If you haven’t heard it before we’re here to tell you again: Obesity is a massive problem in the United States. It destroys your body, and that’s not even taking into account the ways obesity increases your cancer risk.

The thing is, we know obesity is a problem. The ways we work, sleep, and eat all contribute, but we’re not doing anything to change them. We know some foods are hurting us, but we still eat them anyway. The trend is going in the wrong direction, and unfortunately, kids are packing on the extra pounds early in life.

The United Health Foundation’s 2017 America’s Health Rankings looks at several factors that contribute to poor health. Obesity is one of the biggest contributors to poor health, and it’s costing all of us. Obesity is a huge problem in the U.S., but these states didn’t get the memo. They are the fattest in the country and are contributing to a $315.8 billion epidemic. We’ll count down to the worst of all, then we’ll show you just how bad the problem is.

15. North Dakota

• Obese adults: 31.9%

Things are going from bad to worse in North Dakota. Between 1990 and 2003 there was a 100% increase in the rate of obesity to 24%. Now close to one-third of the adult population is obese. Close to 70% of the 755,393 people living there are adults, which boils down to more than 168,000 obese people.

Next: A state taking aim at childhood obesity.

14. Iowa (TIE)

• Obese adults: 32%

If there is a bright side to an obesity epidemic, Iowa might have found it. Despite a nearly 300% increase in obesity since 1990, Iowa’s rate has dropped slightly in recent years. The state is doing what it can to fight the problem. Obese children turn into obese adults, so Iowa is launching a program aimed at curbing childhood obesity.

Next: Now we go to the other side of the Missouri River.

13. Nebraska (TIE)

• Obese adults: 32%

Nebraska is like the rest of the country with its rising obesity rate. Unfortunately, it could be doing a lot more to stem the rate of childhood obesity. According to The State of Obesity report, Nebraska is one of just a handful of states that don’t require early childhood education centers to make water available to kids. It also doesn’t require any amount of recess or physical education to kids in school.

Next: A few problem areas don’t do this state any favors.

12. South Carolina

• Obese adults: 32.3%

When nearly one-third of adults in your state are considered obese, it’s hard to point fingers. Several counties in South Carolina have scary statistics, but one in particular wears the crown of shame. Lee County counts 44.3% of its residents as obese, but several others in the Palmetto State are above 40%.

Next: Those who should know better are the problem in our next state.

11. Indiana (TIE)

• Obese adults: 32.5%

Vice President Mike Pence was part of the winning ticket in the 2016 election, but the state he used to govern isn’t winning any health competitions. Blame the people who should know better for the weight problems in Indiana. Adults ages 45-64 have an obesity rate of 38.4%. That’s nearly 5% more than the second-highest demographic (ages 26-44) and well more than double the rate for 18 to 25-year olds.

Next: Indiana’s nearby neighbor is in equally bad shape

10. Michigan (TIE)

• Obese adults: 32.5%

The not-good-at-all news is the rate of adult obesity in Michigan. The worse news is kids have it even worse. The National Institute for Health Care Management found children and adolescents in Michigan have an obesity rate of 32.6%. That rate represents a twofold increase for kids and a quadrupling for adolescents. Is that why people don’t really want to live in Michigan anymore?

Next: Very shiny silver lining with this next state

9. Oklahoma

• Obese adults: 32.8%

It’s definitely not good for a state to count nearly one-third of the population as obese like Oklahoma does. But as recently as 2015, the numbers were a lot higher in the Sooner State. Back then, 33.9% of the population was obese, so the state is trending in the right direction. Oklahoma could be doing better with policies to help its youngest residents, but politicians in the state capital are doing their part to fight the obesity epidemic.

Next: The majority of adults in this state are overweight or obese.

8. Texas

• Obese adults: 33.6%

Just one of the 11 public health regions in Texas beats the national average in obesity rate. There was a slight dip in the rate of obese adults from 31.7% in 2010 to 30.9% in 2013, but the numbers are rising again. Things are even more alarming when you consider all overweight people. As much as 70% of the adult population is either overweight or obese.

Next: We’re going to hop around one region of the country for our next few entries on the list.

7. Kentucky

• Obese adults: 34.2%

Kentucky is not heading in the right direction with its obesity problem. In 2016, As recently as 2012, Kentucky counted 31.3% of adults as obese. Now that number is even higher, and it’s not hard to see why. A CDC report from that year found 29.7% of adults did no exercise at all over the course of a given week.

Next: Policy problems dog this next state.

6. Tennessee

• Obese adults: 34.8%

Tennessee enjoyed a dip in the rate of obesity in 2014, but the trend hasn’t continued. Now, close to 35% of adults are obese. The state is fighting the problem with a website devoted to tracking fitness and making healthy choices, but it doesn’t seem to be working. Part of the problem is at the policy level. Early childhood educators aren’t required to provide meals or snacks that meet national nutrition guidelines.

Next: A round of applause for our next state.

5. Louisiana

• Obese adults: 35.5%

Louisiana finds itself in the top 5, which is definitely not good. But when compared to recent history, it’s a big improvement. In 2015, Louisiana had 36.6% of adults classified as obese, which was the worst in the nation. So the fact that ‘only’ 35.5% are now obese is a step in the right direction. The state has room for improvement in its policies that can help fight the problem, but it is working on aggressive goals in its battle with childhood obesity.  

Next: The predicted number of heart disease cases in the next state is truly scary.

4. Alabama (TIE)

• Obese adults: 35.7%

Want to know the bad news about Alabama’s rate of obesity? It’s a slight rise from the 35.6% in 2015, so the state has been fighting obesity for a long time. More than 17% of the people are food insecure, meaning they don’t have adequate access to healthy foods. Another scary number? There are expected to be more than 1.4 million cases of heart disease in Alabama in 2030, a nearly 500% increase from 2010.

Next: Not a pretty picture

3. Arkansas (TIE)

• Obese adults: 35.7%

When your rate of obesity goes down and you’re still one of the worst states, you know there’s a problem. In 2014, 35.9% of adults were obese, so the current figure is an improvement but it’s still far from good. A statewide coalition is helping fight the battle of the bulge.

Next: Shocking numbers across the board in this state.

2. Mississippi

• Obese adults: 37.3%

The United Health Foundation rankings look only at adult obesity, and Mississippi’s current rate is up from 35.5% in 2015. That’s not good, and it’s even worse if you look deeper. First, close to 43% of adults ages 26-64 are obese. Second, 21.5% of the people food insecure, the highest rate in the nation. Last, and most shocking of all, is that 25% of kids are food insecure with limited access to adequate healthy food. When people can’t get healthy food they have to eat processed foods, which are terribly unhealthy.

Next: The worst state of them all

1. West Virginia

• Obese adults: 37.7%

As recently as the year 2000, the adult obesity rate in West Virginia was about 24%. Not great, but nowhere near as bad as it is now. Being a rural state with income inequality and limited access to affordable, healthy food are problems for West Virginia. The state is fighting the good fight. Several policies are in place to help curb the growing problem.

Next: Why it all matters

America is fat and it’s a problem

You might have noticed Colorado wasn’t on this list. It can turn its nose up at the rest of the country since it’s obesity rate is the lowest, at 22.3%. Considering the national average is 29.9%, Coloradans can feel good about themselves, at least for a minute.

If Colorado was its own country, it would still be one of the worst for obesity. Of the 35 world power countries that are part of the Organisation for Economic Cooperation and Development, the United States is dead last with its rate of obesity in adults. Australia ranks No. 34 overall, at 21.3%.

All that extra fat isn’t doing us any favors. An article published by Lehigh University estimates the cost of obesity is $315 billion. The United Health Foundation estimates $315.8 billion. Either way, it’s a cost that is costing us all.

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