At Least 20% of US Adults Living With Obesity in Every State

Obesity prevalence in the United States “remains high,” according to newly released population data from the US Centers for Disease Control and Prevention (CDC).

The data, updated this week, showed the proportions of adults with a body mass index ≥ 30, based on self-reported weight and height in 2023 from the Behavioral Risk Factor Surveillance System (BRFSS).

All US states and territories had an obesity prevalence higher than 20%. Overall, the Midwest (36.0%) and South (34.7%) had the highest prevalence of obesity, followed by the West (29.1%) and the Northeast (28.6%).

Three states — Arkansas, Mississippi, and West Virginia — had an obesity prevalence ≥ 40%. In 20 states, Guam, and Puerto Rico, the obesity prevalence was between 35% and < 40%, and seven states had a prevalence between 25% and < 30%. In Washington, DC, and Colorado, the prevalence was between 20% and < 25%.

‘Notable Differences’

Combined BRFSS data from 2021 to 2023 showed notable differences in adult obesity prevalence by race and ethnicity, as well as education and age.

– Asian adults do not have an obesity prevalence at or above 35% in any state.

– In 16 states, White adults have an obesity prevalence at or above 35%.

– In 30 states, American Indian or Alaska Native adults have an obesity prevalence at or above 35%.

– In 34 states, Hispanic adults have an obesity prevalence at or above 35%.

– In 38 states, Black adults have an obesity prevalence at or above 35%.

Stratification by education level showed that obesity prevalence decreased as education level increased. Obesity was seen in 36.5% of adults without a high school diploma or equivalent; 34.7% of those with a high school diploma or equivalent; 35.7% of adults with some college education; and 27.1% of college graduates.

Young adults were half as likely to have obesity as middle-aged adults. Those aged 18-24 years had the lowest prevalence (19.5%) and those aged 45-54 years had the highest (39.2%).

“Many factors contribute to obesity, like genes, certain medications, poor sleep, gut microbiome, stress, access to affordable food, safe places to be active, and access to healthcare,” said Ruth Petersen, MD, director of CDC’s Division of Nutrition, Physical Activity, and Obesity. “Understanding these factors helps us identify potential prevention and treatment strategies.”

The CDC offers some obesity strategies to help address the issue on a population level and for individual providers and patients.

Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDedge, The Lancet (where she was a contributing editor), and Reuters Health.