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Mapped: States with the highest (and lowest) obesity rates


Roughly 40% of American adults have obesity and rates continue to climb across the United States, with 22 states having adult obesity rates over 35%, according to a new report from Trust for America's Health (TFAH).

Report details

For the report, TFAH looked at 2021 data from CDC's Behavioral Risk Factors Surveillance System as well as TFAH's own analysis. It found that, nationwide, 41.9% of American adults have obesity.

The report also found stark contrasts in obesity rates among different demographics. Specifically, the report found that 49.9% of Black adults had obesity compared to 45.6% of Latino adults, 41.4% of white adults, and just 16.1% of Asian adults. Similarly, 57.9% of Black women had obesity compared to 45.7% of Latina women, 39.6% of white women, and 14.5% of Asian women.

TFAH also found that 22 states had an adult obesity rate at or above 35%, up from 19 states in 2022. According to TFAH, no state had an adult obesity rate over 35% over a decade ago.

The report found that West Virginia had the highest obesity rate at 41% followed by Louisiana at 40.1%, Oklahoma at 40%, and Mississippi at 39.5%. Meanwhile, the District of Columbia was found to have the lowest obesity rate at 24.3% followed by Colorado at 25% and Hawaii at 25.9%.

Obesity rates are also increasing among children and adolescents, as nearly 20% of U.S. children ages 2 to 19 have obesity. These obesity rates have more than tripled since the mid-1970s, according to TFAH, and Black and Latino youth have significantly higher obesity rates than their white and Asian peers.

It’s critical to recognize that obesity is a multifactored disease involving much more than individual behavior," said J. Nadine Gracia, president and CEO of TFAH. "In order to stem the decades long trend of increasing obesity rates we have to acknowledge that the obesity crisis is rooted in economic, health, and environmental inequities. Ensuring all people and communities have equitable opportunity and access to healthy food and physical activity is fundamental to addressing this crisis."

More providers get certified in obesity medicine

As obesity rates have continued to climb throughout the United States in recent years, more physicians, including pediatricians, endocrinologists, and gastroenterologists, have started pursuing certifications in obesity medicine.

According to the American Board of Obesity Medicine, almost 1,900 physicians applied to take the annual obesity specialty exam in October of this year, compared to 1,250 in 2022 and less than 900 in 2019.

The board has also noted that around 6,700 physicians in the United States and Canada are board-certified in obesity medicine, more than triple the number in 2017.

"I think [physicians] hear from their patients that this is something they want to … address," said Kimberly Gudzune, medical director at the American Board of Obesity Medicine and associate professor at Johns Hopkins Medicine. "We need more physicians who feel confident in what they're doing [and] understand the evidence-based best practices when treating obesity."

In the past, obesity had been considered a result of poor lifestyle choices and a lack of willpower. But now, more providers are considering the role hormones, brain chemicals, mechanisms of the digestive tract, and other factors play, Gudzune said, which is one of the drivers behind the increase in certifications.

"I think back to when I first started practicing obesity medicine … [and] it was something where a lot of other physicians didn't know that the field existed," Gudzune said.

In recent years, there has also been an increase in the number of obesity medicines available, including Wegovy and Ozempic, two semaglutide injections used to treat Type 2 diabetes that have shown weight management benefits.

"We had medications that could help us achieve about 5% weight loss in our patients, at most 10%, with a single medication," said Katherine Saunders, clinical assistant professor of medicine at Weill Cornell Medicine and co-founder of Intellihealth. "In the last few years, we now have highly effective medications both that are in the market now and in the pipeline."

However, one of the biggest barriers to these newer medications is their cost. Ozempic is listed at a monthly price of $936 while Wegovy is priced at $1,349 per month.

These costs have led some health plans to not cover the medications, according to Angela Fitch, assistant professor of medicine at Harvard University and president of the Obesity Medicine Association.

But some providers, including Fitch, believe obesity treatments should be a standard benefit and that the high-cost medications shouldn't be as widely prescribed.

"People have been treating obesity for a long time in the United States. It just hasn't been as trendy," Fitch said. "We have older medications, we have other pathways, we have behavioral interventions, other nutritional interventions, etc., so we have to think about it as getting patients with obesity to doctors, not getting patients with obesity to medication." (Trust for America's Health press release, 9/21; Hudson, Modern Healthcare, 10/2)


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