Special Report

These Are the Most Obese Counties in Every State

The obesity epidemic in the U.S. is a major health issue and it’s getting worse. Almost half of adults in the U.S. are projected to be obese, not just overweight, by 2030, according to Harvard researchers estimates published in December 2019 in the New England Journal of Medicine.

While the country is facing an obesity crisis, the problem is much more pronounced in certain places within the U.S. To identify the most obese county in each state, 24/7 Tempo reviewed county-level health data from the 2021 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program.

There are a multitude of social and economic factors that predispose certain populations to higher obesity rates. High obesity rates can detrimentally affect the health and life expectancy of the population. 

Only two of the counties on the list have a lower share of adults reporting being in poor or fair health than their respective state. Additionally, only four of the 50 counties on this list have a diabetes rate lower than the statewide rate. 

Many of the counties with high adult obesity rates also tend to have low-income populations. People with lower incomes are less able to afford proper medical care and healthy lifestyles, which include eating a healthy diet and having easy access to gyms and other options for physical activity. 

Only three of the counties with the highest obesity rate in their state have a median annual household income that is higher than the statewide figure. The household income in several counties on this list is as much as $25,000 less than the state median. 

Health experts have pointed to several lifestyle factors that are likely contributing to the excess weight problem among Americans, among them a sedentary lifestyle. Only three of the counties on this list have more adults exercising than the statewide share. 

The consumption of high-calorie diets, including large sugary beverages, is another major contributor to weight gain — these are the unhealthiest items in the most popular fast-food chains in America.

Click here to see the most obese counties in every state

To identify the most obese county in every state, 24/7 Tempo reviewed county-level data from the 2021 County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. A total of 3,142 counties were considered.

The obesity rates — the share of adult residents who report a body mass index of 30 or greater — came from the 2021 CHR.

We also considered other measures of health outcomes and health factors. Health factors reviewed included measures of healthy behavior such as exercise, self-reported overall health, and social and economic factors such as annual household income. Data for these measures also came from the 2021 CHR report. 

The age-adjusted percentage of the total population 20 years and over diagnosed with diabetes in 2017, the latest year for which data is available, also came from the 2021 CHR. 

Population figures as well as median household income came from the American Community Survey 2019 5-Year Estimates.