WalletHub put together a panel of experts to analyze which U.S. cities are struggling the most with this complex health issue. Pulling data from sources like the CDC and the U.S. Department of Agriculture's Economic Research Service, WalletHub evaluated 100 of the most populated U.S. metro areas across numerous metrics, such as prevalence of overweight or obese residents, access to health facilities and healthy food and number of weight-related health issues. You can read the full report and an explanation of the methodology here.
How does your city rank?
10. Lexington-Fayette, Ky.1 of 11
The second largest city in Kentucky may be famous for its horse farms and thoroughbred racetracks, but it's also noteworthy in a less positive way: The city ranks second for the highest percentage of adults with high cholesterol, likely due to the prevalence of obesity within the city.
Obesity is a medical term used to classify individuals with a body mass index of 30 or higher, which usually means the individual is about 20 percent or more above a healthy weight. Obesity has been associated with many serious health outcomes, such as poor mental health, reduced quality of life and the leading causes of death in the U.S., including diabetes, heart disease, stroke and some types of cancer.
9. Baton Rouge, La.2 of 11
The Creole cuisine may be delicious, and the sugary treats like beignets and pralines are tempting, but the residents of Baton Rouge need to add a few more fruits and veggies to their diets: They rank third in the nation for highest percentage of adults with low fruit and vegetable consumption.
Amy Bidwell, Assistant Professor, Undergraduate Advisement Coordinator and Nutrition Minor Coordinator in the Department of Health Promotion and Wellness at the State University of New York at Oswego, believes the state or federal government may have a role to play in helping residents increase their consumption of healthier foods like produce. "The first thing they need to do is subsidize health foods instead of cheap, processed foods," she says. "Someone should not be able to eat cheaper by buying processed, refined foods with no added nutritional value. The government must make obesity a priority and increase access to healthy foods (not just low-calorie) across the nation, especially in urban areas where they suffer from food deserts."
8. Birmingham-Hoover, Ala.3 of 11
Alabama makes its first (but not last) appearance on the list with the metro area of Birmingham-Hoover. Located in the heart of Tornado Alley, "The Magic City" ranks poorly in the "Food & Fitness" category, which measures factors such as access to health foods, percentage of physically active adults, access to parks and recreational facilities and fruit and vegetable consumption.
With so many adults in Birmingham-Hoover and other cities around the U.S. trying to lose weight to improve their health, common dieting pitfalls abound. "One of the biggest mistakes I see people make is embarking on a diet or physical activity plan that is not sustainable," says Ellen E. Fitzsimmons-Craft, Instructor of Psychiatry in the Weight Management and Eating Disorders Program at Washington University School of Medicine. "In order to make lifestyle changes sustainable, it's important to make the healthy choice the easy choice, which really requires re-engineering all areas of the individual's life—their home environment, friendship network, school or work setting and use of community resources."
7. Jackson, Miss.4 of 11
Jackson, Mississippi, improves on its ranking this year, falling from the top spot on 2017's list all the way to number seven. While the city has bettered its overall ranking, there's still room for improvement: Jackson has a high percentage of adults with high blood pressure, a high percentage of residents eating less than one serving of fruits and vegetables a day and the city also ranks poorly in the "Food & Fitness" category.
6. Knoxville, Tenn.5 of 11
One of the largest cities in the Appalachian region, Knoxville is home to the University of Tennessee Volunteers—an athletic powerhouse whose football team has produced legendary players like Reggie White, Doug Atkins and Peyton Manning. But despite being home to these Hall of Fame athletes, Knoxville struggles with a high percentage of overweight or obese residents, including children, teens and adults.
While it's not always easy to make the lifestyle changes necessary to reduce your weight and improve your health, Ruth Henry, Professor of Kinesiology and Vice Chair of the Department of Nutrition and Kinesiology at Lipscomb University, gives this piece of advice to set you up for success: "Often, people try to make too many changes at once. Small changes that can be maintained for a lifetime are the ones that will make the biggest difference in your health. When people try to take giant steps, the whole process can be overwhelming and many times, they end up just quitting."
5. Mobile, Ala.6 of 11
Most of the cities on this list fall in the southern section of the country and Mobile, Alabama, is no exception. The third largest city in the state, Mobile has the highest percentage of adults with high blood pressure of all the cities surveyed. The city fairs poorly in the "Health Consequences" area as well, which means a large percentage of the population struggles with weight-related health concerns such as diabetes, high blood pressure, high cholesterol and heart disease.
4. Memphis, Tenn.7 of 11
Memphis may be famous for blues and barbecue, but the abundance of delicious southern comfort food may not be doing the city any favors: It ranks second in the nation for the highest percentage of obese adults.
As the obesity crisis continues to grow, experts like Kim O'Brien, Associate Professor of Psychology in the College of Humanities and Social and Behavioral Sciences at Central Michigan University, believe it's important to educate citizens of the harmful effects of carrying excess weight. "Obesity is said to account for one out of six deaths of adults in the U.S., and an increasing number outside," she says. "The health costs are enormous. The obesity epidemic is considered on par with smoking, but it's hard to think of eating a fast food value meal as having a cigarette."
3. McAllen-Edinburg-Mission, Texas8 of 11
They say everything's bigger in Texas, and for the metro area of McAllen-Edinburg-Mission that extends to the residents: The city has the number one highest percentage of obese adults in the nation. Also coming in second in the nation for highest percentage of diabetic adults, and first in the nation for highest percentage of inactive adults, the city is sure to feel the downstream effects of their overweight population.
According to one of the study's experts, Ryan C. Johnson, Assistant Professor of Psychology at Ohio University, obesity impacts both a city's economy and worker productivity as well. "The economic impact of obesity is likely linked to both reduced productivity and additional health care expenditures," he says. "For instance, if an obese employee is also managing a comorbid condition, such as Type 2 diabetes, they may utilize health care resources at a higher rate, resulting in increased costs for their employer. Simultaneously, managing their comorbid condition may make it more difficult for them to successfully meet the demands of their job."
2. Shreveport-Bossier City, La.9 of 11
Coming in second in 2018, Shreveport-Bossier is the metropolitan area in the center of the region known as the Ark-La-Tex. Separated by the Red River, the city of Shreveport and its sister city of Bossier check a number of boxes in this study: They have the third highest percentage of obese residents, the second highest percentage of adults with high cholesterol and the second highest percentage of adults with high blood pressure.
With the health of so many residents negatively impacted by weight-related conditions, some of the study's experts advocate for implementing policies on a state or federal level to help combat obesity.
According to Joe Mazzola, Associate Professor of Industrial and Organizational Psychology and Director of the Industrial and Organizational Psychology Master's Program at Roosevelt University, implementing policies around preventative care is a worthy investment. "One of the best things governments can do is support prevention efforts," he says. "Helping people pay for preventative care or a gym membership costs little compared to the medical costs associated with a heart attack or major injury or surgery. The continued efforts to get kids moving and to help them see the value of healthy eating and exercise is also important."
1. Little Rock-North Little Rock-Conway, Ark.10 of 11
The capital city of Arkansas takes the number one spot on this list due to a high percentage of its population with weight-related health concerns and a large share of physically inactive adults.
The city also scored poorly in the "Food & Fitness" category. And while the official state fruit and vegetable may be the "Pink Tomato," the residents of Little Rock don't seem to be eating very many of them: The city has the lowest fruit and vegetable consumption of all locations in the study.