Over the last 50 years, the adult obesity rate has more than doubled in the United States. Health officials declared obesity an epidemic in 1999, and recent studies estimate that the total health care costs for diseases and medical conditions associated with obesity range from $147 billion to $210 billion per year.

Though the national obesity rate continues to rise, the problem is less acute in some parts of the country. The share of obese adults ranges from 21.3% in Colorado to 35.1% in West Virginia and is more than four times as high in the most obese county than in the least. Obesity rates are highly associated with factors such as exercise and income, and vary accordingly. These disparities in obesity prevalence contribute to disparities in health outcomes such as diabetes, hypertension, and premature mortality.

To determine the least obese county in every state, 24/7 Wall St. reviewed reviewed the percentage of obese adults — defined as having a body mass index of at least 30.0 — in 2013 with data from the Centers for Disease Control and Prevention. Body mass index is a screening tool for determining weight status based on a person’s weight and height. A 5-feet-9-inch tall person weighing 203 pounds or more would be considered obese.

In some of the least healthy states, even residents of the healthiest county are worse off than the average American by a number of health metrics. In Arkansas, for example, 34.6% of adults are obese, the third largest share of any state. While the obesity rate in Arkansas County of 30.1% is the lowest in the state, it is far above of the 28.9% national obesity rate.

Click here to see the full list of the least obese county in every state.
Click here to see our detailed findings and methodology.

1. Alabama: Autauga County
> County seat: Prattville
> Obesity rate: 27.4% (county), 32.4% (AL)
> Adults who do not exercise: 22.3% (county), 31.5% (AL)
> Median household income: $51,365 (county), $46,257 (AL)

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2. Alaska: Aleutians East Borough
> County seat: Sand Point
> Obesity rate: 25.5% (county), 28.4% (AK)
> Adults who do not exercise: 17.0% (county), 22.3% (AK)
> Median household income: $53,125 (county), $76,440 (AK)

3. Arizona: Apache County
> County seat: St. Johns
> Obesity rate: 23.0% (county), 26.8% (AZ)
> Adults who do not exercise: 17.7% (county), 25.2% (AZ)
> Median household income: $38,941 (county), $53,558 (AZ)

4. Arkansas: Arkansas County
> County seat: Stuttgart & De Witt
> Obesity rate: 30.1% (county), 34.6% (AR)
> Adults who do not exercise: 24.9% (county), 34.4% (AR)
> Median household income: $59,016 (county), $44,334 (AR)

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5. California: Alameda County
> County seat: Oakland
> Obesity rate: 16.1% (county), 24.1% (CA)
> Adults who do not exercise: 15.5% (county), 21.4% (CA)
> Median household income: $87,701 (county), $67,739 (CA)

6. Colorado: Adams County
> County seat: Brighton
> Obesity rate: 11.8% (county), 21.3% (CO)
> Adults who do not exercise: 9.4% (county), 17.9% (CO)
> Median household income: $78,763 (county), $65,685 (CO)

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7. Connecticut: Fairfield County
> County seat: N/A
> Obesity rate: 21.4% (county), 25.0% (CT)
> Adults who do not exercise: 18.8% (county), 24.9% (CT)
> Median household income: $86,670 (county), $73,433 (CT)

8. Delaware: Kent County
> County seat: Dover
> Obesity rate: 27.7% (county), 31.1% (DE)
> Adults who do not exercise: 22.4% (county), 27.8% (DE)
> Median household income: $66,283 (county), $61,757 (DE)

9. Florida: Alachua County
> County seat: Gainesville
> Obesity rate: 19.5% (county), 26.4% (FL)
> Adults who do not exercise: 18.5% (county), 27.7% (FL)
> Median household income: $59,783 (county), $50,860 (FL)

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10. Georgia: Appling County
> County seat: Baxley
> Obesity rate: 22.9% (county), 30.3% (GA)
> Adults who do not exercise: 18.3% (county), 27.2% (GA)
> Median household income: $68,818 (county), $53,559 (GA)

11. Hawaii: Hawaii County
> County seat: Hilo
> Obesity rate: 20.6% (county), 21.8% (HI)
> Adults who do not exercise: 17.9% (county), 22.1% (HI)
> Median household income: $68,224 (county), $74,511 (HI)

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12. Idaho: Ada County
> County seat: Boise
> Obesity rate: 19.2% (county), 29.6% (ID)
> Adults who do not exercise: 12.5% (county), 23.7% (ID)
> Median household income: $58,086 (county), $51,807 (ID)

13. Illinois: Adams County
> County seat: Quincy
> Obesity rate: 23.0% (county), 29.4% (IL)
> Adults who do not exercise: 17.2% (county), 25.1% (IL)
> Median household income: $81,521 (county), $60,960 (IL)

14. Indiana: Adams County
> County seat: Decatur
> Obesity rate: 22.1% (county), 31.8% (IN)
> Adults who do not exercise: 19.6% (county), 31.0% (IN)
> Median household income: $43,389 (county), $52,314 (IN)

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15. Iowa: Adair County
> County seat: Greenfield
> Obesity rate: 23.0% (county), 31.3% (IA)
> Adults who do not exercise: 16.8% (county), 28.5% (IA)
> Median household income: $56,808 (county), $56,247 (IA)

16. Kansas: Allen County
> County seat: Iola
> Obesity rate: 23.8% (county), 30.0% (KS)
> Adults who do not exercise: 16.6% (county), 26.5% (KS)
> Median household income: $46,609 (county), $54,935 (KS)

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17. Kentucky: Adair County
> County seat: Columbia
> Obesity rate: 27.3% (county), 33.2% (KY)
> Adults who do not exercise: 20.9% (county), 30.2% (KY)
> Median household income: $50,661 (county), $46,659 (KY)

18. Louisiana: Acadia Parish
> County seat: Crowley
> Obesity rate: 27.8% (county), 33.1% (LA)
> Adults who do not exercise: 22.5% (county), 32.2% (LA)
> Median household income: $63,686 (county), $45,146 (LA)

19. Maine: Androscoggin County
> County seat: Auburn
> Obesity rate: 22.7% (county), 28.9% (ME)
> Adults who do not exercise: 15.2% (county), 23.3% (ME)
> Median household income: $61,902 (county), $53,079 (ME)

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20. Maryland: Allegany County
> County seat: Cumberland
> Obesity rate: 20.1% (county), 28.3% (MD)
> Adults who do not exercise: 15.9% (county), 25.3% (MD)
> Median household income: $100,352 (county), $78,945 (MD)

21. Massachusetts: Barnstable County
> County seat: Barnstable
> Obesity rate: 18.9% (county), 23.6% (MA)
> Adults who do not exercise: 15.3% (county), 23.5% (MA)
> Median household income: $62,608 (county), $75,297 (MA)

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22. Michigan: Alcona County
> County seat: Harrisville
> Obesity rate: 24.4% (county), 31.5% (MI)
> Adults who do not exercise: 15.3% (county), 24.4% (MI)
> Median household income: $62,484 (county), $52,492 (MI)

23. Minnesota: Aitkin County
> County seat: Aitkin
> Obesity rate: 22.8% (county), 25.5% (MN)
> Adults who do not exercise: 16.2% (county), 23.5% (MN)
> Median household income: $67,989 (county), $65,599 (MN)

24. Mississippi: Adams County
> County seat: Natchez
> Obesity rate: 28.6% (county), 35.1% (MS)
> Adults who do not exercise: 27.2% (county), 38.1% (MS)
> Median household income: $65,924 (county), $41,754 (MS)

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25. Missouri: Adair County
> County seat: Kirksville
> Obesity rate: 25.0% (county), 30.4% (MO)
> Adults who do not exercise: 20.9% (county), 28.3% (MO)
> Median household income: $75,603 (county), $51,746 (MO)

26. Montana: Beaverhead County
> County seat: Dillon
> Obesity rate: 15.5% (county), 24.6% (MT)
> Adults who do not exercise: 13.0% (county), 22.5% (MT)
> Median household income: $57,021 (county), $50,027 (MT)

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27. Nebraska: Adams County
> County seat: Hastings
> Obesity rate: 24.5% (county), 29.6% (NE)
> Adults who do not exercise: 26.2% (county), 25.3% (NE)
> Median household income: $56,797 (county), $56,927 (NE)

28. Nevada: Churchill County
> County seat: Fallon
> Obesity rate: 21.4% (county), 26.2% (NV)
> Adults who do not exercise: 17.0% (county), 23.7% (NV)
> Median household income: $59,769 (county), $55,180 (NV)

29. New Hampshire: Belknap County
> County seat: Laconia
> Obesity rate: 25.2% (county), 26.7% (NH)
> Adults who do not exercise: 18.6% (county), 22.4% (NH)
> Median household income: $56,289 (county), $70,936 (NH)

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30. New Jersey: Atlantic County
> County seat: Mays Landing
> Obesity rate: 21.0% (county), 26.3% (NJ)
> Adults who do not exercise: 18.5% (county), 26.8% (NJ)
> Median household income: $102,798 (county), $76,126 (NJ)

31. New Mexico: Bernalillo County
> County seat: Albuquerque
> Obesity rate: 13.7% (county), 26.4% (NM)
> Adults who do not exercise: 10.5% (county), 24.3% (NM)
> Median household income: $55,370 (county), $46,748 (NM)

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32. New York: Albany County
> County seat: Albany
> Obesity rate: 14.7% (county), 25.4% (NY)
> Adults who do not exercise: 17.5% (county), 26.7% (NY)
> Median household income: $75,513 (county), $62,909 (NY)

33. North Carolina: Alamance County
> County seat: Graham
> Obesity rate: 23.3% (county), 29.4% (NC)
> Adults who do not exercise: 16.7% (county), 26.6% (NC)
> Median household income: $61,130 (county), $50,584 (NC)

34. North Dakota: Adams County
> County seat: Hettinger
> Obesity rate: 26.9% (county), 31.0% (ND)
> Adults who do not exercise: 24.9% (county), 27.6% (ND)
> Median household income: $50,250 (county), $60,656 (ND)

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35. Ohio: Adams County
> County seat: West Union
> Obesity rate: 26.7% (county), 30.4% (OH)
> Adults who do not exercise: 23.7% (county), 28.5% (OH)
> Median household income: $59,958 (county), $52,334 (OH)

36. Oklahoma: Adair County
> County seat: Stilwell
> Obesity rate: 27.4% (county), 32.5% (OK)
> Adults who do not exercise: 32.7% (county), 33.0% (OK)
> Median household income: $40,036 (county), $49,176 (OK)

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37. Oregon: Baker County
> County seat: Baker City
> Obesity rate: 21.3% (county), 26.5% (OR)
> Adults who do not exercise: 12.6% (county), 18.5% (OR)
> Median household income: $57,449 (county), $57,532 (OR)

38. Pennsylvania: Adams County
> County seat: Gettysburg
> Obesity rate: 23.0% (county), 30.0% (PA)
> Adults who do not exercise: 17.1% (county), 26.3% (PA)
> Median household income: $88,995 (county), $56,907 (PA)

39. Rhode Island: Bristol County
> County seat: Bristol
> Obesity rate: 22.9% (county), 27.3% (RI)
> Adults who do not exercise: 19.9% (county), 26.9% (RI)
> Median household income: $73,096 (county), $60,596 (RI)

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40. South Carolina: Abbeville County
> County seat: Abbeville
> Obesity rate: 22.0% (county), 31.7% (SC)
> Adults who do not exercise: 15.2% (county), 26.9% (SC)
> Median household income: $59,227 (county), $49,501 (SC)

41. South Dakota: Aurora County
> County seat: Plankinton
> Obesity rate: 25.7% (county), 29.9% (SD)
> Adults who do not exercise: 18.0% (county), 23.8% (SD)
> Median household income: $48,220 (county), $54,467 (SD)

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42. Tennessee: Anderson County
> County seat: Clinton
> Obesity rate: 25.9% (county), 33.7% (TN)
> Adults who do not exercise: 20.2% (county), 37.2% (TN)
> Median household income: $100,140 (county), $48,547 (TN)

43. Texas: Anderson County
> County seat: Palestine
> Obesity rate: 20.3% (county), 30.9% (TX)
> Adults who do not exercise: 15.0% (county), 30.1% (TX)
> Median household income: $64,422 (county), $56,565 (TX)

44. Utah: Beaver County
> County seat: Beaver
> Obesity rate: 14.4% (county), 24.1% (UT)
> Adults who do not exercise: 11.1% (county), 20.6% (UT)
> Median household income: $91,470 (county), $65,977 (UT)

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45. Vermont: Addison County
> County seat: Middlebury
> Obesity rate: 19.8% (county), 24.7% (VT)
> Adults who do not exercise: 15.1% (county), 20.5% (VT)
> Median household income: $66,414 (county), $57,677 (VT)

46. Virginia: Accomack County
> County seat: Accomac
> Obesity rate: 16.1% (county), 27.2% (VA)
> Adults who do not exercise: 13.4% (county), 25.5% (VA)
> Median household income: $108,706 (county), $68,114 (VA)

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47. Washington: Adams County
> County seat: Ritzville
> Obesity rate: 20.7% (county), 27.2% (WA)
> Adults who do not exercise: 15.1% (county), 20.0% (WA)
> Median household income: $58,029 (county), $67,106 (WA)

48. West Virginia: Barbour County
> County seat: Philippi
> Obesity rate: 28.8% (county), 35.1% (WV)
> Adults who do not exercise: 24.1% (county), 31.4% (WV)
> Median household income: $47,060 (county), $43,385 (WV)

49. Wisconsin: Adams County
> County seat: Friendship
> Obesity rate: 23.7% (county), 29.8% (WI)
> Adults who do not exercise: 15.5% (county), 23.8% (WI)
> Median household income: $64,773 (county), $56,811 (WI)

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50. Wyoming: Albany County
> County seat: Laramie
> Obesity rate: 12.7% (county), 27.8% (WY)
> Adults who do not exercise: 10.8% (county), 25.1% (WY)
> Median household income: $75,594 (county), $59,882 (WY)

Detailed Findings

The prevalence of health behaviors such as regular exercise and caloric consumption are some of the main predictors of obesity. Studies have shown that exercise programs consistent with national public health recommendations — between 150 and 250 minutes of physical activity per week — can contribute to modest weight loss. In 49 of the 50 counties with the lowest rates of obesity, the share of adults who do not exercise is smaller than the 22.3% national inactivity rate.

While the relationship is complicated, income is also a primary determinant of obesity. Individuals with higher incomes are more likely to exercise, can better afford fresh, healthy food, and are less likely to be obese overall. In 38 of the 50 least obese counties, the typical household earns more annually than the $55,322 national median household income.

Though obesity is not synonymous with poor health, obesity is considered a national health epidemic. Overweight and obese adults are more likely to have heart disease, stroke, type 2 diabetes, and certain types of cancers, and are more likely to die prematurely overall. According to a study by the Global BMI Mortality Collaboration published in July 2016, moderate obesity is associated with a reduction in life expectancy of about three years, and every five-unit increase in body mass index results in a 31% increase in the risk of premature death. In 44 of the 50 counties with the lowest obesity rates, the premature mortality rate is lower than the national rate of 336 deaths before age 75 per 100,000 Americans.

Rural areas face unique health problems and have higher rates of obesity overall. Rural denizens are often poorer, have less access to medical care, have less access to fresh, healthy food, and have less access to opportunities for physical activity. In 48 of the 50 counties with the highest rates of obesity, the share of the population living in a rural area is greater than the 19.3% national figure.

Methodology

To determine the least obese county in every state, 24/7 Wall St. reviewed the percentage of adults with a body mass index of at least 30.0 in 2013 with data from the Centers for Disease Control and Prevention. Body mass index is a screening tool for determining weight status based on a person’s weight and height. A person standing at 5 feet 9 inches weighing at least 203 pounds would be considered obese. State- and county-level data on inactivity also came from the CDC. Data on median household income came from the U.S. Census Bureau’s American Community Survey and are five-year averages for 2012 to 2016.

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