The 7 Most Obese U.S. States

Obesity in the U.S. is a growing problem in more ways than one.

The U.S., which ranks as the most obese nation in the world according to the Organization for Economic Cooperation and Development, has seen a relatively steady increase over the past couple of decades in obesity rates which brings with it the potential for added health complications like cardiovascular disease, diabetes, and even cancer. More so, the amount of resources being devoted to treating obesity and obesity-related complications is soaring. Based on figures from a study from Cornell University in the Journal of Health Economics published last year, obesity costs accounted for 21% of all health expenditures in the United States.  

The scope of this problem is particularly evident in the nation's most obese states. In a recent Gallup poll conducted in collaboration with Healthways, the following seven states were determined to have the highest obesity rates: 


Source: Gallup. 

More of the same
As you can see, there are some identifiable similarities here, as we saw with the seven least obese U.S. states. Whereas many of the least obese states were located in the West or in New England, the most obese states tend to be located in the South or Southeastern United States.

Here, we also have a mixture of culture -- a reliance on deep-fried foods and food high in fat content -- and socioeconomic status making up the bulk of the reasoning behind the belt-widening status of these states. According to data from the U.S. Census Bureau averaged over a three-year period, Mississippi, Arkansas, and Tennessee (all among the most obese states) were the first, second, and third lowest in terms of median household income. With fewer nutritious food choices available to the typical family in these states, fast-food restaurants have thrived.

As a compassionate group of people, we'd all love to see these figures beginning to reverse, because it would result in lower cumulative health-care costs, less strain on the health-care system, and an overall healthier population. For pharmaceutical and biotech companies, however, the opportunity to manage obesity and its related complications is poised to be undeniably profitable for decades to come.

The battle over obesity
Two names in this space that made big waves last year are anti-obesity-drug makers Arena Pharmaceuticals (NASDAQ: ARNA  ) and VIVUS (NASDAQ: VVUS  ) . Arena's Belviq was approved in June -- just weeks before VIVUS' Qsymia -- but its debut has been on hold because of drug labeling by the Drug Enforcement Agency. The good news for shareholders here is that the DEA found the potential for abuse to be relatively low for Belviq, and it's expected to be on pharmacy shelves in as early as two weeks.

VIVUS's Qsymia has been available since September, but sales haven't exactly shot out of the gate. Partly to blame was that insurers have been slow to latch onto covering these chronic weight-management drugs, and few users are willing to pay for the medication out of pocket. From a clinical standpoint, Qsymia delivered better results with regard to weight loss relative to Belviq, but Belviq presented the more favorable safety profile of the two. This could be a case where it takes years to determine which drug is better. But that may not matter in the end, as the patient pool is certainly big enough to accommodate both drugs.

Complications matter, too!
Health-care companies aren't just targeting chronic weight-management drugs; they're positioning themselves to deal with what will assuredly be a growing number of complications. In this same Gallup poll, the seven most obese states were also the seven states polled to have the highest blood pressure (not necessarily in the same order as listed above), while six of the seven states appear in the top 10 in terms of highest rate of diabetes. 

Drugmakers such as Johnson & Johnson (NYSE: JNJ  ) and Bristol-Myers Squibb are two names that could clean up with their new class of type 2 diabetes drug known as SGLT2 inhibitors. Previous diabetes medications worked by controlling the body's glycemic balance through actions in the pancreas or liver. SGLT2 inhibitors instead work in the kidneys and allow the body to rid itself of excess glucose through urination. In addition, unlike the current standard of treatment, which tends to cause weight gain, SGLT2 inhibitors have been shown to induce weight loss in patients.

J&J's Invokana, for example, got FDA approval in March after delivering lower A1C levels in trials and improving glycemic balance. Bristol-Myers and AstraZeneca weren't nearly as lucky in the U.S., getting a complete response letter in January 2012 because of concerns over elevated cancer risks, but they did get their SGLT2 inhibitor known as Forxiga approved in Europe. It could just be a matter of time, though, before Forxiga finds itself back in front of the FDA looking for another approval.

A scary risk factor
Cancer risk is another serious concern associated with obesity. According to the National Institutes of Health, obesity has been shown to increase a person's chances of developing esophageal, pancreatic, colorectal, breast, kidney, endometrial, thyroid, and gall bladder cancer. A further study utilizing the National Cancer Institutes Surveillance, Epidemiology, and End Results data estimates that 84,500 new cases of cancer in 2007 were a direct cause of being obese.

Think about the dozens of cancer medications already on the market and being developed that will see sales soar if obesity trends continue to climb. One potential beneficiary here is Pfizer's (NYSE: PFE  ) Sutent, which is approved to treat kidney cancer, pancreatic neuroendocrine tumors, and gastrointestinal stromal tumors. Sutent is already a blockbuster, with sales totaling $1.24 billion in 2012 and 10% growth witnessed in the United States. If obesity rates track higher, it's likely to see a steady increase in sales.

Another name to consider here (there are so many to choose from) is Onyx Pharmaceuticals (UNKNOWN: ONXX.DL  ) with its lead drug, Nexavar. Like Sutent, Nexavar acts as an inhibitor of VEGF receptors, which are essential for blood vessel growth. The idea for both drugs is to inhibit blood vessel growth to tumors and starve them. Nexavar is already approved to treat renal cell carcinoma (the most common type of kidney cancer) and hepatocellular carcinoma (liver cancer) and looks likely to gain an additional indication in aggressive cases of thyroid cancer.

You can do it; they can help
If there's one thing that needs to be recognized, it's that there is a clear-cut obesity problem in the United States. Some cases are unavoidable and caused by a combination of genetics, but a vast majority of obese patients would see a benefit from a lifestyle change that saw them eat healthier and exercise more regularly. In those instances where proper diet and exercise aren't enough, chronic weight-management-drug makers such as Arena and VIVUS, and those who specialize in treating complications associated with obesity, stand ready in the wings to assist those patients. Ultimately, until this obesity trend reverses, you can expect the pharmaceutical and biotech industries' profits to widen in accord with America's waistline.

While obesity remains an important topic of discussion, Obamacare is perhaps the most contentious issue in health care today. The Motley Fool’s new free report, “Everything You Need to Know About Obamacare,” lets you know how your health insurance, your taxes, and your portfolio will be impacted. Click here to read more. 


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  • Report this Comment On May 26, 2013, at 4:43 PM, leftmo wrote:

    I'm wondering where these states rank in food stamps and welfare? Seems as though the obese people riding the scooters at the grocery store, with a basket full of snack cakes, pay with a government card most of the time. Maybe if they would attempt to get a job and stop depending on the Democrats for handouts, the weight problem would go away and we would stop getting our taxes raised

  • Report this Comment On May 26, 2013, at 4:44 PM, caligirl63 wrote:

    Not exactly sure what a "Red State" is..but as a native Californian living in one of the 7 states mentioned..I can attest that everything is smothered covered..chunked and diced here..(a Waffle House reference) and I get made fun of at my work for eating healthy and going to the gym..because i am "skinny"..which I am not..but I consider myself FIT..and well next to most of them I am skinny..

  • Report this Comment On May 26, 2013, at 4:47 PM, Lynnek0 wrote:

    The reason poor people are fat is that they eat Mac-n-cheese, potatoes, rice, cereal, sodas and chips... Not good meats and healthy fat which is expensive. Starches and sugar are strangling our health (and healthcare budget). Read "Good Calories, Bad Calories" by Gary Taubes and get out of your pharmaceutical stocks!

  • Report this Comment On May 26, 2013, at 5:11 PM, rqm237p wrote:

    The Tea Party does eat well. It must be all those food stamps.

  • Report this Comment On May 26, 2013, at 5:58 PM, Spartan14 wrote:

    @ei8thx: Actually, your argument about Southern and Southeastern states having much higher minority populations is invalid. According to the U.S. Census Bureau and demographic information collected in the 2010 Census, the average minority rate for the seven most obese states is 26.4%, while the average minority rate for the seven least obese states (CO, MA, MT, CT, CA, UT, and AZ) is 32.4%. This shows that even though the minority population rates in these states are higher, the rate of obesity is lower than the rate of obesity in the Southern and Southeastern states. Therefore, the statements you made of the correlation between minority populations and obesity rates are false. Learn to thoroughly research before spreading ignorance.

    The world would be so much better if people took responsibility for their actions instead of trying to make excuses and blaming a scapegoat.

  • Report this Comment On May 26, 2013, at 6:52 PM, Robnati wrote:

    Do I have to subsidize their health care? (Of course I do.) Twisted socialism: From those who have to those who need, has become: from those who take care of themselves to those who don't or won't.

  • Report this Comment On May 26, 2013, at 7:26 PM, Mystery47 wrote:

    What did you think would happen when you priced cigarettes out of the reach of most folks? Everyone needs some crutch to handle stress.

    Without cigarettes, it has become comfort foods. Another example of the government meddling in the private lives of people with disasterous and unpredictable results.

  • Report this Comment On May 26, 2013, at 7:34 PM, justpicky01 wrote:

    I was at the grocery store yesterday brought a few items , and seen this couple , I said to a friend darn I should get on "link card " joking , come to find out , the couple in front of us were on Link card , seen it in the lady's hand ...and what else brought my attention were a bunch of ice cream in the box ...

    I thought to myself nobody needs that much ice cream all at once . The lady and her boyfriend , wasn't over weight . Each state needs to stop giving Link cards just to anyone . Because that boyfriend had a handful of cash ....The men carries the cash and the girlfriends carries the link cards.......And I'll keep my 2 jobs :)

  • Report this Comment On May 26, 2013, at 7:37 PM, justpicky01 wrote:

    There's obese throughout USA , all 50 states and a bunch of illegals who's receiving Link aka Govt money , they shouldn't receive anything . They're in this country against the law .....

    Stop giving out to those who doesn't need it ...

  • Report this Comment On May 26, 2013, at 7:45 PM, ReasonableRant wrote:

    I think it is interesting that our poor are obese and the rest of the worlds poor are hungry. We took care of one problem causing another. Running and walking are cheap and most people can do it. Infrastructure must be created to encourage exercise. Drugs are not the answer, when will we learn that?

  • Report this Comment On May 26, 2013, at 8:35 PM, Dadw5boys wrote:

    All down wind from the Coal Fired Power Plants in Texas

  • Report this Comment On May 26, 2013, at 8:36 PM, tiredofobama wrote:

    Not every person that is obese is that way because of eating the wrong foods. A lot of times medications can make a person obese, thyroid problems can cause it. So instead of blaming everyone that is obese because you think they do nothing all day and sit and eat, think again. Read and become learn before speaking! I am diabetic and I work my ass off at a hard job, I work around my house and stay busy from the moment I get up in the morning until I go to bed at night. I for one do not sit and just eat junk food and I am not on welfare. I see this as another area Obama is going to control people with his obamacare. Again America wake up! We all have an appointed time to die. I have had friends that every spare moment of their life was spent in a gym, working out, running and eating only healthy food. They are dead from cancer, heart disease and yes diabetes. I have a close friend that is a Dr. and he is also one that once leaving the office after working a 12 hour day would run, or work out. Never drank a carbonated soft drink, never put a candy bar to his mouth and he is dying from cancer now. And you know what he says everyday I don't understand it I lived such a healthy life. People when its your time to go God will take you home whether you are skinny, slim or fat!

  • Report this Comment On May 26, 2013, at 8:49 PM, natebob32 wrote:

    I've lived 17 years in Alabama and 15 in California, and I think this is mostly a cultural thing rather than an economic one. Frying food became the norm in the south out of environmental necessity. Before AC, baking indoors in the south in the summer months would make most homes unbearable. Frying food cooks it faster, lessening the impact on heat indoors. That's how the cuisine of the region evolved, and now fried food is a sort of cultural-heritage badge. It's how mama learned to cook from her mama, and from her mama before that, and on... Just some food for thought.

  • Report this Comment On May 26, 2013, at 9:01 PM, ReasonableRant wrote:

    Nothing is always true. That is the truth. The studies say that obesity is primarily caused by diet and lack of exercise. Both of my parents have had cancer and my father died of it 7 years ago. If cancer was easy we would have beaten it already but I think we can agree there are things we can do to make our chances better.

  • Report this Comment On May 26, 2013, at 9:12 PM, nonofya wrote:

    fat is everywhere, skinny is everywhere... move on

  • Report this Comment On May 26, 2013, at 9:28 PM, Philgumbo wrote:

    I'm surprised Maine is not on this list; there is certainly no shortage of fat (and ugly to boot) women up here!

  • Report this Comment On May 26, 2013, at 10:11 PM, jicecold69 wrote:

    hum i wonder why cause in the south they deep fry everything lol im from north carolina but in case your wondering im 157 lol

  • Report this Comment On May 26, 2013, at 10:12 PM, Gowithit wrote:

    What, are we surprised that the most uneducated states are also the fattest? And, gosh darn it, they are all red states, too. Didn't y'all learn about gluttony or did you skip that sin because you we're too focused on the gay?

  • Report this Comment On May 26, 2013, at 10:26 PM, KWK23 wrote:

    For the folks suggesting that this is a hormonal issue -- no, sorry. MAYBE 5% of the population have pathological manifestations of diseases that lead to higher than average adipose layering (i.e., putting on fat). There's not a chance in hell that 30% of the population has this kind of genetic disorder -- especially when we compare Canada, which has a similar ethnic makeup as the USA, with one of the world's lower obesity rates (among industrialized nations).

    And you 'blue state' folks don't get too smug...the population every state in the union has been getting fatter.

  • Report this Comment On May 26, 2013, at 10:45 PM, tweeter31469 wrote:

    Wait wait wait. What are all these libs doing here? For the past 20 years you have been telling me that it is not ok to say people are fat or obese or really even speak about it because it isnt PC, since it is a "disease/disorder." Now a list comes out with red states at the top and as if by some type of hypocrite magic, all of the sudden it is something that you can control and these people are pathetic? It's AMAZING how that works...

  • Report this Comment On May 26, 2013, at 11:04 PM, AlfredHussein wrote:

    I am sure the culture has a lot to do with it. Also, while the 7 least obese states have some of the lowest percentage of blacks in the population (.04%, 1.1%, 4%), the 7 most obese states have some of the highest percentages (26%, 32%, 37%).

  • Report this Comment On May 26, 2013, at 11:09 PM, WacoKid60 wrote:

    “West Virginia, Mountain Mama, Take Me Home Country Roads” A standing ovation to all the BBW – SSBBW’s out there! YOU ROCK & RULE!!!!!!!!

  • Report this Comment On May 27, 2013, at 12:01 AM, emailnodata wrote:

    Cross-reference with:

    -Lowest test scores

    -Highest gun ownership rates

    -Highest gun death rates

    -Most church-goers

    -Net Federal "takers" of tax money

    -Strongest GOP supporters

    And I'd bet you get 90% or more correlations.

  • Report this Comment On May 27, 2013, at 3:12 AM, ei8htx wrote:

    @Spartan

    Flagrant lies. The data is all right here in the very first google image search for "US Map Minorities"

    http://www.raconline.org/racmaps/mapfiles/minority.jpg

    Not only is the 7 most/ 7 least easy to follow, but you'll notice that the high concentration counties in the Southeast are right on the higher population urban ares.

  • Report this Comment On May 27, 2013, at 3:27 AM, Sensemilla99 wrote:

    Number 7 on 'the most obese' is only a few points off from number 7 on 'the least obese'. This doesn't say much in support of some grace difference between our states. All it says is that we're all a bunch of fat asses...

  • Report this Comment On May 27, 2013, at 6:24 AM, DQ10 wrote:

    6 out of 7 are Southern, Bible Belt, Republican states. Praise the Lord and pass the gravy.

  • Report this Comment On May 27, 2013, at 6:25 AM, jthoen wrote:

    Leftmo, not everyone that is obese is that way because they ride the scooters at Wal-Mart and eat snack cakes. I have rheumatoid arthritis, ankylosing spondylitis and fibromyalgia, plus a bulging disc in my low back. I am on Social Security disability and cannot work. It's pretty hard to get around and get the weight off. I get a whopping 16.00 in food stamps. I'm told that's all I qualify for. Poor people cannot afford to eat healthy foods. We have to buy what we can afford. I myself love salads and fruits. You sure won't get that at a food shelf.

    Before you run your mouth you should check the facts.

  • Report this Comment On May 27, 2013, at 6:32 AM, sidewind5r wrote:

    @rgm237p they might be all red states but combined they don't even close to cali which is the biggest blue state on welfare. the 9 out of the 10 states are blue states on welfare. texas is in the top 10 but at #6.

    Alabama 2.1

    arkansa 1.3

    west Virginia 1.1

    Mississippi 1.2

    Louisana 3.8

    Kentucky 2.8

    tennessee 4.3

    all totals are in billion california tops it out at 58.7 billion

  • Report this Comment On May 27, 2013, at 9:10 AM, rwscid wrote:

    If obesity problems are responsible for 21% of all health care costs, why is it Obamacare does not allow insurance companies to charge non-obese people lower premiums, so they do not have to pay for the extra health care costs of obese people?

    This is clearly a complete injustice for people who take the steps necessary to be non-obese.

  • Report this Comment On May 27, 2013, at 9:25 AM, consAREidiots wrote:

    It must be those red states' great education system.

  • Report this Comment On May 27, 2013, at 9:31 AM, CaptnDan13 wrote:

    "On May 26, 2013, at 9:28 PM, Philgumbo wrote:

    I'm surprised Maine is not on this list; there is certainly no shortage of fat (and ugly to boot) women up there"....................Apparently no shortage of ugly misogynistic men either...I thought Maine had beautiful women! The men tho,gah......No wonder he thinks the beautiful women are not there,they probably flee when they see him coming.

  • Report this Comment On May 27, 2013, at 9:54 AM, iceire wrote:

    Why is New York not on this list?

    Where I live there are more over weight people than thin,on the 1st of every month when ye go to the store for grocery's ye have to deal with these people riding in the motorized chairs and how some are able to even stay on the seat baffles me since they are so huge,or ye deal with obese parents with their obese kids purchasing food that is not even close to healthy,most are frozen dinners,junk food,soda up the wazoo,when I see these obese people using their food stamp card I seethe,even our teens here are big,personally I feel it all starts in the home and I'm fed up with seeing over weight people especially the women wearing clothes they think they can carry off when in fact their butt cracks show and that not even bending over,and their 3 stomachs hanging over their pants and yet as a tax payer I get to pay for them to keep over indulging on fatty foods!

  • Report this Comment On May 27, 2013, at 10:35 AM, garb2222 wrote:

    To all you libtards who like to feel superior, the truth is obesity is due to economics, not to political opinion.

    The difference between obesity in the conservative states and the liberal states is that in the conservative states, the people spend their OWN money on unhealthy food, while in the liberal states they use welfare and food stamps.

    In either case, giving all these people free health care will bankrupt the country, not that we aren't there already.

  • Report this Comment On May 27, 2013, at 10:40 AM, NOYB781 wrote:

    You want to know what is REALLY sad? You can buy a snack cake for CHEAPER than you can a fresh apple!! Snack foods are not only cheaper, but encouraged to buy for on food stamps than FRESH, HEALTHY FOOD!! you want to change the obesity problem in this country? SET PRIORITIES STRAIGHT with regards to FOOD PRICES!!

  • Report this Comment On May 27, 2013, at 11:03 AM, peterwolf wrote:

    Where's Texas?? They've got some real beef-fed fatties in that state.

  • Report this Comment On May 27, 2013, at 11:57 AM, Wasatcher wrote:

    From what I've seen, obese people eat constantly and, if they're not eating, they're drinking something sweet! You are what you eat, literally, and it's showing on a whole lot of people!

  • Report this Comment On May 27, 2013, at 1:02 PM, Rixar13 wrote:

    I am surprised the State of Maine isn't on the list as most rural men have a large pick-up truck to haul their woman to the store... smile :-)

  • Report this Comment On May 27, 2013, at 1:03 PM, kkrimmer wrote:

    More Conservatives Getting Government Benefits, Poll Says

    More Americans who identified themselves as conservative received government benefits than those who said they are moderate or liberal, a Pew survey shows. 

    http://tinyurl.com/ar5l3t4

    LMAO... they vote GOP ... the GOP cuts their benefits... they vote GOP again... LMAO

  • Report this Comment On May 27, 2013, at 2:36 PM, DDUUPP wrote:

    I had a older guy without a child yet say he didn't want to have a child because it would be embarrassing for them to have him as a very old man go to there school functions.

    Not near as embarrassing as it is for these kids that have obese parents. Having an old Dad that is spry and wise might be cool.

    Having an obese parent who is addicted to "diet" cola and donuts is just embarrassing and hurts the kids self esteem. I'd rather have an old Dad show up at a school event than a younger Obese parent.

    If your honest you would probably say the same thing.

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