In today’s health landscape, many countries are facing struggles with the levels of overweight people, obesity, and diabetes. This has been an ongoing concern in the United States, where lifestyles, diets, and socioeconomic factors fuel these health issues.
Each US state faces unique challenges in tackling obesity and the impact of diabetes and physical inactivity. But the issue can also be seen globally, with countries around the world facing the same widespread health struggles.
While prescription drugs can help mitigate the effects of obesity and diabetes, the medical expenses attached to the conditions can reach thousands of dollars a year. We will reveal how these costs differ in the most populous US states.
The top US states and territories facing obesity
1. Tennessee | Obesity score: 8.58/10
Tennessee is most affected by obesity out of all states and territories in the US. Almost two in five (38.9%) adult residents in the country music capital state are obese, and over a third (36.6%) are classified as overweight using the BMI scale. Just over a fifth (20.9%) of children aged 10-17 are obese, and almost one in five (18.3%) are overweight.
One-eighth (12.2%) of the state’s adult population has diabetes, and less than half (52.5%) are physically active, achieving over 150 minutes a week of moderate activity or 75 minutes of vigorous activity. For children, just over a fifth (21.6%) of students in grades nine to twelve are physically active.
2. Puerto Rico | Obesity score: 8.02/10
The US territory of Puerto Rico comes in second place as one of the locations most affected by obesity. The tropical island is home to an adult obesity rate of 34.1%, and over a third (36.4%) of the population is overweight. Of all children aged 10-17, around one in six (15.6%) are overweight.
Almost one in six (14.4%) adults on the island are diagnosed with diabetes, and just under a third (30.5%) are physically active. Just one in six (15.3%) children in grades nine to twelve are physically active.
3. Kentucky | Obesity score: 7.78/10
Kentucky completes the top three US states and territories most affected by obesity. Almost two in five (37.7%) adult residents are obese and just under a third (31.9%) are overweight, according to the BMI scale. Regarding the state’s child population, almost a quarter (24.0%) of children aged 10-17 are obese, while over one in six (17.8%) are overweight.
Over one in ten (12.3%) adult residents of Kentucky have diabetes, and just over a third (36.3%) are physically active. The physical activity rate for students in grades nine to twelve is lower at 19.0%.
How much does obesity cost in the US?
California
California is the most expensive state for those living with obesity. Living in California could mean expenses of around $5,812 per year if you are classified as obese on the BMI scale. For those living with class 1 obesity, with a BMI of 30 to <35, the costs are around $4,363. For people with class 2 obesity, with a BMI of 35 to <40, medical expenses are estimated at $7,508 per year. Residents with class 3 obesity, indicating a BMI of 40 or above, could spend around $17,648 annually on medical expenses.
New York
Those living with obesity in New York spend more on medical expenses on average than residents of Texas and Florida. The average cost of medical expenses related to obesity is $4,952 per year. For those with class 1 obesity, indicating a BMI of 30 to <35, medical costs can amount to $4,372 a year. For class 2 obesity, the figure is around $5,355. For New York residents living with class 3 obesity, with a BMI of 40 and higher, the average medical spend a year can reach around $7,306.
Florida
Out of the four most populated US states, Florida is the third most expensive state to live with obesity. On average, the cost of medical expenses for obesity is around $3,733 a year. For class 1 obesity, medical costs can be an estimated $3,543 per year, and for class 2 obesity, that figure is around $3,841. For those affected by class 3 obesity, with a BMI of 40 and above, medical costs are around $4,399 per year.
Texas
Texas is the cheapest state out of the four most populous US states for residents living with obesity. Medical expenses are, on average, $3,673 per year. For those with class 1 obesity, with a BMI of 30 to <35, medical costs can amount to around $3,045 annually, and for class 2 obesity, costs are estimated at $4,013. For those with the most severe class of obesity, class 3, medical expenses can reach $6,321 per year.
The top countries facing obesity
1. Nauru | Obesity score: 9.21/10
One of the smallest islands in the world, Nauru, is the country most affected by obesity. The adult obesity rate on the Micronesian island is over half (59.85%), while almost nine in ten (88.5%) are classed as obese according to the BMI scale. Under half (42.0%) of all adults are physically inactive throughout the week. For children aged 11-17, almost nine in ten (87.0%) are physically inactive, reporting fewer than 60 minutes of exercise per day. The adult diabetes rate in the country is just under a quarter (23.4%).
2. Kuwait | Obesity score: 8.82/10
Kuwait is one of the countries most affected by obesity, ranking second on our list. The Middle Eastern state has an adult obesity rate of over a third (34.28%), while almost three-quarters (73.4%) of the population is considered overweight. Over two-thirds (68.0%) of adults are physically inactive throughout the week. For children aged 11-17, this rate is 84.5%. Over a fifth (24.9%) of the adult population has diabetes.
3. Kiribati | Obesity score: 8.19/10
Kiribati is the second Micronesian island to rank in our top three countries most affected by obesity. Over two-fifths (42.87%) of the adult population is obese, and over three-quarters, (78.7%) are considered overweight by BMI classifications. Four in ten (40.5%) adults are physically inactive. Over 4 out of 5 (82.5%) children who live in Kiribati are physically inactive, reporting fewer than 60 minutes of exercise per day. Over a fifth (22.1%) of the Kiribati adult population is affected by diabetes.
Methodology
We wanted to reveal the US states and territories most affected by obesity, so we compiled a list of states and territories. We used a per cent rank system to give each state/ territory a normalized score out of ten for each factor. We then took the average score for each location across all factors, forming our ranking.
We sourced the obesity rate in 2022 from the Centers for Disease Control and Prevention, looking at the prevalence of obesity based on self-reported weight and height among U.S. adults by state and territory.
We sourced the overweight rate in 2021 from the Centers for Disease Control and Prevention, looking at the percentage of adults aged 18 years and older with an overweight classification. For Florida, data was unavailable for 2021; therefore, we used data from 2020.
We sourced the childhood obesity rate in 2021-22 from the State of Childhood Obesity, looking at children aged 10-17.
We sourced the childhood overweight rate in 2019 from the Centers for Disease Control and Prevention, looking at the percentage of students in grades 9-12 with an overweight classification. We used the most recently available data for Delaware, Indiana, and Wyoming.
We sourced the diabetes rate in 2021 from the Centers for Disease Control and Prevention, looking at adults aged 18+ with diagnosed diabetes. For Florida, data was unavailable for 2021; therefore, we used data from 2020.
We sourced the physical activity rate for adults in 2019 from the Centers for Disease Control and Prevention, looking at the percentage of adults who achieve at least 150 minutes a week of moderate-intensity aerobic physical activity or 75 minutes a week of vigorous-intensity aerobic activity (or an equivalent combination).
We sourced the physical activity for children in 2019 from the Centers for Disease Control and Prevention. We looked at the percentage of students in grades 9-12 who achieve 1 hour or more of moderate or vigorous-intensity physical activity daily. We used the most recently available data for Delaware, Indiana, and Wyoming.
We also looked at the medical costs related to obesity in the four most populated states sourced from the National Library of Medicine, looking at Table 2.
We also wanted to reveal the countries most affected by obesity, so we looked at all countries with the relevant information available. Any countries for which we could not source the relevant data were removed from our list. We used a percent rank system to give each country a normalized score out of ten for each of the following factors. We then took the average score for each location across all factors, forming our ranking.
We sourced the adult obesity rate for the most recent available year using World Obesity.
We sourced the adult overweight rate for the most recent available year using the World Bank.
We sourced the adult physical inactivity rate in 2022 using the World Health Organization, looking at adults who report fewer than 150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous-intensity aerobic exercise weekly.
We sourced the childhood physical inactivity rate in 2022 using the World Health Organization, looking at children reporting fewer than 60 minutes of exercise daily.
We sourced the adult diabetes rate in 2021 using the World Bank, looking at the percentage of the population with diagnosed diabetes aged 20-79.
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