A new study released this week ranks South Carolina as the 13th most obese state in America and North Carolina as 20th, highlighting growing public health concerns across our region.
The new report from WalletHub arrives just as November’s National Diabetes Awareness Month begins, drawing attention to obesity’s role in rising diabetes and heart disease rates nationwide.
Most Overweight & Obese States in the US
| Overall Rank* | State | Total Score | Obesity & Overweight Prevalence Rank | Health Consequences Rank | Food & Fitness Rank |
|---|---|---|---|---|---|
| 1 | West Virginia | 75.24 | 1 | 1 | 36 |
| 2 | Mississippi | 73.56 | 2 | 11 | 19 |
| 3 | Arkansas | 70.19 | 3 | 10 | 12 |
| 4 | Louisiana | 69.50 | 4 | 15 | 1 |
| 5 | Alabama | 68.16 | 6 | 8 | 8 |
| 6 | Tennessee | 68.00 | 9 | 7 | 2 |
| 7 | Kentucky | 66.48 | 8 | 13 | 10 |
| 8 | Texas | 65.94 | 5 | 30 | 11 |
| 9 | Delaware | 64.87 | 11 | 5 | 43 |
| 10 | Oklahoma | 64.86 | 7 | 31 | 18 |
| 11 | Maine | 63.54 | 29 | 2 | 16 |
| 12 | Ohio | 63.30 | 12 | 24 | 15 |
| 13 | South Carolina | 62.99 | 13 | 23 | 23 |
| 14 | North Dakota | 62.52 | 27 | 6 | 14 |
| 15 | Kansas | 62.44 | 15 | 19 | 7 |
| 16 | New Mexico | 62.01 | 10 | 36 | 42 |
| 17 | Georgia | 61.86 | 14 | 25 | 21 |
| 18 | Michigan | 61.75 | 25 | 14 | 4 |
| 19 | Indiana | 61.07 | 16 | 27 | 22 |
| 20 | North Carolina | 60.97 | 20 | 21 | 5 |
| 21 | Nebraska | 60.69 | 18 | 32 | 13 |
| 22 | Maryland | 60.44 | 24 | 12 | 38 |
| 23 | Missouri | 60.18 | 19 | 28 | 29 |
| 24 | Wisconsin | 59.55 | 26 | 26 | 28 |
| 25 | Pennsylvania | 59.23 | 28 | 22 | 32 |
| 26 | Iowa | 59.23 | 17 | 42 | 24 |
| 27 | Illinois | 58.69 | 22 | 39 | 20 |
| 28 | Rhode Island | 58.38 | 30 | 18 | 47 |
| 29 | Nevada | 58.27 | 31 | 41 | 3 |
| 30 | Florida | 57.84 | 38 | 9 | 44 |
| 31 | Alaska | 57.40 | 23 | 38 | 45 |
| 32 | New Hampshire | 57.34 | 45 | 3 | 33 |
| 33 | Virginia | 57.01 | 34 | 29 | 30 |
| 34 | Wyoming | 57.00 | 35 | 16 | 37 |
| 35 | Arizona | 56.77 | 21 | 46 | 31 |
| 36 | Connecticut | 56.03 | 37 | 34 | 35 |
| 37 | South Dakota | 55.73 | 32 | 45 | 26 |
| 38 | New York | 55.37 | 39 | 35 | 27 |
| 39 | New Jersey | 55.06 | 41 | 40 | 9 |
| 40 | Idaho | 54.75 | 46 | 17 | 6 |
| 41 | Oregon | 54.58 | 36 | 33 | 41 |
| 42 | Vermont | 54.24 | 48 | 4 | 48 |
| 43 | Washington | 53.07 | 42 | 37 | 40 |
| 44 | District of Columbia | 53.02 | 33 | 48 | 51 |
| 45 | Montana | 52.98 | 47 | 20 | 39 |
| 46 | Minnesota | 51.39 | 43 | 43 | 34 |
| 47 | Hawaii | 51.29 | 44 | 50 | 25 |
| 48 | California | 51.16 | 40 | 49 | 49 |
| 49 | Massachusetts | 48.50 | 49 | 44 | 46 |
| 50 | Utah | 45.90 | 50 | 51 | 17 |
| 51 | Colorado | 43.73 | 51 | 47 | 50 |
The financial analysis firm compared all 50 states and the District of Columbia using 31 health, food, and fitness metrics, grouped into three main categories — obesity prevalence, health consequences, and food and fitness access. These factors included adult and childhood obesity rates, physical inactivity, diabetes prevalence, access to healthy foods, and the number of fitness centers per capita.
The report found that obesity costs the U.S. healthcare system roughly $173 billion annually, with average obesity-related medical expenses exceeding $1,500 per person each year. Both Carolinas scored poorly in categories linked to physical inactivity, access to nutritious foods, and growing rates of Type 2 diabetes and hypertension.
In South Carolina, adult obesity and diabetes rates continue to rise faster than the national average, with health experts warning of long-term strain on state healthcare systems. Meanwhile, North Carolina’s rankings show similar challenges, particularly among children and teens, where sedentary lifestyles and sugary drink consumption remain high.
Despite the troubling statistics, both states have recently increased public health funding and school nutrition initiatives aimed at curbing obesity. The Centers for Disease Control and Prevention (CDC) and local health departments continue to promote programs encouraging daily physical activity and healthier food access in schools and underserved communities.
Public health officials say the findings should serve as a wake-up call for families, schools, and policymakers. “We’re seeing more obesity-related diseases at younger ages,” one local health expert said. “If we don’t reverse these trends, the costs—both financial and human—will only keep rising.”
As the Carolinas work to improve nutrition education and access to healthier food options, researchers hope that increased awareness during National Diabetes Month will help shift habits and policies toward building healthier communities across both states.
