America’s least obese cities are Boulder; Charlottesville, Va.; Bellingham Wash.; Fort Collins, Colo.; Naples, Fla.; Denver; San Francisco; San Lois Obisco; Madison, Wisc.; and Colorado Springs. Many of these cities have relatively high income levels. And apparently the outdoor life in Colorado allows people to burn calories.

McAllen-Edinburg-Mission, Texas; Beaumont-Port Arthur, Texas; Reading, Pa.; Huntington-Ashland, W.Va.; Mobile, Ala.; Myrtle Beach, S.C.; Toledo; Erie, Pa.; Charlestown, W.Va.; and Little Rock are the areas with the highest obesity rates. Living in the cities of the crumbling rust belt of the Midwest, near the Texas border with Mexico, and in the Old South draw, or produce, fat people. Also, residents of these cities tend to have lower incomes than the national average

According to a new poll by Gallup on obesity:

The metro areas with the 11 highest obesity rates in 2012 had an average obesity rate of 34.1%, while the metro areas with the 10 lowest obesity rates averaged 16.6%. Neither average differs substantially from the 2011 averages of 34.8% and 15.9%, respectively.

Nationwide, 26.2% of Americans aged 18 and older were obese in 2012, unchanged from 26.1% in 2011. Of the 189 reportable metro areas surveyed in 2012, 102 had obesity rates lower than the national average. Nineteen of the 25 most populous metro areas surveyed boasted obesity rates lower than the national average. Smaller metro areas were more likely to have above-average obesity rates, consistent with past reporting.

There are questions that health officials and the governments that pay for the effects of the diseases many obese people have need to ask. If obesity is local, how can the habits of McAllen-Edinburg-Mission be transferred from Boulder. They probably cannot be, although it would be an elegant solution to the problem.

Two solutions have been offered to bring down the weight of the typical obese American. In each case, the solutions could be applied to America’s “obese” cities, although either solution could be overturned in the courts. The first is that fat people pay higher insurance premiums because their health is more at risk and therefore a financial burden on the system. The other is that fat people pay higher taxes, the fruits of which can then be moved from the government to programs most likely to change behavior. Neither system has been proven to be effective, at least on a broad scale. But as the costs of obesity, and the heart disease and diabetes that go along with them, press well into the hundreds of billions of dollars a year, some solutions are needed.

Gallup offers its own partial solutions:

The complexity of decreasing obesity must be met with community and workforce leaders moving in tandem to promote the health of citizens and employees. By working together to educate and offer insights into healthier lifestyles, both companies and communities can benefit.

This assumes that education will make people eat less and exercise more. However, most people know that obesity likely will undermine their health, hurt their quality of living and make them candidates for early death. Those things have not worked. So, it is time to turn to real penalties.

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