Gallup-Sharecare Well-Being Index

Obesity Rate Lowest in Hawaii, Highest in West Virginia

Written by Gallup | May 11, 2016


  • Hawaii and Colorado are the only two states with obesity rate below 20%
  • Obesity rate exceeds 30.0% in 18 states
  • Fourteen states have seen significant increases in obesity since 2008

WASHINGTON, D.C. -- At 18.5%, Hawaii has the lowest adult obesity rate in the U.S., closely followed by Colorado at 19.8%. They are the only two states in which the obesity rate is below 20%. West Virginia has the highest adult obesity rate, at 37.0%. In addition to West Virginia, at least one in three adults are obese in Mississippi, Delaware, Arkansas and Oklahoma.


These data, from daily interviews conducted January through December 2015 as part of the Gallup-Healthways Well-Being Index, are based on U.S. adults' self-reports of their height and weight, which are then used to calculate Body Mass Index (BMI) scores. Americans who have a BMI of 30 or higher are classified as obese.

The national obesity rate reached a new high of 28.0% in 2015, up significantly from 25.5% in 2008, when Gallup and Healthways began tracking obesity. Fourteen states had statistically significant increases in their obesity rates from 2008 to 2015, while no state registered a statistically significant decline. Maine, West Virginia, Idaho and Oklahoma experienced the sharpest upticks in obesity.


Obesity Remains Highest in the South, Lowest in the West

Of the 18 states with obesity rates of at least 30.0%, all but one are located in the South or Midwest. Meanwhile, all 11 states with obesity rates below 25.0% are located in the Northeast or West.

Since 2008, the obesity rate for the Midwest has increased by 3.2 percentage points, more than any other region. The South followed closely behind, with a 2.9-point increase. The Northeast and West have seen smaller, but still statistically significant, increases of 2.0 and 1.8 points, respectively.


As Obesity Rates Rise, So Do Healthcare Costs

Given that obesity is associated with illnesses such as heart disease, diabetes, stroke, osteoarthritis and some forms of cancer, the medical costs for an obese person amounted to $1,429 more per year than for a person of a normal weight, according to research conducted in 2008 by RTI International and the Centers for Disease Control and Prevention. After adjusting for inflation, the annual medical costs for 2015 are $1,573 more for a person who is obese than for a person of a normal weight.

Gallup calculated the incremental cost of healthcare per year for each state by multiplying the estimated number of obese people in the state's population by the annual incremental $1,573 cost of obesity per person.

In the five most obese states, the annual incremental cost of obesity per 100,000 residents averages $54 million. By contrast, the average cost is $34 million in the five least obese states. In other words, per capita medical costs attributable to obesity are about 1.6 times higher in the five states with the highest obesity rates than in the states with the five lowest rates. Additional annual medical costs attributable to obesity for each state appear at the end of the article.



As the adult obesity rate continues to rise both nationally and within many states, preventable healthcare costs will also rise. If states can lower their obesity rates, even modestly, they can achieve significant cost savings and improve their residents' well-being.

"There's no better time than now to comprehensively look at what drives people to make sustained changes in their lives, as the costs of obesity are staggering, both financially and personally," says Sean Slovenski, president, Population Health Services at Healthways. "We know from both science and experience that to be effective, the weight-loss journey needs to be personalized, easy to implement and supported."

But reducing obesity rates is no easy task. Gallup previously found that Americans are twice as likely to want to lose weight as to say they are seriously trying to do so. Most of the burden for reducing obesity falls on individuals and how motivated they are to consistently make healthier choices. This motivation is often difficult to find and maintain, but there are proven population health interventions that are effective in supporting sustained weight loss.

"We can reverse our nation's growing obesity epidemic," says Dan Buettner, National Geographic Fellow and founder of Blue Zones Project, a community well-being improvement initiative of Healthways and its community partners. "The key is creating an environment that makes the healthy choice not only easy but at times unavoidable -- so that people will eat less, eat better, move more and connect socially. Communities that have the courage to implement simple, evidence-based designs and policies that support lasting change, such as Los Angeles Beach cities, are seeing a measurable reduction in obesity and healthcare costs, and an increase in well-being."

In the long run, interventions designed to prevent and reduce obesity at both the individual and community levels can potentially lead to substantial cost savings for families, employers and states.

Survey Methods

Results are based on telephone interviews conducted Jan. 2-Dec. 30, 2015, as a part of the Gallup-Healthways Well-Being Index, with a random sample of 177,281 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia. For results based on the total sample of national adults, the margin of sampling error for the Well-Being Index score is ±0.1 point at the 95% confidence level. The margin of sampling error for most states is about ±0.6 points, although this increases to about ±1.6 points for the smallest population states such as North Dakota, Wyoming, Hawaii and Delaware. All reported margins of sampling error include computed design effects for weighting.

Each sample of national adults includes a minimum quota of 60% cellphone respondents and 40% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods.

Learn more about how the Gallup-Healthways Well-Being Index works.

States' Obesity Rates and Annual Incremental Healthcare Costs Attributable to Obesity
  Population(estimate)Obese%Annual healthcare cost, $per 100k adultsAnnual healthcare cost, $all adults
Alabama 3,605,323 31.3 49,226,788 1,774,784,825
Alaska 507,786 26.9 42,341,525 215,004,526
Arizona 4,997,570 25.2 39,607,728 1,979,424,088
Arkansas 2,215,461 33.5 52,743,928 1,168,521,191
California 28,976,914 23.9 37,568,175 10,886,097,470
Colorado 4,019,462 19.8 31,109,252 1,250,424,550
Connecticut 2,753,871 24.9 39,121,828 1,077,364,755
Delaware 697,965 33.8 53,223,481 371,481,197
Florida 15,310,183 26.5 41,640,933 6,375,302,924
Georgia 7,308,940 28.8 45,270,849 3,308,819,237
Hawaii 1,049,465 18.5 29,067,060 305,048,588
Idaho 1,143,436 29.7 46,672,559 533,670,743
Illinois 9,722,823 28.5 44,791,368 4,354,985,445
Indiana 4,787,573 30.8 48,507,743 2,322,343,645
Iowa 2,350,298 31.3 49,183,224 1,155,952,222
Kansas 2,122,250 29.4 46,246,165 981,459,412
Kentucky 3,388,106 31.4 49,371,304 1,672,751,984
Louisiana 3,401,841 30.9 48,678,881 1,655,978,248
Maine 1,059,901 31.5 49,616,061 525,881,043
Maryland 4,579,313 28.8 45,234,297 2,071,420,005
Massachusetts 5,144,065 23.6 37,087,771 1,907,818,922
Michigan 7,626,867 31.5 49,506,287 3,775,778,488
Minnesota 4,108,141 25.5 40,135,581 1,648,826,157
Mississippi 2,163,049 35.5 55,914,797 1,209,464,207
Missouri 4,599,839 29.9 47,037,567 2,163,652,388
Montana 761,679 24.1 37,963,384 289,159,074
Nebraska 1,382,728 30.8 48,440,906 669,805,974
Nevada 2,095,527 23.9 37,539,385 786,648,014
New Hampshire 1,047,071 24.3 38,252,914 400,535,242
New Jersey 6,783,035 24.7 38,811,280 2,632,582,873
New Mexico 1,596,641 23.7 37,245,304 594,673,741
New York 15,288,727 25.2 39,662,822 6,063,940,591
North Carolina 7,348,433 30.4 47,864,652 3,517,301,775
North Dakota 546,602 31.3 49,265,603 269,286,532
Ohio 8,845,679 31.6 49,668,724 4,393,535,766
Oklahoma 2,767,117 33.5 52,647,884 1,456,828,340
Oregon 3,092,890 27.1 42,567,733 1,316,573,044
Pennsylvania 10,088,111 29.2 45,922,440 4,632,706,653
Rhode Island 833,367 27.9 43,832,271 365,283,748
South Carolina 3,601,643 31.4 49,324,541 1,776,493,862
South Dakota 629,820 25.1 39,527,315 248,950,936
Tennessee 4,951,234 29.5 46,352,321 2,295,012,093
Texas 19,317,031 30.7 48,335,957 9,337,071,646
Utah 1,987,310 24.5 38,590,349 766,909,780
Vermont 496,733 27.5 43,201,649 214,596,826
Virginia 6,283,576 26.3 41,358,191 2,598,773,404
Washington 5,240,763 27.1 42,659,689 2,235,693,068
West Virginia 1,452,598 37.0 58,273,467 846,479,005
Wisconsin 4,288,406 27.4 43,094,391 1,848,062,566
Wyoming 440,048 25.8 40,556,297 178,467,077