Nineteen states had adult obesity rates at or above 35 percent

Nineteen states had adult obesity rates at or above 35 percent in 2024, down from 23 states in 2023 (Figures 1 and 2), a first time decrease in the number of states at or above the 35 percent level for this dataset. The findings were featured in the ‘State of Obesity 2025: Better Policies for a Healthier America’, released by Trust for America’s Health (TFAH), a non-partisan, non-profit organization focused on public health research and policy.

Figure 1: Adult Obesity Rate by State, 2024

The report, based in part on TFAH’s analysis of newly released 2024 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System  (BRFSS), and recent data from the 2021-2023 National Health and Nutrition Examination Survey (NHANES), shows that while the rise in the number of US adults with obesity slowed in some states, the overall obesity rate in the country continues to be alarmingly high. Nationally, four in ten American adults have obesity.

“Structural barriers to healthy eating and physical activity need continued policy attention and investment,” said Dr J Nadine Gracia, President and CEO of Trust for America’s Health. “It is vital that government and other sectors invest in – not cut – proven programmes that support good nutrition and physical activity and ensure they reach all communities.”

Key findings from the report include:

• The states with the highest rates of obesity among adults in 2024 were West Virginia (41.4%), Mississippi (40.4%), and Louisiana (39.2%) (2024 data from BRFSS).

• States with lowest levels of adult obesity in 2024 were Colorado (25.0%), Hawaii (27.0%), and Massachusetts (27.0%) plus Washington, D.C. (25.5%) (2024 data from BRFSS).

• Black and Latino adults had the highest rates of obesity at 49.9 percent and 45.6 percent respectively.

• People living in rural communities tend to have higher rates of obesity compared to people living in metro areas.

• Obesity levels are typically lower among people with college degrees and for people with higher household incomes, suggesting that the affordability of healthy foods plays a role in nation’s rates of people with obesity.

• Obesity rates are increasing among children and adolescents, with just over 21 percent of U.S. children and adolescents, ages 2 to 19, having obesity nationwide (2021–2023 NHANES).

• These rates have more than tripled since the mid-1970s, and Black and Latino youth have substantially higher rates of obesity compared to their Asian and white peers.

Figure 2: Percent Change in Adult Obesity Rate by State, 2019–2024

Obesity and other diet-related diseases are associated with a range of physical and mental health conditions, higher mortality, higher healthcare costs, and productivity losses. While obesity rates depend on many factors, economic and community context shape Americans’ daily life and available choices around healthy food, physical activity, education, jobs, stress, and financial security, which systematically affect people’s weight and health.

While obesity rates have increased for all population groups, groups with higher rates, including people who live in rural communities and some populations of colour, typically face more structural barriers to healthy eating, including food cost and access and a lack of opportunities and safe places to be physically active in their neighbourhoods.

The report includes a special feature on the emerging science and policy considerations concerning ultra-processed foods and their role in the obesity crisis, an issue that is gaining increased national attention and is a focus of the Make America Healthy Again effort. The report authors interviewed a Colorado school nutrition director who delves into the specific technical and funding challenges associated with limiting ultra-processed foods in school meals.

The report includes recommendations for policy action by the administration, Congress, and states to address the nation’s obesity crisis, including:

• Retain and strengthen the National Center for Chronic Disease Prevention and Health Promotion at CDC, which supports proven disease prevention activities in states and communities.

• Reverse cuts or proposed cuts to nutrition support programs while improving the nutritional quality of available foods, including the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).

• The Food and Drug Administration should implement a front-of-package nutrition label requirement to help consumers make informed choices.

• Ensure access to healthcare, including obesity prevention and treatment programs, by reversing cuts to Medicaid and marketplace subsidies.

• Address upstream drivers and root causes of health disparities and target obesity prevention programs to communities with the highest needs.

• Make physical activity more accessible by increasing evidence-based initiatives that support active transportation and physical activity in communities.

• Address industry marketing and pricing strategies to reduce advertising of unhealthy foods to children.

The report also highlights the federal programmes that seek to address rising rates of chronic diseases like obesity. However, the president’s fiscal year (FY) 2026 budget request proposes the near total elimination of the National Center for Chronic Disease Prevention and Health Promotion at CDC. The centre’s work includes cornerstone programmes that fund state, local, tribal, and territorial efforts to address and prevent obesity, diabetes, heart disease and stroke and other chronic diseases.

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