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