates, at least one in 10 adults are diagnosed with diabetes. Colorado, the state with the lowest obesity rate, also has the lowest rate of diabetes at 6.8%.

High obesity rates are also linked to higher levels of preventable hospitalizations in an area. Nine of the 10 states with the highest obesity rates have higher rates of preventable hospitalizations than the national average.

The increase in illness and hospitalizations drives up health care costs both for individuals and for health systems. Health care costs are highest in states with the highest rates of obesity. Louisiana, which has the second highest obesity rate, also has the highest annual health care costs in the nation. By contrast, Colorado has the lowest obesity rate and lowest health care costs of all states.

Ultimately, a lifetime of obesity can lead to a premature death. According to a National Institutes of Health study, participants with a BMI of 40-44.9 — an extreme level of obesity — lost 6.5 years of life. At BMI levels of 55-59.9, the years of life lost more than doubled to 13.7.

To identify the states with the highest obesity rates, 24/7 Wall St. reviewed the percentage of adults in each state with a body mass index (BMI) of 30.0 or higher — people with BMI values over this threshold are considered obese. Data came from County Health Rankings and Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. The percentage of adults who have been diagnosed with diabetes, the number of deaths before age 75 per 100,000 people in a given year (the premature death rate), as well as annual health care costs also came from County Health Rankings and Roadmaps. Annual health care costs are based on the amount of price-adjusted medicare reimbursements per enrollee, a widely used approximation of per capita health care costs in a population. All data is as of the most recent period available.

These are the states with the highest obesity rates.

chairlift, skiing, colorado
Source: Thinkstock

50. Colorado
> Obesity rate:
20.1%
> Pct. diabetic: 6.8% (the lowest)
> Annual per capita healthcare cost: $8,303 (15th lowest)
> Premature deaths per 100,000: 279.4 (6th lowest)

Ki'i Carving, Hawaii
Source: Thinkstock

49. Hawaii
> Obesity rate:
22.1%
> Pct. diabetic: 9.2% (18th lowest)
> Annual per capita healthcare cost: $6,900 (2nd lowest)
> Premature deaths per 100,000: 278.7 (5th lowest)

San Diego, California, Waves
Source: Thinkstock

48. California
> Obesity rate:
22.5%
> Pct. diabetic: 9.9% (23rd highest)
> Annual per capita healthcare cost: $9,102 (25th lowest)
> Premature deaths per 100,000: 272.5 (4th lowest)

Zion National Park, Arizona
Source: Thinkstock

47. Arizona
> Obesity rate:
23.5%
> Pct. diabetic: 9.6% (24th lowest)
> Annual per capita healthcare cost: $8,960 (24th lowest)
> Premature deaths per 100,000: 321.0 (25th lowest)

New Mexico, Desert hiking
Source: Thinkstock

46. New Mexico
> Obesity rate:
23.6%
> Pct. diabetic: 10.8% (14th highest)
> Annual per capita healthcare cost: $7,700 (7th lowest)
> Premature deaths per 100,000: 362.6 (14th highest)

Boston docks, Massachusetts
Source: Thinkstock

45. Massachusetts
> Obesity rate:
23.7%
> Pct. diabetic: 9.3% (21st lowest)
> Annual per capita healthcare cost: $9,214 (23rd highest)
> Premature deaths per 100,000: 268.9 (3rd lowest)

Chelsea Piers, New York, 10011
Source: Thinkstock

44. New York
> Obesity rate:
24.1%
> Pct. diabetic: 8.6% (10th lowest)
> Annual per capita healthcare cost: $8,545 (18th lowest)
> Premature deaths per 100,000: 282.5 (8th lowest)

Stowe, Vermont, skier
Source: Thinkstock

43. Vermont
> Obesity rate:
24.4%
> Pct. diabetic: 7.6% (3rd lowest)
> Annual per capita healthcare cost: $7,675 (6th lowest)
> Premature deaths per 100,000: 288.7 (12th lowest)

Glacier National Park, Montana
Source: Thinkstock

42. Montana
> Obesity rate:
24.6%
> Pct. diabetic: 8.8% (14th lowest)
> Annual per capita healthcare cost: $7,477 (4th lowest)
> Premature deaths per 100,000: 339.1 (24th highest)


Hartford, Connecticut dusk
Source: Thinkstock

41. Connecticut
> Obesity rate:
24.7%
> Pct. diabetic: 8.6% (11th lowest)
> Annual per capita healthcare cost: $9,135 (25th highest)
> Premature deaths per 100,000: 266.3 (2nd lowest)

Atlantic City, New Jersey 2
Source: Thinkstock

40. New Jersey
> Obesity rate:
24.7%
> Pct. diabetic: 9.8% (25th highest)
> Annual per capita healthcare cost: $10,037 (9th highest)
> Premature deaths per 100,000: 285.7 (10th lowest)

Salt Lake City, Utah
Source: Thinkstock

39. Utah
> Obesity rate: 24.9%
> Pct. diabetic: 7.1% (2nd lowest)
> Annual per capita healthcare cost: $8,673 (19th lowest)
> Premature deaths per 100,000: 287.7 (11th lowest)

Las Vegas, Nevada 2
Source: Thinkstock

38. Nevada
> Obesity rate:
25.4%
> Pct. diabetic: 10.3% (20th highest)
> Annual per capita healthcare cost: $9,574 (16th highest)
> Premature deaths per 100,000: 360.7 (16th highest)

Daytona Beach, Florida
Source: Thinkstock

37. Florida
> Obesity rate: 25.5%
> Pct. diabetic: 11.2% (12th highest)
> Annual per capita healthcare cost: $10,980 (2nd highest)
> Premature deaths per 100,000: 325.4 (25th highest)

Portland, Oregon 2
Source: Thinkstock

36. Oregon
> Obesity rate:
26.0%
> Pct. diabetic: 9.2% (17th lowest)
> Annual per capita healthcare cost: $7,213 (3rd lowest)
> Premature deaths per 100,000: 308.5 (17th lowest)

Minneapolis, Minnesota
Source: Thinkstock

35. Minnesota
> Obesity rate:
26.3%
> Pct. diabetic: 7.8% (5th lowest)
> Annual per capita healthcare cost: $7,828 (8th lowest)
> Premature deaths per 100,000: 262.4 (the lowest)

Providence, Rhode Island
Source: Thinkstock

34. Rhode Island
> Obesity rate:
26.4%
> Pct. diabetic: 9.3% (22nd lowest)
> Annual per capita healthcare cost: $8,844 (22nd lowest)
> Premature deaths per 100,000: 299.3 (13th lowest)


Teton County, Wyoming
Source: Thinkstock

33. Wyoming
> Obesity rate:
26.6%
> Pct. diabetic: 8.1% (7th lowest)
> Annual per capita healthcare cost: $7,643 (5th lowest)
> Premature deaths per 100,000: 341.0 (22nd highest)

Seattle, Washington
Source: Thinkstock

32. Washington
> Obesity rate:
27.2%
> Pct. diabetic: 8.5% (9th lowest)
> Annual per capita healthcare cost: $7,863 (9th lowest)
> Premature deaths per 100,000: 284.8 (9th lowest)

New Hampshire
Source: Thinkstock

31. New Hampshire
> Obesity rate:
27.3%
> Pct. diabetic: 8.8% (15th lowest)
> Annual per capita healthcare cost: $8,284 (13th lowest)
> Premature deaths per 100,000: 280.1 (7th lowest)

Richmond, Virginia
Source: Thinkstock

30. Virginia
> Obesity rate:
27.3%
> Pct. diabetic: 9.4% (23rd lowest)
> Annual per capita healthcare cost: $8,761 (20th lowest)
> Premature deaths per 100,000: 314.7 (21st lowest)

Chicago, Illinois 4
Source: Thinkstock

29. Illinois
> Obesity rate:
27.4%
> Pct. diabetic: 9.7% (25th lowest)
> Annual per capita healthcare cost: $9,880 (12th highest)
> Premature deaths per 100,000: 321.0 (25th lowest)

Boise, Idaho, Ada County
Source: Thinkstock

28. Idaho
> Obesity rate:
27.7%
> Pct. diabetic: 8.1% (8th lowest)
> Annual per capita healthcare cost: $8,197 (12th lowest)
> Premature deaths per 100,000: 308.5 (17th lowest)

Portland Lighthouse, Maine
Source: Thinkstock

27. Maine
> Obesity rate:
27.9%
> Pct. diabetic: 9.2% (20th lowest)
> Annual per capita healthcare cost: $8,343 (17th lowest)
> Premature deaths per 100,000: 314.4 (20th lowest)

Riverwalk, San Antonio, Texas
Source: Thinkstock

26. Texas
> Obesity rate:
28.4%
> Pct. diabetic: 11.0% (13th highest)
> Annual per capita healthcare cost: $10,837 (3rd highest)
> Premature deaths per 100,000: 340.0 (23rd highest)

Aleutians West, Adak Island, Alaska
Source: Thinkstock

25. Alaska
> Obesity rate:
28.4%
> Pct. diabetic: 7.7% (4th lowest)
> Annual per capita healthcare cost: $6,875 (the lowest)
> Premature deaths per 100,000: 345.3 (18th highest)

Baltimore, Maryland 3
Source: Thinkstock

24. Maryland
> Obesity rate:
28.4%
> Pct. diabetic: 10.2% (22nd highest)
> Annual per capita healthcare cost: $9,197 (24th highest)
> Premature deaths per 100,000: 317.4 (22nd lowest)

Pittsburgh, Pennsylvania 2
Source: Thinkstock

23. Pennsylvania
> Obesity rate:
28.8%
> Pct. diabetic: 10.6% (16th highest)
> Annual per capita healthcare cost: $9,926 (11th highest)
> Premature deaths per 100,000: 342.8 (20th highest)

Wilmington, Delaware
Source: Thinkstock

22. Delaware
> Obesity rate:
29.0%
> Pct. diabetic: 10.7% (15th highest)
> Annual per capita healthcare cost: $9,273 (22nd highest)
> Premature deaths per 100,000: 343.0 (19th highest)

Atlanta, Georgia 3
Source: Thinkstock

21. Georgia
> Obesity rate:
29.0%
> Pct. diabetic: 11.4% (9th highest)
> Annual per capita healthcare cost: $9,357 (19th highest)
> Premature deaths per 100,000: 372.0 (13th highest)

North Carolina
Source: Thinkstock

20. North Carolina
> Obesity rate:
29.1%
> Pct. diabetic: 10.5% (17th highest)
> Annual per capita healthcare cost: $8,937 (23rd lowest)
> Premature deaths per 100,000: 362.1 (15th highest)

Farm, Wisconsin
Source: Thinkstock

19. Wisconsin
> Obesity rate:
29.4%
> Pct. diabetic: 9.2% (19th lowest)
> Annual per capita healthcare cost: $8,322 (16th lowest)
> Premature deaths per 100,000: 302.4 (15th lowest)

Omaha, Nebraska
Source: Thinkstock

18. Nebraska
> Obesity rate:
29.5%
> Pct. diabetic: 8.7% (13th lowest)
> Annual per capita healthcare cost: $8,787 (21st lowest)
> Premature deaths per 100,000: 302.1 (14th lowest)

Oglala, South Dakota
Source: Thinkstock

17. South Dakota
> Obesity rate:
29.8%
> Pct. diabetic: 8.7% (12th lowest)
> Annual per capita healthcare cost: $7,938 (10th lowest)
> Premature deaths per 100,000: 320.3 (23rd lowest)

Kansas City, Missouri 2
Source: Thinkstock

16. Kansas
> Obesity rate:
30.2%
> Pct. diabetic: 9.8% (24th highest)
> Annual per capita healthcare cost: $9,340 (20th highest)
> Premature deaths per 100,000: 341.7 (21st highest)

Bison, North Dakota
Source: Thinkstock

 15. North Dakota
> Obesity rate:
30.2%
> Pct. diabetic: 7.9% (6th lowest)
> Annual per capita healthcare cost: $8,074 (11th lowest)
> Premature deaths per 100,000: 314.4 (20th lowest)

Cincinnati, Ohio
Source: Thinkstock

14. Ohio
> Obesity rate:
30.5%
> Pct. diabetic: 11.4% (8th highest)
> Annual per capita healthcare cost: $10,177 (6th highest)
> Premature deaths per 100,000: 376.6 (12th highest)

St. Louis, Missouri 3
Source: Thinkstock

13. Missouri
> Obesity rate:
30.6%
> Pct. diabetic: 10.5% (18th highest)
> Annual per capita healthcare cost: $9,457 (17th highest)
> Premature deaths per 100,000: 381.1 (11th highest)

Dubuque, Iowa
Source: Thinkstock

12. Iowa
> Obesity rate:
30.7%
> Pct. diabetic: 9.1% (16th lowest)
> Annual per capita healthcare cost: $8,298 (14th lowest)
> Premature deaths per 100,000: 309.4 (18th lowest)

Indianapolis, Indiana
Source: Thinkstock

11. Indiana
> Obesity rate:
31.4%
> Pct. diabetic: 10.3% (19th highest)
> Annual per capita healthcare cost: $9,753 (15th highest)
> Premature deaths per 100,000: 382.4 (10th highest)

Detroit, Michigan ducks
Source: Thinkstock

10. Michigan
> Obesity rate:
31.4%
> Pct. diabetic: 10.2% (21st highest)
> Annual per capita healthcare cost: $10,153 (7th highest)
> Premature deaths per 100,000: 356.5 (17th highest)

Myrtle Beach, South Carolina
Source: Thinkstock

9. South Carolina
> Obesity rate:
31.6%
> Pct. diabetic: 11.8% (6th highest)
> Annual per capita healthcare cost: $9,283 (21st highest)
> Premature deaths per 100,000: 400.2 (9th highest)

Chattanooga, Tennessee
Source: Thinkstock

8. Tennessee
> Obesity rate:
32.2%
> Pct. diabetic: 11.6% (7th highest)
> Annual per capita healthcare cost: $9,868 (14th highest)
> Premature deaths per 100,000: 429.5 (8th highest)

Louisville, Kentucky
Source: Thinkstock

7. Kentucky
> Obesity rate:
32.3%
> Pct. diabetic: 11.9% (4th highest)
> Annual per capita healthcare cost: $10,384 (5th highest)
> Premature deaths per 100,000: 443.3 (7th highest)

Oklahoma City, Oklahoma
Source: Thinkstock

6. Oklahoma
> Obesity rate:
32.4%
> Pct. diabetic: 11.2% (11th highest)
> Annual per capita healthcare cost: $10,058 (8th highest)
> Premature deaths per 100,000: 452.7 (4th highest)

Arkansas, Countryside
Source: Thinkstock

5. Arkansas
> Obesity rate:
33.3%
> Pct. diabetic: 11.8% (5th highest)
> Annual per capita healthcare cost: $9,409 (18th highest)
> Premature deaths per 100,000: 446.0 (5th highest)

Birmingham, Alabama 2
Source: Thinkstock

4. Alabama
> Obesity rate:
33.6%
> Pct. diabetic: 12.4% (2nd highest)
> Annual per capita healthcare cost: $9,950 (10th highest)
> Premature deaths per 100,000: 461.0 (3rd highest)

Wheeling, West Virginia
Source: Thinkstock

3. West Virginia
> Obesity rate:
34.1%
> Pct. diabetic: 12.3% (3rd highest)
> Annual per capita healthcare cost: $9,872 (13th highest)
> Premature deaths per 100,000: 466.4 (2nd highest)

Street car, New Orleans, Louisiana
Source: Thinkstock

2. Louisiana
> Obesity rate:
34.3%
> Pct. diabetic: 11.2% (10th highest)
> Annual per capita healthcare cost: $11,201 (the highest)
> Premature deaths per 100,000: 445.9 (6th highest)

Vicksburg Bridge, Mississippi
Source: Thinkstock

1. Mississippi
> Obesity rate:
35.3%
> Pct. diabetic: 12.5% (the highest)
> Annual per capita healthcare cost: $10,507 (4th highest)
> Premature deaths per 100,000: 487.0 (the highest)

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