REVEALED: Fattest states in America ranked… including region where three-quarters of residents are obese

West Virginia has been named the most obese state in the US for the fifth year in a row, according to an analysis.

In a report ranking all 50 states and Washington, DC, the Mountain State took the top spot, with 73 percent of adults considered either overweight or obese.

It also ranked number one for obesity rates among children between the ages of 10 and 17, and landed among the top 10 worst states for access to healthy food, with only 41 percent of residents living near a healthy food retailer.

Overall, nine of the 10 fattest US states were in the South, an area long plagued by obesity and chronic conditions like diabetes.

Mississippi and Arkansas came in second and third place, respectively, with up to 71.5 percent of adult residents classified as overweight or obese. Louisiana and Alabama rounded out the top five. 

Delaware was the only state in the top 10 that was not in the South. The state has one of the largest senior populations in the nation, which tends to be less active than younger age groups. 

Experts at personal finance website WalletHub revealed the rankings for this year based on an analysis of CDC data and other official figures.

It marked the fifth consecutive year – and sixth year in total – that West Virginia landed at the top of the ranking since the report was first published in 2015.

Though, WalletHub experts said their methodology changes annually, and this year’s data is not exactly comparable to that of any previous year. 

In addition to limited access to healthy foods and high levels of sugary drink consumption, the state also has lower levels of physical activity and the second-lowest number of gyms and fitness centers nationwide, the researchers said.

West Virginia has the second lowest average salary in the US, at $55,900 per year. And the study found that lower salaries are linked to worse diets.

It does, however, have the fourth highest rate in the nation for prescriptions of Ozempic and other GLP-1 drugs, according to a 2024 report from Real Chemistry, in a sign that its obesity rates may soon start to fall.

For WalletHub’s report, the researchers ranked states based on three categories: overweight and obesity rates, health consequences (such as the proportion of adults with weight-related complications like type 2 diabetes, high cholesterol and heart disease), and food and fitness (the number of fast food restaurants per area and the proportion of adults consuming sugar-sweetened beverages or at least one fruit or vegetable per day).

To come up with the rankings, they analyzed official data on 31 factors – including the share of adults with obesity and high cholesterol, and the state’s projected obesity rate in 2030.

The team did not calculate an overall obesity rate for the US, although recent statistics have suggested that, amid the advent of weight loss drugs, this has started to drop.

A survey by Gallup released last week suggested that 37 percent of adults in the US are now considered to be obese, down from 37.4 percent last year and the peak of 39.9 percent in 2022. Gallup did not break down its data by state.

Another report from Trust for America’s Health, a nonprofit focused on health policy, also suggested that obesity rates have declined. It found the number of states with an obesity rate above 35 percent fell to 19 last year, compared to 23 the year before.

The Trust for America’s Health report also found West Virginia was among the 16 states to record a drop in the proportion of adults considered to be obese by at least five percent over the one-year period.

Figures from the CDC published in 2024 also suggest that America’s obesity rate is falling.

In its latest report, the agency found that, between 2021 and 2023, a total of 40.3 percent of US adults were obese, a drop from the 41.9 percent over the previous three-year period.

Researchers have repeatedly suggested that weight loss drugs such as Ozempic are behind the downturn.

According to estimates, at least one in eight Americans use these drugs, which help someone lose weight with little more than a weekly injection.

A report from nonprofit Fair Health suggests that about 5 million adults in the US were taking the drugs in May this year.

At the other end of the scale, the WalletHub report found that the state with the lowest obesity rate was Colorado, where 11.6 percent of adults are considered obese.

Reports have previously suggested that this is linked to the state’s culture, which is said to promote outdoor activities, boosting health and fitness.

Colorado is also home to the nation’s least-fat city, Boulder, where only 12 percent of residents are obese – nearly four times lower than the national average.

YouTuber Will Tennyson spoke with locals in Boulder late last year and found many felt a stronger social pressure to stay healthy than those in other cities.

Rounding out the bottom five for the fattest cities list were Utah, Massachusetts, California and Hawaii, generally wealthier states with increased access to fresh produce and gyms.

‘While losing weight largely hinges on whether an individual chooses to eat healthy foods, limit their calorie intake and exercise consistently, certain states make shedding the pounds easier than others,’ said Chip Lupo, a WalletHub analyst behind the report.

‘For example, some states are much better at regulating school lunches to make sure they are healthy, and have more opportunities for adults to buy fresh, nutritious ingredients.

‘In addition, while anyone can exercise at home, some states provide far more locations for people to go to work out or play sports.’