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.
Where does your city rank?
10. Knoxville, Tenn.1 of 11
Most of the cities on this list fall in the southern part of the country and Knoxville, Tenn., is no exception. It's one of the largest cities in the Appalachian region and the third largest in the state of Tennessee.
According to one of the study's experts, Dana Hunnes, Senior Dietitian at the Ronald Reagan Medical Center and Adjunct Assistant Professor at UCLA's Fielding School of Public Health, one of the main indicators in evaluating an unhealthy population is cultural norms.
"In the Deep South for example, it is more culturally accepted to be overweight or obese," she says. "Not only that, but dietary quality is typically lower in the south, where many foods are deep-fat fried, highly salted or sugar-sweetened."
9. Winston-Salem, N.C.2 of 11
This City of Arts & Innovation has some work to do in the getting-fit department—of all 100 cities evaluated, it ranks fourth for the highest percentage of adults with high cholesterol.
High cholesterol is a serious condition and can lead to clogged arties, blood clots, heart attacks and even strokes. It's often associated with being overweight, inactive and consuming too much saturated and trans fat.
8. Lafayette, La.3 of 11
Another southern city claims the eighth spot on this list. Lafayette scored especially low in the "healthy environment" category, meaning the city's residents have less access to healthy food stores, parks and recreational facilities and are overall less active compared to other cities.
Simone A. French, Professor of the Division of Epidemiology & Community Health in the School of Public Health at the University of Minnesota, says environments like these are by no means uncommon in the United States.
"It may help people to realize that our society and food environment and marketing does not support maintaining a healthy weight," she says. "A person has to swim against the current to be able to achieve a healthy lifestyle for food and physical activity."
7. Mobile, Ala.4 of 11
Mobile, the third most populous city in the state of Alabama, is also home to the highest percentage of adults with high blood pressure in the country, landing it in the seventh slot on this list.
High blood pressure, or hypertension, occurs when the force of the blood flowing through the body's blood vessels is consistently too high, potentially leading to health problems like vision loss, heart attack, stroke, kidney disease and sexual dysfunction. About one out of three adults over the age of 20 suffers from high blood pressure; that's 85 million Americans.
6. Chattanooga, Tenn.5 of 11
Tennessee lands itself on this list for the second time with Chattanooga, which ranks especially low in the "weight-related health problems" category.
Chattanooga currently has the highest percentage of overweight adults in the country and, like Mobile, has a disproportionate amount of residents with high blood pressure.
French advocates that a healthy diet is the key to reversing these health problems, specifically through the consumption of whole foods. She puts it simply: "Don't eat anything your great-grandmother would not recognize as food."
5. Shreveport, La.6 of 11
Shreveport, La., checks a number of boxes in this study—of all 100 cities surveyed, it has the third highest percentage of obese residents, plus the second highest percentage of adults with high cholesterol and with high blood pressure.
When residents are facing a number of alarming health conditions, some experts advocate change on a grander scale, specifically through government intervention or adjustments in the workplace.
According to Jennifer D. Roberts, Director of Public Health Outcomes and Effects of the Built Environment Laboratory at the University of Maryland, "Since one of the indirect costs of obesity is related to productivity loss in the labor market, employers can play a role by providing employer-sponsored wellness and health improvement programs like weight management classes, nutrition classes, physical activity classes and active living offices."
4. McAllen, Texas7 of 11
McAllen, located at the southern tip of Texas in the Rio Grande Valley, came in at number four on this list for one daunting reason—the city currently has the highest percentage of obese adults in the nation.
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 is an especially serious health concern because it is associated with a lower quality of life and the leading causes of death in the U.S., including diabetes, heart disease, stroke and cancer.
3. Little Rock, Ark.8 of 11
The capital of Arkansas comes in third on the list, mostly due to a high ranking in weight-related health problems and the prevalence of overweight or obese residents.
Little Rock also scored poorly in one interesting category. Of all 100 cities surveyed, it has the highest percentage of adults eating fewer than one serving of fruits and vegetables per day.
According to Hunnes, a healthy diet is even more important than exercise because it's all too easy to eat more calories than you burn—30 minutes of jogging can be erased by five minutes of dessert. "The best thing to do is consistently eat a mostly plant-based diet that is rich in whole grains, fruits, vegetables, nuts, seeds legumes and pulses."
2. Memphis, Tenn.9 of 11
Tennessee, just barely missing the top spot, places for a third time on this list with its largest city.
Memphis, home to around 650,000 residents, has the third highest percentage of adults with high blood pressure, the fourth highest percentage of diabetic adults and the second highest percentage of obese adults in the nation.
1. Jackson, Miss.10 of 11
Jackson, Miss., took the No. 1 spot on this list due to its combination of overweight residents and the prevalence of weight-related health problems in the population.
The city has one of the highest percentages of adults eating fewer than one serving of fruits and vegetables per day, a high percentage of adults with high blood pressure, a high percentage of physically inactive adults—and it has the single highest percentage of diabetic adults in the nation.