According to the U.S. Centers for Disease Control and Prevention (CDC), more than a third of adults in the United States are obese. That is 78.6 million members of the nation’s adult population.
The obesity epidemic comes at great cost to individual and population health, as well as accumulating medical costs that then add to the skyrocketing expenses of our healthcare system. In 2008, the CDC estimates, the annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars. Further, medical costs for those with obesity were an average of $1,429 higher than for those of normal weight.
Now the personal finance website WalletHub has released its list of the most obese metro areas in the United States. According to WalletHub, its analysts made comparisons of 100 of the most populated U.S. metro areas, taking into account a range of 19 metrics, in order to identify the cities “where weight-related problems call for heightened attention.”
The following metro areas topped the list.
Memphis ranked first as the most obese metro area overall, receiving a total score from WalletHub of 76.97. Memphis had the highest percentage of obese adults as well as the highest percentage of physically inactive adults.
Memphis tied for second place (with El Paso, TX) for the highest percentage of adults with diabetes. Obesity is a known cause of Type 2 diabetes, so this correlation should be of no surprise. As the prevalence rates of obesity have skyrocketed in the United States and across the world, so have the rates of Type 2 diabetes.
Shreveport-Bossier City, Louisiana
The Shreveport-Bossier City metro area in Louisiana received a total score of 75.24 from WalletHub, putting them in second place on the “fattest cities” list.
This metro area ranked fifth in terms of percentage of obese adults and tied for first place in the percentage of adults eating fewer than a single serving of fruits and/or vegetables per day.
The consumption of fruits and vegetables is important because studies have shown that the higher the intake of whole fruits and vegetables, the lower the rates of obesity and other chronic diseases like heart disease and cancer.
Whole fruits and vegetables (with emphasis on “whole”—we are not talking about apple pie here) contain loads of fiber, vitamins, antioxidants, and other nutrients that your body needs. Studies have shown that, due to many of these nutritious properties, eating whole fruits and vegetables can even reduce inflammation within your body. Fruit and vegetable intake has also been shown to improve the function of blood vessels (known as endothelial function).
Fruit and vegetable intake is not just a trivial matter; in fact, it is essential for life. The World Health Organization (WHO) estimates that approximately 1.7 million, or 2.8%, of deaths worldwide can be attributed to consuming too few fruits and vegetables.
WHO further estimates that insufficient intake of fruits and vegetables causes approximately 14% of deaths due to gastrointestinal cancer, 11% of ischemic heart disease deaths, and 9% of stroke deaths.
Additionally, research has shown that eating three to five servings of fruits and vegetables per day will decrease your risk of stroke, and eating more than five servings per day will decrease that risk even more. In an incremental fashion, the more fruits and vegetables you eat, the lower your risk. A very good return on your investment.
Fruits and vegetables also constitute low-calorie foods. A report by WHO has stated that there is convincing evidence that eating fruits and vegetables decreases the risk for obesity. Compared to high-calorie foods such as processed foods that are high in sugar and fat, fruits and vegetables are less likely to contribute to obesity or overweight. And, because they contain higher amounts of dietary fiber and other nutrients, they are associated with a lower risk for diabetes and insulin resistance. For the same reasons, they also make people feel full with fewer calories, thus helping to prevent weight gain.
Through a combination of factors, the metro area that ranked third on WalletHub’s list of most obese metro areas was Indianapolis-Carmel-Anderson, with a total score of 73.88. WalletHub’s analysis included weighted averages across metrics like “fat prevalence,” “weight-related health problems” and “healthy environment,” to name but a few.
Jackson ranked fourth on the WalletHub list, with a total score of 73.75. This metro area ranked third in the percentage of obese adults and in the percentage of physically inactive adults.
Jackson ranked fifth in the percentage of adults eating less than one serving of fruits and/or vegetables per day.
The connection between physical inactivity and obesity is also well established. Most national and international guidelines recommend getting at least 150 minutes of moderate-intensity exercise every week. This can translate into 30 minutes of moderate-intensity exercise five times per week, for instance. And research has borne out the health benefits of a daily 30-minute walk: in the Nurses’ Health Study, for instance, those who walked briskly or otherwise achieved moderate-intensity exercise for at least 30 minutes every day had a low risk of sudden cardiac death during 26 years of follow up.
What counts as moderate-intensity exercise? Physical activities such as general gardening, brisk walking, ballroom dancing, and the equivalent fall into the category of moderate-intensity exercise.
Additionally, according to the Physical Activity Guidelines for Americans from the U.S. Department of Health and Human Services (HHS), obtaining at least 1 hour and 15 minutes of vigorous-intensity exercise weekly can meet the minimum amount of recommended exercise. Vigorous-intensity exercise includes physical activities such as hiking uphill, bicycling at or above ten miles per hour, fast swimming, running, traditional aerobics, and heavy shoveling or ditch digging, among others.
The HHS guidelines note that additional health benefits can be obtained by increasing the amount of moderate-intensity physical activity to at least five hours per week, or increasing vigorous-intensity exercise to at least 2 1/2 hours per week.
These guidelines also recommend engaging in muscle-strengthening exercise at least two days per week. This is important for building and maintaining strong bones, for overall fitness, and for increasing lean muscle mass—which also helps in combating obesity.
The guidelines also note that “Adults should move more and sit less throughout the day. Some physical activity is better than none.” And this gets to the point that making a goal to stay in motion as much as possible throughout the day is key to optimal health and wellness over the long term.
New Orleans-Metairie, Louisiana
Rounding out the top five was the New Orleans-Metairie metro area of Louisiana, with a total score of 72.94. The WalletHub analysts found this area to be in a tie for first place in terms of the percentage of adults who eat less than a single serving of fruits and/or vegetables per day.
As evidenced by the rankings above, while the entire nation (and, in fact, the world) is battling the obesity epidemic, not all areas are affected equally. Notably, according to a special report by Trust for America’s Health and the Robert Wood Johnson Foundation, while obesity rates have increased among all ethnic and racial groups, some groups are affected more than others.
For example, among U.S. adults, those classified by the report as Black and Latino populations were found to have substantially higher rates of obesity than do those populations classified as White. This was true for both men and women in these ethnic and racial groups.
Specifically, for the time period 2015 to 2016, the rate of obesity for all U.S. adults was 39.6%. However, the rate among Black adults was 46.8%, and among Latino adults it was 47.0%. Among White adults, the rate was 37.9%.
These disparities extended to childhood obesity rates as well, which were higher among Black and Latino children than among White children.
The report puts forth analyses as well as strategies for preventing obesity that are specific to each racial and ethnic community. For Black communities, the report authors note that “communities of color are disproportionately affected by obesity… and not coincidentally, Black communities have more fast-food establishments and fewer grocery stories than White communities.”
In Latino communities, the report notes “Latino children and adults continue to have higher obesity rates than Whites and Asians.” Researchers have also found that “food and beverage companies disproportionately target advertising for many of their least nutritious brands, including fast food, candy, sugary drinks, and snacks to Black and Latino youth.”
The report further notes that “obesity rates are alarmingly high; sustained, meaningful reductions have not yet been achieved nationally except possibly among our youngest children in low-income families; many populations continue to see steady increases in obesity; and racial, ethnic, and geographic disparities are persistent.”
Thus, addressing a broad range and combination of factors is going to be essential if we are ever to defeat this epidemic.