By any standard, obesity in the United States is a huge problem. Though we are not the fattest country in the world, we are the fattest country that is also a high income country—the twelfth richest in the world, actually! About 70 percent of American adults are overweight, and 40 percent of Americans are obese, up from 30 percent in 2000.

Experts predict that that figure will rise to 50 percent by 2030 unless drastic action is taken in the meantime. Even 20 percent of American adolescents are overweight, as are 18 percent of our 6-11 year-olds and almost 14 percent of our 2-5 year-olds.

In another alarming statistic illustrating the depth of the problem, the average woman today weighs about the same as the average man did in 1960 (168 pounds), and the average man weighs about 30 pounds more than his 60's counterpart.

Obese patients spend more on healthcare, live shorter lives, and miss more work, adding up to a devastating effect on our overall economy as well as on individual lives. About a tenth of premature deaths (those occurring before age 64) can be traced to weight-related health conditions, and about one in five health care dollars end up going towards the treatment of such conditions, costing our country an estimated $480.7 billion yearly.

Combined with an estimated $1.24 trillion in loss to productivity due to obesity and related conditions, that equals a $1.7 trillion loss overall, nearly ten percent of our nation's entire gross domestic product! Worse, these costs will likely raise by billions more if experts' dreary predictions come to pass.

While physiological factors like epigenetic changes, shifting gut bacteria, and rising inflammation and hunger hormones may have helped the obesity epidemic take hold, it's likely that our poor diets spurred these changes in the first place.

Processed food companies put much effort and money behind their goal of getting us to eat and purchase as much food as possible and even used lobbying to get the federal government in on their schemes. They pushed food full of artificial and addictive ingredients at oversized portions, and, over time, our health and waistlines paid a higher and higher price.

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Obesity is even rising despite the fact that more Americans than ever report dieting and despite the existence of a booming 72 billion dollar weight loss industry. Instead of embracing whole foods and a truly healthy lifestyle, many Americans suffer through cycles of crash diets and weight regain, feeling less motivated after every futile round.

Some of the blame might also be reasonably placed on our high-powered, high-stress, and overly individualistic culture, one in which skipping out on sleep or spending hours at a time at your desk is more socially acceptable than letting your productivity falter and which practically invites harmful coping mechanisms like overindulgence in alcohol and food. Evidence includes the fact that some of the more laid-back states, like Hawaii, are also some of the least obese. Yet there are some parts of the United States where obesity is even worse. Using not just adult obesity rates but a combination of relevant metrics like sugary beverage consumption, obesity-related healthcare costs, heart disease rates, and child obesity rates, finance website Wallethub calculated which among our 50 states are the "fattest," listed below.

Fattest States

1. Mississippi

2. West Virginia

3. Kentucky

4. Tennessee

5. Alabama

6. Oklahoma

7. Louisiana

8. Arkansas

9. Delaware

10. Ohio

11. Michigan

12. Maine

13. South Carolina

14. Iowa

15. Kansas

16. Texas

17. North Carolina

18. Maryland

19. Georgia

20. Rhode Island

More obese states have predictably higher rates of health problems like type 2 diabetes and heart disease, and tend to fare worse on other important health metrics; for example, people in southern states are more sedentary, smoke more, and have a lower life expectancy.

Over thirty percent of adults in Louisiana have high cholesterol, while over fifteen percent of West Virginian adults suffer from diabetes and almost forty percent have high blood pressure. Many of these states also bear the brunt of the projected obesity increase. For example, some researchers estimate that the obese population of Mississippi may soon constitute as as much two thirds of the state's total.

As you can see, quite a few of these states are southern ones, which may be due to cultural and culinary factors (fried chicken and sweet potato pie, anyone?). Yet the situation is also a lot more complicated than a dietary preference for gravy and southern fried steak.

So, then, what factors do go into making the south such a hotbed for obesity? Likewise, what, more generally, separates those who fall prey to the obesity epidemic and those who escape it across the grand old US of A?

For one thing, people in more obese states tend to have lower incomes. Frying, after all, rose to prominence largely because it was an inexpensive way to make supbar cheap food tastier, more filling, and more calorie-dense, a move that backfired when too much food became a bigger problem than too little of it.

On a not entirely unrelated note, given the persistent disparity in income between Caucasians and racial minorities in the US, many of the fattest states are those with the highest percentage of African American residents.

Nationwide, Hispanic people have an obesity rate eleven percent higher (25 percent) than Caucasians (14 percent) do, and African-Americans (22 percent) suffer from twice as much obesity as Asians (11 percent).

While the rich can mitigate the effects of a toxic food culture by indulging in luxuries like personal trainers, expensive diet programs, and hired childcare (leaving them more time for health and fitness), it may take all of a poorer families' resources to make ends meet and all their mental strength just to get through another day.

Unfortunately, these income effects extend to childhood obesity, with nineteen percent of children in the lowest income group being in the obese category as compared to eleven percent of the highest one.

Since those who have a lower income also tend to have less education, they also may lack an understanding of what constitutes a healthy diet and how bad obesity may be for their health.

More obese areas also tend to be more rural, have less farmer's markets and grocery stores, have less public transportation (even walking to a train station is walking, after all), and have fewer and harder to use sidewalks.

These areas also tend to have less doctors and mental health professionals, meaning that obese patients may receive less nutrition and health guidance from their physicians and that underlying mental illnesses like depression or addictive tendencies that can contribute to obesity may not be appropriately dealt with.

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Predictably, the 10 "fittest" states, which Wallethub also calculated, have some of the lowest heart disease rates and lowest healthcare costs. Interestingly enough, Utah and Colorado top the list!

Both states have favorable and temperate climates, cultures that place an emphasis on health, and easily accessible bike and hiking trails. It may even be a factor that both places are at a higher altitude, since some research indicates that people living higher above sea level expend more energy.

Yet even Utah's obesity rate is still a healthily unhealthy 23.5 percent (with a youth obesity rate of 8.7 percent). In fact, even in all but two of even the "fit" states (Hawaii and Colorado), close to one in four adults are obese. When it comes to the ravages of a poor American diet, it seems like no state gets off entirely scot-free.

Of course, the current dismal state of obesity in the USA doesn't mean all is lost, but it does mean that we probably have to make some big changes if we don't want to get even bigger. Country-wide policy changes, such as stricter regulations for junk food peddlers, more practical and affordable obesity prevention programs, and more support for anti-obesity school programs could all pave the way for a fitter American future.

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