America's Most Obese Cities

Once considered an affliction of the lazy and indulgent, obesity now affects about one-third of Americans. The epidemic has swept up the wealthy, middle class and the poor; city dwellers, suburbanites and those in rural areas; and people of all races and ethnicities.

The causes, researchers say, are numerous. These include a diet of calorie-dense but nutrient-deficient food found in grocery and convenience stores, public planning strategies that favor motorists over walkers and cyclists, and simply bad habits.

And while the causes are many, the costs are enormous. Obesity's associated costs add $93 billion to the nation's medical bill annually. Each year, 112,000 people die from obesity-related causes, and the condition is responsible for an increased risk of chronic diseases like Type 2 diabetes, cancer and heart disease.

To better understand the local and state implications of the obesity epidemic, we ranked the nation's heaviest cities. In doing so, we discovered states with multiple offenders, metropolitan areas with expanding waistlines and a high representation of Southern cities. Worse yet, after claiming the title of the most sedentary city, Memphis, Tenn., has also ranked first as the country's most obese.

Behind the Numbers

To determine which cities were the most obese, we looked at 2006 data on body mass index, or BMI, collected by the Centers for Disease Control's Behavioral Risk Factor Surveillance System, which conducts phone interviews with residents of metropolitan areas about health issues, including obesity, diabetes and exercise.

In this case, participants report their height and weight, which survey analysts use to calculate a BMI. Those with a BMI between 18.5 and 24.9 are considered at a healthy weight, those with a BMI between 25 and 29.9 are considered overweight, and those with a BMI of 30 or higher are considered obese. About 32% of the nation is obese, according to the Centers for Disease Control; Memphis ranked above the national average at 34%.

Though data is collected for roughly 145 metropolitan statistical areas, we looked only at the country's 50 most populated cities and ranked the top 20. Because of an insufficient number of survey responses, data from some cities, including Sacramento, Calif., Columbus, Ohio, and Buffalo, N.Y., was not included. Had we included every area on the list, the smaller cities of Huntington, W.V., and Ashland, Ohio, on the West Virginia, Kentucky and Ohio state borders would have far outpaced every city on the list with obesity rates of 45%. Of the 50 cities we did rank, Boston entered last, with only 19%.

Noticeable Trends

Many of the cities on the list have high poverty rates and high frequencies of fast-food consumption.

In the city of Memphis, which does not include the outlying areas surveyed by the CDC, 24% of residents live below the poverty line. According to the U.S. Census Bureau, the national average is 13%. The same trend was noticeable in the cities of Milwaukee (No. 17), Detroit (No. 5), and San Antonio, Texas, (No. 3) where 26%, 33%, and 18% of residents, respectively, live beneath the poverty line.