The percentage of children and adolescents who are not just overweight but obese has more than tripled since the 1970s, according to the Centers for Disease Control and Prevention. By 2018, nearly one in five children between the age of 2 and 19 are obese.

Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obesity can increase the risk of a number of serious diseases and conditions, including heart disease, type 2 diabetes, and certain types of cancer.

To determine the states struggling where children in high school — ninth to 12th graders — are struggling obesity, 24/7 Tempo reviewed 2019 data from the Youth Risk Behavior Surveillance System. We ranked the states based on the reported youth obesity rate as of 2019, the latest year for which data is available. Eight states — Delaware, Indiana, Massachusetts, Minnesota, Ohio, Oregon, Washington, Wyoming — do not have data on youth obesity from the YRBSS.

Genetic background, environmental factors, and lifestyle preferences, are just some of the factors that contribute to obesity and its concentration in certain parts of the country.

Poverty is another potential factor contributing to a higher obesity rate among children. Healthier foods that tend to be lower in calories and more nutritious are relatively more expensive and may be less affordable to low-income households. States that are struggling the most with childhood obesity tend to have a relatively high share of children living in poverty. 

Health experts have pointed to several lifestyle factors that are likely contributing to the excess weight problem among Americans, among them a sedentary lifestyle and the consumption of high-calorie diets, including large sugary beverages — these are the unhealthiest items in the most popular fast-food chains in America.

Click here to see states where children are struggling with obesity
Click here to see our detailed methodology