By Valerie Banner
Reviewed by QualityHealth's Medical Advisory Board
Is your city making you fat? It may sound strange, but where you live probably plays a role in your weight.
While obesity isn't confined to any one part of the country, some parts of the nation are heavier than others. In fact, one study by the University of Washington found that researchers were able to predict the prevalence of obesity simply by looking at zip codes. Among other things, thinner communities had better access to exercise facilities and healthy foods, such as fresh fruits and vegetables.
The slimmer cities were also friendlier for walkers. A study published in the American Journal of Health Promotion found that residents of sprawling cities weighed more and walked less than those in denser urban environments. The authors pointed out that people living in the most widespread community in the study (Geauga County, Ohio) weighed an average of six pounds more than people living in the most compact (New York City).
So, which metropolitan centers are tipping the scales? Here, the top 10 fattest cities in the nation.
Weighing In The rankings are based on the percentage? of people who are obese or overweight, according to the CDC's National Center for Chronic Disease Prevention and Health Promotion. In addition, the CDC asked if respondents had participated in any type of physical activity in the last month. Those with the largest percentage of people saying no were ranked higher. (All CDC data included the entire metropolitan area, not just the city itself.) Also factored into the rating was information about the best walking cities from the American Podiatric Medical Association (APMA).
These two cities sit at the spot where West Virginia, Kentucky, and Ohio meet. And it's the fattest place in the country. This area easily had the most obese people at 45.3 percent; slightly more than 20 percent were at a healthy weight. Residents here tied with those living in El Paso, Texas, as the least likely to report participating in any physical activity in the past month, with just over 31 percent saying they hadn't exercised. It also has the highest percentage of people living with diabetes: an outrageous 12.7 percent.
In Yuma, more than two-thirds of the population is either overweight or obese. Not surprisingly, 29 percent admitted they hadn't exercised in the past month. But Yuma health officials are taking some important steps to slim down. The Steps to a Healthier Arizona Initiative aims to reduce the prevalence of obesity and its related conditions, such as diabetes and heart disease.
It's not a shock to see a Mississippi city on this list. State-by-state studies have found that Mississippians, in general, are the most obese in the country. Perhaps that's why lawmakers in Mississippi took the unusual step of introducing a bill that would prohibit restaurants from serving people who are obese. Though the bill never took effect, it certainly provoked outrage.
Though San Antonio actually scored well for its walkability (landing in the top 50 cities), it still has some of the heaviest residents—31 percent are considered obese. Dozens of businesses in San Antonio have names like Fat Boys Fajitas, Two Fat Guys Automotive, Fat Boy's Sports Bar, and Fat Cowboys, showing that the city also appears to have one of the proudest overweight populations around.
Only a third of the people living in Augusta and Richmond County have a body mass index (BMI) of 25 or less. (A BMI between 19 and 25 is considered healthy.) Approximately 27 percent are sedentary. In fact, the Georgia Hospital Association estimates that the state's hospitals spent more than $540 million in one year to treat conditions that resulted from a lack of physical activity. The Live Healthy Georgia campaign hopes to change that by encouraging Georgians to become more active and eat healthier.
Tied for number one as the most inactive city, El Paso is also one of the APMA's least walkable locales (it was ranked 485 out of 501). The lack of exercise and places to walk probably contribute to the fact that 65 percent of the city's residents are obese or overweight. El Paso has started a program intended to reduce the prevalence of childhood obesity.
You might be inclined to think of tall, lean, corn-fed boys and girls when picturing people from Nebraska. Not so in Scottsbluff. Although the town is tiny (population: 14,000), the people are large: 31 percent are obese. It also has high occurrences of diabetes—coming in at more than 9 percent.
Another unwalkable city with high levels of inactivity, nearly a quarter of Yakima residents report having had no exercise in the past month, and more than 30 percent are obese. One project, called Health in Your Hands, aims to help improve the nutrition and overall health of Yakima's higher risk residents, who are more likely to be poor, Hispanic, and live in rural areas.
After Huntington/Ashland, Fayetteville has the fewest number of people at a healthy weight: only 28.6 percent. About 10 percent have diabetes. It's reached the point that the local newspaper, the Fayetteville Observer, promoted healthy lifestyles by assembling a team to help them lose weight.
Former governor and presidential candidate Mike Huckabee might be the poster child for weight loss—he dropped more than 100 pounds in a little over a year--but few Little Rock residents have followed his lead. More than a quarter of them are obese. While Huckabee is running marathons, more than 26 percent of people in Little Rock report that they haven't even gotten off their couches in the past 30 days.