Special Report

The Most Obese States in America

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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 as a whole is facing an obesity crisis, the problem is much more pronounced in some states. To identify the most obese states, 24/7 Tempo reviewed 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 four of the 15 states with the highest obesity rates have a lower share of adults reporting being in poor or fair health than the U.S. as a whole. Additionally, only three of those 15 states report a diabetes rate lower than the national rate. Obesity is a leading risk factor for Type 2 diabetes.

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 one of the 20 states with the highest share of obese adults has a median annual household income that is higher than the median household income across the country. The household income in several of the most obese states is between $15,000 and $20,000 less than the U.S. figure.

Insufficient sleep has been shown to be a contributing factor to obesity. Sleep deprivation messes with the two hormones that control appetite — ghrelin, which tells you you’re hungry, and leptin, which tells you you’re full. Insufficient sleep is defined as sleeping less than seven hours per night on average. 

Lack of sleep can lead to increased levels of ghrelin (increased appetite) and decreased levels of leptin (diminished feeling of fullness), possibly leading to weight gain. All but four of the 20 states with the highest obesity rates have a higher share of the population reporting insufficient sleep than the country as a whole.

 Health experts have pointed to several lifestyle factors that are likely contributing to the excess weight problem among Americans, including  a sedentary lifestyle. Eighteen of the 20 states with the highest adult obesity rate report a lower share of adults exercising than the national share.

Obesity rates in the U.S. have risen over the last few decades — and so have the misconceptions about the condition. Here are the 16 most stubborn myths about obesity that need to go away.

Click here to see the states with the highest obesity rates
Click here to see our detailed methodology

50. Colorado
> Adult obesity rate: 22.4% (US rate: 29.7%)
> Adults who don’t exercise: 14.8% — the lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 6.6% — the lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 30.0% — 2nd lowest (US rate: 35.2%)
> Adults in fair or poor health: 13.8% — 9th lowest (US rate: 17.0%)
> Premature deaths (before 75): 282 per 100,000 people — 6th fewest (US rate: 339 per 100,000 people)
> Median household income:$77,127 — 9th highest (US median: $65,712)

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49. California
> Adult obesity rate: 24.3% (US rate: 29.7%)
> Adults who don’t exercise: 17.7% — 5th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 8.8% — 7th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 34.5% — 22nd lowest (US rate: 35.2%)
> Adults in fair or poor health: 17.6% — 22nd highest (US rate: 17.0%)
> Premature deaths (before 75): 268 per 100,000 people — 2nd fewest (US rate: 339 per 100,000 people)
> Median household income:$80,440 — 5th highest (US median: $65,712)

48. Hawaii
> Adult obesity rate: 24.6% (US rate: 29.7%)
> Adults who don’t exercise: 19.6% — 10th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 11.1% — 16th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 43.2% — the highest (US rate: 35.2%)
> Adults in fair or poor health: 15.4% — 18th lowest (US rate: 17.0%)
> Premature deaths (before 75): 283 per 100,000 people — 8th fewest (US rate: 339 per 100,000 people)
> Median household income:$83,102 — 4th highest (US median: $65,712)

47. Massachusetts
> Adult obesity rate: 25.0% (US rate: 29.7%)
> Adults who don’t exercise: 20.0% — 12th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 8.7% — 5th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 34.3% — 20th lowest (US rate: 35.2%)
> Adults in fair or poor health: 13.5% — 7th lowest (US rate: 17.0%)
> Premature deaths (before 75): 279 per 100,000 people — 5th fewest (US rate: 339 per 100,000 people)
> Median household income:$85,843 — 2nd highest (US median: $65,712)

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46. Connecticut
> Adult obesity rate: 26.3% (US rate: 29.7%)
> Adults who don’t exercise: 19.9% — 11th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.2% — 10th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 33.8% — 18th lowest (US rate: 35.2%)
> Adults in fair or poor health: 13.0% — 4th lowest (US rate: 17.0%)
> Premature deaths (before 75): 278 per 100,000 people — 4th fewest (US rate: 339 per 100,000 people)
> Median household income:$78,833 — 6th highest (US median: $65,712)

45. New York
> Adult obesity rate: 26.4% (US rate: 29.7%)
> Adults who don’t exercise: 23.4% — 19th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.1% — 25th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 38.9% — 8th highest (US rate: 35.2%)
> Adults in fair or poor health: 16.3% — 22nd lowest (US rate: 17.0%)
> Premature deaths (before 75): 276 per 100,000 people — 3rd fewest (US rate: 339 per 100,000 people)
> Median household income:$72,108 — 14th highest (US median: $65,712)

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44. New Jersey
> Adult obesity rate: 27.0% (US rate: 29.7%)
> Adults who don’t exercise: 26.6% — 11th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.9% — 21st lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 37.5% — 17th highest (US rate: 35.2%)
> Adults in fair or poor health: 15.5% — 19th lowest (US rate: 17.0%)
> Premature deaths (before 75): 292 per 100,000 people — 10th fewest (US rate: 339 per 100,000 people)
> Median household income:$85,751 — 3rd highest (US median: $65,712)

43. Utah
> Adult obesity rate: 27.0% (US rate: 29.7%)
> Adults who don’t exercise: 16.7% — 3rd lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 7.5% — 2nd lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 31.2% — 6th lowest (US rate: 35.2%)
> Adults in fair or poor health: 14.8% — 13th lowest (US rate: 17.0%)
> Premature deaths (before 75): 282 per 100,000 people — 7th fewest (US rate: 339 per 100,000 people)
> Median household income:$75,780 — 11th highest (US median: $65,712)

42. Vermont
> Adult obesity rate: 27.0% (US rate: 29.7%)
> Adults who don’t exercise: 18.4% — 6th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 8.8% — 7th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 30.1% — 4th lowest (US rate: 35.2%)
> Adults in fair or poor health: 12.8% — the lowest (US rate: 17.0%)
> Premature deaths (before 75): 302 per 100,000 people — 11th fewest (US rate: 339 per 100,000 people)
> Median household income:$63,001 — 25th lowest (US median: $65,712)

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41. Nevada
> Adult obesity rate: 27.1% (US rate: 29.7%)
> Adults who don’t exercise: 22.5% — 24th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.5% — 22nd highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 37.3% — 20th highest (US rate: 35.2%)
> Adults in fair or poor health: 19.1% — 12th highest (US rate: 17.0%)
> Premature deaths (before 75): 360 per 100,000 people — 18th most (US rate: 339 per 100,000 people)
> Median household income:$63,276 — 24th highest (US median: $65,712)

40. Montana
> Adult obesity rate: 27.1% (US rate: 29.7%)
> Adults who don’t exercise: 21.7% — 19th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 8.9% — 8th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 30.9% — 5th lowest (US rate: 35.2%)
> Adults in fair or poor health: 14.1% — 11th lowest (US rate: 17.0%)
> Premature deaths (before 75): 334 per 100,000 people — 23rd fewest (US rate: 339 per 100,000 people)
> Median household income:$57,153 — 11th lowest (US median: $65,712)

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39. Florida
> Adult obesity rate: 27.2% (US rate: 29.7%)
> Adults who don’t exercise: 25.8% — 15th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.8% — 20th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 37.3% — 19th highest (US rate: 35.2%)
> Adults in fair or poor health: 19.5% — 10th highest (US rate: 17.0%)
> Premature deaths (before 75): 337 per 100,000 people — 25th fewest (US rate: 339 per 100,000 people)
> Median household income:$59,227 — 17th lowest (US median: $65,712)

38. New Mexico
> Adult obesity rate: 27.3% (US rate: 29.7%)
> Adults who don’t exercise: 19.0% — 7th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.5% — 15th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 33.1% — 12th lowest (US rate: 35.2%)
> Adults in fair or poor health: 20.3% — 9th highest (US rate: 17.0%)
> Premature deaths (before 75): 400 per 100,000 people — 13th most (US rate: 339 per 100,000 people)
> Median household income:$51,945 — 6th lowest (US median: $65,712)

37. Arizona
> Adult obesity rate: 27.9% (US rate: 29.7%)
> Adults who don’t exercise: 21.2% — 17th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.6% — 17th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 34.9% — 24th lowest (US rate: 35.2%)
> Adults in fair or poor health: 18.6% — 14th highest (US rate: 17.0%)
> Premature deaths (before 75): 331 per 100,000 people — 22nd fewest (US rate: 339 per 100,000 people)
> Median household income:$62,055 — 23rd lowest (US median: $65,712)

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36. Rhode Island
> Adult obesity rate: 28.5% (US rate: 29.7%)
> Adults who don’t exercise: 23.5% — 18th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.1% — 25th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 36.7% — 22nd highest (US rate: 35.2%)
> Adults in fair or poor health: 16.5% — 25th lowest (US rate: 17.0%)
> Premature deaths (before 75): 304 per 100,000 people — 14th fewest (US rate: 339 per 100,000 people)
> Median household income:$71,169 — 15th highest (US median: $65,712)

35. New Hampshire
> Adult obesity rate: 28.6% (US rate: 29.7%)
> Adults who don’t exercise: 20.8% — 16th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.6% — 17th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 35.3% — 25th highest (US rate: 35.2%)
> Adults in fair or poor health: 12.8% — 2nd lowest (US rate: 17.0%)
> Premature deaths (before 75): 305 per 100,000 people — 15th fewest (US rate: 339 per 100,000 people)
> Median household income:$77,933 — 8th highest (US median: $65,712)

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34. Washington
> Adult obesity rate: 28.6% (US rate: 29.7%)
> Adults who don’t exercise: 16.4% — 2nd lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.3% — 12th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 31.8% — 7th lowest (US rate: 35.2%)
> Adults in fair or poor health: 15.0% — 14th lowest (US rate: 17.0%)
> Premature deaths (before 75): 288 per 100,000 people — 9th fewest (US rate: 339 per 100,000 people)
> Median household income:$78,687 — 7th highest (US median: $65,712)

33. Minnesota
> Adult obesity rate: 29.0% (US rate: 29.7%)
> Adults who don’t exercise: 19.6% — 9th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 8.5% — 4th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 29.1% — the lowest (US rate: 35.2%)
> Adults in fair or poor health: 12.9% — 3rd lowest (US rate: 17.0%)
> Premature deaths (before 75): 267 per 100,000 people — the fewest (US rate: 339 per 100,000 people)
> Median household income:$74,593 — 13th highest (US median: $65,712)

32. Idaho
> Adult obesity rate: 29.0% (US rate: 29.7%)
> Adults who don’t exercise: 20.4% — 14th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.3% — 12th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 33.4% — 15th lowest (US rate: 35.2%)
> Adults in fair or poor health: 15.1% — 15th lowest (US rate: 17.0%)
> Premature deaths (before 75): 304 per 100,000 people — 13th fewest (US rate: 339 per 100,000 people)
> Median household income:$60,999 — 20th lowest (US median: $65,712)

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31. Wyoming
> Adult obesity rate: 29.2% (US rate: 29.7%)
> Adults who don’t exercise: 23.1% — 22nd highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.0% — 9th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 33.8% — 17th lowest (US rate: 35.2%)
> Adults in fair or poor health: 15.3% — 17th lowest (US rate: 17.0%)
> Premature deaths (before 75): 344 per 100,000 people — 22nd most (US rate: 339 per 100,000 people)
> Median household income:$65,003 — 19th highest (US median: $65,712)

30. Oregon
> Adult obesity rate: 29.3% (US rate: 29.7%)
> Adults who don’t exercise: 17.3% — 4th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.7% — 18th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 32.8% — 11th lowest (US rate: 35.2%)
> Adults in fair or poor health: 18.2% — 18th highest (US rate: 17.0%)
> Premature deaths (before 75): 303 per 100,000 people — 12th fewest (US rate: 339 per 100,000 people)
> Median household income:$67,058 — 18th highest (US median: $65,712)

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29. Illinois
> Adult obesity rate: 29.7% (US rate: 29.7%)
> Adults who don’t exercise: 21.6% — 18th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.9% — 21st lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 33.5% — 16th lowest (US rate: 35.2%)
> Adults in fair or poor health: 15.9% — 21st lowest (US rate: 17.0%)
> Premature deaths (before 75): 328 per 100,000 people — 21st fewest (US rate: 339 per 100,000 people)
> Median household income:$69,187 — 17th highest (US median: $65,712)

28. Maine
> Adult obesity rate: 29.8% (US rate: 29.7%)
> Adults who don’t exercise: 20.8% — 15th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.4% — 24th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 34.5% — 23rd lowest (US rate: 35.2%)
> Adults in fair or poor health: 17.1% — 24th highest (US rate: 17.0%)
> Premature deaths (before 75): 338 per 100,000 people — 25th most (US rate: 339 per 100,000 people)
> Median household income:$58,924 — 16th lowest (US median: $65,712)

27. Virginia
> Adult obesity rate: 30.5% (US rate: 29.7%)
> Adults who don’t exercise: 22.2% — 23rd lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.7% — 21st highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 38.6% — 11th highest (US rate: 35.2%)
> Adults in fair or poor health: 16.6% — 25th highest (US rate: 17.0%)
> Premature deaths (before 75): 320 per 100,000 people — 19th fewest (US rate: 339 per 100,000 people)
> Median household income:$76,456 — 10th highest (US median: $65,712)

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26. Pennsylvania
> Adult obesity rate: 30.8% (US rate: 29.7%)
> Adults who don’t exercise: 22.0% — 22nd lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 11.0% — 18th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 38.6% — 10th highest (US rate: 35.2%)
> Adults in fair or poor health: 17.6% — 23rd highest (US rate: 17.0%)
> Premature deaths (before 75): 355 per 100,000 people — 19th most (US rate: 339 per 100,000 people)
> Median household income:$63,463 — 23rd highest (US median: $65,712)

25. Texas
> Adult obesity rate: 31.4% (US rate: 29.7%)
> Adults who don’t exercise: 23.2% — 21st highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.2% — 25th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 34.4% — 21st lowest (US rate: 35.2%)
> Adults in fair or poor health: 18.7% — 13th highest (US rate: 17.0%)
> Premature deaths (before 75): 339 per 100,000 people — 24th most (US rate: 339 per 100,000 people)
> Median household income:$64,034 — 22nd highest (US median: $65,712)

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24. Maryland
> Adult obesity rate: 31.6% (US rate: 29.7%)
> Adults who don’t exercise: 21.9% — 20th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 11.1% — 16th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 37.7% — 16th highest (US rate: 35.2%)
> Adults in fair or poor health: 15.2% — 16th lowest (US rate: 17.0%)
> Premature deaths (before 75): 339 per 100,000 people — 23rd most (US rate: 339 per 100,000 people)
> Median household income:$86,738 — the highest (US median: $65,712)

23. Wisconsin
> Adult obesity rate: 31.7% (US rate: 29.7%)
> Adults who don’t exercise: 20.3% — 13th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.5% — 15th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 32.7% — 9th lowest (US rate: 35.2%)
> Adults in fair or poor health: 14.8% — 12th lowest (US rate: 17.0%)
> Premature deaths (before 75): 308 per 100,000 people — 16th fewest (US rate: 339 per 100,000 people)
> Median household income:$64,168 — 21st highest (US median: $65,712)

22. Alaska
> Adult obesity rate: 31.9% (US rate: 29.7%)
> Adults who don’t exercise: 19.3% — 8th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 8.3% — 3rd lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 33.3% — 14th lowest (US rate: 35.2%)
> Adults in fair or poor health: 15.6% — 20th lowest (US rate: 17.0%)
> Premature deaths (before 75): 351 per 100,000 people — 21st most (US rate: 339 per 100,000 people)
> Median household income:$75,463 — 12th highest (US median: $65,712)

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21. Georgia
> Adult obesity rate: 32.3% (US rate: 29.7%)
> Adults who don’t exercise: 26.4% — 12th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 12.0% — 12th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 38.3% — 12th highest (US rate: 35.2%)
> Adults in fair or poor health: 18.4% — 15th highest (US rate: 17.0%)
> Premature deaths (before 75): 378 per 100,000 people — 14th most (US rate: 339 per 100,000 people)
> Median household income:$61,980 — 22nd lowest (US median: $65,712)

20. North Carolina
> Adult obesity rate: 32.3% (US rate: 29.7%)
> Adults who don’t exercise: 23.3% — 20th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 11.5% — 14th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 36.1% — 24th highest (US rate: 35.2%)
> Adults in fair or poor health: 18.0% — 19th highest (US rate: 17.0%)
> Premature deaths (before 75): 370 per 100,000 people — 15th most (US rate: 339 per 100,000 people)
> Median household income:$57,341 — 12th lowest (US median: $65,712)

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19. South Dakota
> Adult obesity rate: 32.4% (US rate: 29.7%)
> Adults who don’t exercise: 22.0% — 21st lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.1% — 25th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 30.1% — 3rd lowest (US rate: 35.2%)
> Adults in fair or poor health: 13.4% — 5th lowest (US rate: 17.0%)
> Premature deaths (before 75): 335 per 100,000 people — 24th fewest (US rate: 339 per 100,000 people)
> Median household income:$59,533 — 18th lowest (US median: $65,712)

18. Delaware
> Adult obesity rate: 32.4% (US rate: 29.7%)
> Adults who don’t exercise: 27.3% — 8th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 11.8% — 13th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 36.5% — 23rd highest (US rate: 35.2%)
> Adults in fair or poor health: 16.3% — 23rd lowest (US rate: 17.0%)
> Premature deaths (before 75): 360 per 100,000 people — 17th most (US rate: 339 per 100,000 people)
> Median household income:$70,176 — 16th highest (US median: $65,712)

17. Michigan
> Adult obesity rate: 32.4% (US rate: 29.7%)
> Adults who don’t exercise: 23.1% — 24th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 11.0% — 18th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 40.4% — 6th highest (US rate: 35.2%)
> Adults in fair or poor health: 18.3% — 16th highest (US rate: 17.0%)
> Premature deaths (before 75): 364 per 100,000 people — 16th most (US rate: 339 per 100,000 people)
> Median household income:$59,584 — 19th lowest (US median: $65,712)

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16. Missouri
> Adult obesity rate: 32.5% (US rate: 29.7%)
> Adults who don’t exercise: 25.5% — 16th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 11.4% — 15th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 35.2% — 25th lowest (US rate: 35.2%)
> Adults in fair or poor health: 19.5% — 11th highest (US rate: 17.0%)
> Premature deaths (before 75): 404 per 100,000 people — 11th most (US rate: 339 per 100,000 people)
> Median household income:$57,409 — 13th lowest (US median: $65,712)

15. Kansas
> Adult obesity rate: 33.0% (US rate: 29.7%)
> Adults who don’t exercise: 23.9% — 17th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.5% — 22nd highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 34.0% — 19th lowest (US rate: 35.2%)
> Adults in fair or poor health: 16.3% — 24th lowest (US rate: 17.0%)
> Premature deaths (before 75): 354 per 100,000 people — 20th most (US rate: 339 per 100,000 people)
> Median household income:$62,087 — 24th lowest (US median: $65,712)

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14. Tennessee
> Adult obesity rate: 33.3% (US rate: 29.7%)
> Adults who don’t exercise: 27.2% — 9th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 12.5% — 8th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 40.8% — 4th highest (US rate: 35.2%)
> Adults in fair or poor health: 21.2% — 7th highest (US rate: 17.0%)
> Premature deaths (before 75): 453 per 100,000 people — 7th most (US rate: 339 per 100,000 people)
> Median household income:$56,071 — 9th lowest (US median: $65,712)

13. Nebraska
> Adult obesity rate: 33.4% (US rate: 29.7%)
> Adults who don’t exercise: 22.7% — 25th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 10.0% — 22nd lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 32.3% — 8th lowest (US rate: 35.2%)
> Adults in fair or poor health: 13.8% — 10th lowest (US rate: 17.0%)
> Premature deaths (before 75): 313 per 100,000 people — 17th fewest (US rate: 339 per 100,000 people)
> Median household income:$63,229 — 25th highest (US median: $65,712)

12. Ohio
> Adult obesity rate: 33.5% (US rate: 29.7%)
> Adults who don’t exercise: 26.1% — 13th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 12.2% — 10th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 40.6% — 5th highest (US rate: 35.2%)
> Adults in fair or poor health: 17.8% — 21st highest (US rate: 17.0%)
> Premature deaths (before 75): 407 per 100,000 people — 10th most (US rate: 339 per 100,000 people)
> Median household income:$58,642 — 15th lowest (US median: $65,712)

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11. North Dakota
> Adult obesity rate: 33.9% (US rate: 29.7%)
> Adults who don’t exercise: 23.1% — 23rd highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.4% — 13th lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 32.8% — 10th lowest (US rate: 35.2%)
> Adults in fair or poor health: 13.6% — 8th lowest (US rate: 17.0%)
> Premature deaths (before 75): 320 per 100,000 people — 18th fewest (US rate: 339 per 100,000 people)
> Median household income:$64,577 — 20th highest (US median: $65,712)

10. Indiana
> Adult obesity rate: 33.9% (US rate: 29.7%)
> Adults who don’t exercise: 26.7% — 10th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 12.1% — 11th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 38.0% — 14th highest (US rate: 35.2%)
> Adults in fair or poor health: 18.2% — 17th highest (US rate: 17.0%)
> Premature deaths (before 75): 401 per 100,000 people — 12th most (US rate: 339 per 100,000 people)
> Median household income:$57,603 — 14th lowest (US median: $65,712)

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9. South Carolina
> Adult obesity rate: 34.0% (US rate: 29.7%)
> Adults who don’t exercise: 26.0% — 14th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 13.3% — 5th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 38.8% — 9th highest (US rate: 35.2%)
> Adults in fair or poor health: 17.8% — 20th highest (US rate: 17.0%)
> Premature deaths (before 75): 411 per 100,000 people — 9th most (US rate: 339 per 100,000 people)
> Median household income:$56,227 — 10th lowest (US median: $65,712)

8. Iowa
> Adult obesity rate: 34.3% (US rate: 29.7%)
> Adults who don’t exercise: 22.6% — 25th lowest (US rate: 22.7%)
> Pop. over 20 with diabetes: 9.9% — 21st lowest (US rate: 10.5%)
> Adults who don’t get enough sleep: 33.1% — 13th lowest (US rate: 35.2%)
> Adults in fair or poor health: 13.5% — 6th lowest (US rate: 17.0%)
> Premature deaths (before 75): 322 per 100,000 people — 20th fewest (US rate: 339 per 100,000 people)
> Median household income:$61,691 — 21st lowest (US median: $65,712)

7. Oklahoma
> Adult obesity rate: 34.5% (US rate: 29.7%)
> Adults who don’t exercise: 27.8% — 7th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 12.3% — 9th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 37.5% — 18th highest (US rate: 35.2%)
> Adults in fair or poor health: 20.9% — 8th highest (US rate: 17.0%)
> Premature deaths (before 75): 457 per 100,000 people — 6th most (US rate: 339 per 100,000 people)
> Median household income:$54,449 — 8th lowest (US median: $65,712)

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6. Kentucky
> Adult obesity rate: 34.6% (US rate: 29.7%)
> Adults who don’t exercise: 28.7% — 4th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 12.7% — 7th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 42.1% — 3rd highest (US rate: 35.2%)
> Adults in fair or poor health: 21.8% — 4th highest (US rate: 17.0%)
> Premature deaths (before 75): 470 per 100,000 people — 4th most (US rate: 339 per 100,000 people)
> Median household income:$52,295 — 7th lowest (US median: $65,712)

5. Arkansas
> Adult obesity rate: 35.0% (US rate: 29.7%)
> Adults who don’t exercise: 30.4% — the highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 13.5% — 4th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 37.2% — 21st highest (US rate: 35.2%)
> Adults in fair or poor health: 23.3% — 2nd highest (US rate: 17.0%)
> Premature deaths (before 75): 457 per 100,000 people — 5th most (US rate: 339 per 100,000 people)
> Median household income:$48,952 — 3rd lowest (US median: $65,712)

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4. Alabama
> Adult obesity rate: 36.1% (US rate: 29.7%)
> Adults who don’t exercise: 29.3% — 3rd highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 14.5% — 3rd highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 39.6% — 7th highest (US rate: 35.2%)
> Adults in fair or poor health: 21.4% — 6th highest (US rate: 17.0%)
> Premature deaths (before 75): 472 per 100,000 people — 3rd most (US rate: 339 per 100,000 people)
> Median household income:$51,734 — 5th lowest (US median: $65,712)

3. Louisiana
> Adult obesity rate: 36.3% (US rate: 29.7%)
> Adults who don’t exercise: 28.0% — 6th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 13.0% — 6th highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 38.0% — 13th highest (US rate: 35.2%)
> Adults in fair or poor health: 21.4% — 5th highest (US rate: 17.0%)
> Premature deaths (before 75): 453 per 100,000 people — 8th most (US rate: 339 per 100,000 people)
> Median household income:$51,073 — 4th lowest (US median: $65,712)

2. West Virginia
> Adult obesity rate: 37.8% (US rate: 29.7%)
> Adults who don’t exercise: 28.0% — 5th highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 15.1% — the highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 42.5% — 2nd highest (US rate: 35.2%)
> Adults in fair or poor health: 23.6% — the highest (US rate: 17.0%)
> Premature deaths (before 75): 505 per 100,000 people — the most (US rate: 339 per 100,000 people)
> Median household income:$48,850 — 2nd lowest (US median: $65,712)

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1. Mississippi
> Adult obesity rate: 39.1% (US rate: 29.7%)
> Adults who don’t exercise: 30.4% — 2nd highest (US rate: 22.7%)
> Pop. over 20 with diabetes: 14.6% — 2nd highest (US rate: 10.5%)
> Adults who don’t get enough sleep: 37.8% — 15th highest (US rate: 35.2%)
> Adults in fair or poor health: 22.1% — 3rd highest (US rate: 17.0%)
> Premature deaths (before 75): 502 per 100,000 people — 2nd most (US rate: 339 per 100,000 people)
> Median household income:$45,792 — the lowest (US median: $65,712)

Methodology

To identify the states with the highest obesity rates, 24/7 Tempo reviewed data about the share of adults who are obese in all 50 states. The measure came from the 2021 County Health Rankings & Roadmaps, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The share of adults who report being in poor or fair health, the share of the population leading a sedentary lifestyle, as well as the share of adults who don’t get enough sleep at night also came from the 2021 CHR. The CHR defines insufficient sleep as having less than seven hours of sleep per night on average. 

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

Premature mortality includes all deaths before the age of 75 per 100,000 people. Data on premature mortality is from the 2021 CHR.

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

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