Obesity has reached alarming levels across the United States. According to 2023 data from the CDC’s Behavioral Risk Factor Surveillance System, no state has an adult obesity rate under 20%, and 23 states report rates exceeding 35%.
But the most striking data point? West Virginia leads the nation with a 41–41.2% obesity rate among adults, the highest rate recorded anywhere in the country.
Top 10 Most Obese States (2023 Data)
Based on multiple sources, including U.S. News and CDC data, the ten states with the highest adult obesity rates in 2023 are:
| Rank | State | Obesity Rate (%) |
|---|---|---|
| 1 | West Virginia | ~41.2 |
| 2 | Mississippi | ~40.1 |
| 3 | Arkansas | ~40.0 |
| 4 | Louisiana | ~39.9 |
| 5 | Alabama | ~39.3 |
| 6 | Oklahoma | ~38.2 |
| T‑7 | Indiana | ~37.8 |
| T‑7 | Iowa | ~37.8 |
| 9 | Tennessee | ~37.6 |
| 10 | Nebraska | ~36.6 |
These rankings align closely across sources: U.S. News lists Arkansas, Mississippi, and West Virginia all over 40%, while Visual Capitalist data shows West Virginia first, followed by Louisiana and Oklahoma near the 40% threshold.
Regional Patterns: The South and Midwest
Most of the high-obesity states cluster in the South and Midwest. The CDC data shows the South leads with a regional average of 34.7%, closely followed by the Midwest at 36.0%. States like Mississippi, Alabama, and Louisiana consistently rank among the highest nationally, while regions like the Northeast and West maintain lower averages (around 28–29%).
Why the Rates Are So High
Several structural and behavioral factors contribute to elevated obesity rates in these regions:
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Limited access to healthy foods: Low-income and rural neighborhoods often lack supermarkets, while fast-food outlets are prevalent—a trend linked to poor dietary patterns.
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Poverty and food deserts: Holmes County, Mississippi—one of the poorest counties with over 50% adult obesity—illustrates how income and environment exacerbate risk .
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Sedentary lifestyle trends: Lower rates of physical activity, combined with high consumption of ultra-processed food, contribute significantly to obesity.
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Education and awareness gaps: The CDC notes that adults with lower education levels have higher obesity rates—27.1% among college grads vs. 36.5% among those without a high school diploma.
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Stress and stigma: Social determinants, including chronic stress and stigma, can worsen obesity by undermining mental health and access to care .
Louisiana vs. Colorado: A Contrast in Health Policy
While Louisiana hovers around a 40% obesity rate, states like Colorado (24.6–24.9%) are at the other end of the spectrum. Colorado’s lower rate is often credited to its active outdoors culture and residents’ strong focus on healthy eating and exercise.
Why This Matters
High obesity rates carry heavy health and economic burdens. States at the top of the obesity charts also face elevated rates of diabetes, heart disease, certain cancers, and stubbornly low life expectancy compared to healthier states .
What’s Being Done
Efforts to curb obesity include:
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Policy interventions: Some states ban soda in schools, enforce nutritional standards, and implement community exercise programs.
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Proposal experiments: West Virginia has floated ideas like tax incentives if the state can reduce its obesity rate—though such plans are still in early discussion.
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Medicaid/Medicare coverage: There’s growing interest in covering weight-loss medications under government healthcare plans, as obesity rates reach record highs.
Looking Ahead
With projections showing obesity continuing to climb—potentially impacting half the U.S. adult population by 2030—the stakes are rising . Understanding geographic disparities is essential as targeted, region-sensitive policies become more urgent than ever.
