For the fifth consecutive year, West Virginia has been identified as the most obese state in America, according to a recent analysis.

The report, which evaluates all 50 states alongside Washington, D.C., placed the Mountain State at the forefront of obesity statistics, revealing that 73 percent of its adult population is either overweight or obese.

West Virginia also leads in childhood obesity rates, specifically among those aged 10 to 17. Compounding this issue, the state ranks poorly in terms of access to nutritious food, with just 41 percent of its residents living near a store offering healthy food options.

The analysis highlights a troubling trend in the southern United States, with nine out of the ten states with the highest obesity rates situated in this region, an area historically afflicted by obesity-related health challenges such as diabetes.

Following West Virginia, Mississippi and Arkansas claim the second and third spots, with up to 71.5 percent of their adult populations classified as overweight or obese. Louisiana and Alabama complete the top five in this ranking.

Interestingly, Delaware is the only state outside the South to appear in the top 10. The state is home to one of the country’s largest senior populations, a demographic generally characterized by lower physical activity levels than younger 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 above graph, based on estimates from pollster Gallup, suggests that obesity rates in the US are now starting to decline after peaking at 39.9 percent in 2022

A separate report published in October showed that the proportion of America’s states with very high levels of obesity had now started to fall

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.

Researchers have previously suggested that the decline may be down to weight loss drugs, which can help people to lose weight with little more than a weekly injection (Stock image)

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.’