1. Alabama

Cityscape scene of downtown Huntsville, Alabama, from Big Spring Park
Rob Hainer / Shutterstock
The most fast food per residents.
  • Fast-food rate: 6.3 restaurants per 10,000 people
  • Obesity rate: over 35%

Fast food is in-your-face in Alabama, both literally and figuratively.

This southern state has the largest ratio of restaurants to residents in the country, and it’s not particularly close. Compared to the No. 2 state, every 10,000 residents has an extra McDonald’s or Subway to choose from.

The availability of cheap and easy meals is aggravating one of the worst obesity rates in the country. Well over a third of Alabama’s residents are considered obese.

That shouldn’t come as too much of a surprise, coming from the state that invented “white” barbecue sauce. That’s barbecue sauce mixed with mayonnaise, for those unfamiliar. Perfect for fried chicken and hamburgers, deadly for your waistline.

2. Nebraska

Morning in Omaha - skyline of the city. Omaha, Nebraska, USA.
Henryk Sadura / Shutterstock
Nebraska is continuing research on fighting obesity.
  • Fast food rate: 5.4 restaurants per 10,000 people
  • Obesity rate: 30% to 35%

By some accounts, Nebraska is home to the deliciously unhealthy reuben sandwich. Even without the cheese and Russian dressing, the standard mountain of corned beef alone is packed with fat and sodium.

If you want a taste, one of the largest fast-food chains around, Arby’s, serves its own reuben. Unfortunately, this quick-and-easy version contains a distressing 2.4 grams of salt — about your recommended daily salt intake.

Thankfully, this state may be able to undo some of the damage it’s brought on the world. The Nebraska Center for the Prevention of Obesity Diseases through Dietary Molecules — say that five times fast — received an $11-million grant last year that will allow it to continue its research in the coming years.

3. West Virginia

Structures dot the landscape of Wheeling Island in West Virgina
Real Window Creative / Shutterstock
West Virginia residents need to eat more fruits and vegetables.
  • Fast-food rate: 5.3 restaurants per 10,000 people
  • Obesity rate: over 35%

Until recently, if you wanted a Thundering Herd breakfast sandwich from Tudor’s Biscuit World or pizza bread from Gino’s Pizza and Spaghetti, you had to go to West Virginia. Evidently the state wasn’t satisfied with the preponderance of fast-food joints, so it decided to invent some more of its own.

West Virginia’s obesity problem is so bad, celebrity chef Jamie Oliver spent the first season of his “Food Revolution” show trying to improve eating habits in the city of Huntington. It’s easy to see the problem: a CDC study released in 2017 found that just 7.3% of West Virginians are eating enough fruits and 5.8% are eating enough vegetables — the worst rates in the entire country.

4. Oklahoma

Skyline of Oklahoma City, Oklahoma.
Henryk Sadura / Shutterstock
People love cherry limeade.
  • Fast-food rate: 5.3 restaurants per 10,000 people
  • Obesity rate: 30% to 35%

Oklahoma is the birthplace of Sonic Drive-In, famous for its retro styling and calorie-heavy burgers laden with saturated and trans fats. Founded in 1953, this fast-food restaurant also lets you skip the wearisome, calorie-burning walk to the counter by delivering your meal to your car via rollerskates.

The company boasts that its famous cherry limeade is made with fresh fruit. That may be true, but it certainly doesn’t make the drink healthy; just looking at the sugar content is enough to induce cavities.

A small cherry limeade has a whopping 38 grams of sugar; by comparison, a small cup of the infamously sugary Coca-Cola only has 29 grams. That means you’re spending your entire daily allotment of sugar all on one small drink.

It’s hard to avoid temptation. In 2018, Sonic released a line of cherry-limeade-flavored pudding mixes, ice pops and candy, meaning even grocery stores aren’t safe.

5. Tennessee

Clarksville, Tennessee Museum
SannaBlue / Shutterstock
Tennessee needs more accessible grocery stores.
  • Fast-food rate: 5.2 restaurants per 10,000 people
  • Obesity rate: 30% to 35%

It’s trivial to find a quick bite to eat in Tennessee. The state even founded its own chain, Krystal, in Chattanooga back in 1932.

Little known outside the south, Krystal serves bite-sized square burgers — in combos of three or more, of course. The most calorie-packed item on the menu is the junkyard loaded tots (that’s tater tots covered in cheese, jalapenos, bacon and ranch dressing) coming in at 540 calories per serving.

It’s not so easy to find an actual grocery store. In February, a state senator’s bill to combat “food deserts” in Tennessee passed in a Senate sub-committee. According to the bill’s sponsor, 1 in 5 residents has to travel for miles just to buy a carrot.

6. Indiana

Downtown of Indianapolis by Indiana Central Canal
f11photo / Shutterstock
Pizza is unhealthy.
  • Fast-food rate: 5 restaurants per 10,000 people
  • Obesity rate: 30% to 35%

From Indiana comes the fourth-largest pizza chain in the United States. Papa John’s opened its first pizzeria in Jeffersonville in 1984.

The chain boasts that it offers “better ingredients, better pizza,” but you’ll still need to choose wisely and limit your intake to keep your lunch remotely healthy.

A large slice of Mediterranean veggie pizza contains 250 calories and 630 mg of salt. Going for a bacon cheddarburger slice, however, cranks that up to 400 calories and 960 mg of salt — approaching half your daily sodium intake. And are you really going to have just one slice?

7. District of Columbia

Washington DC - Aerial view of Pennsylvania street with federal buildings including US Archives building, Department of Justice and US Capitol
Orhan Cam / Shutterstock
The least obese state in this list.
  • Fast-food rate: 5 restaurants per 10,000 people
  • Obesity rate: 20 to 25%

While fast-food and obesity went hand in hand in every other region on this list, Washington, D.C. bucks the trend. “Only” a fifth to a quarter of its residents are considered obese.

That said, the nation’s capital is currently home to the world’s most powerful fast-food aficionado: President Donald Trump.

During his 2016 election campaign, Trump gushed about McDonald’s, Burger King and other fast food chains. He praised the taste and cleanliness of the establishments, saying customers are better off eating at such chains than other types of restaurants.

Then, once in office, Trump started an infamous tradition of feeding fast-food feasts to visiting sports teams at the White House. Only the best!

8. Georgia

Atlanta, Georgia, USA midtown skyline from Piedmont Park in autumn.
Sean Pavone / Shutterstock
Many fast food chains started in Georgia.
  • Fast-food rate: 4.9 restaurants per 10,000 people
  • Obesity rate: 30% to 35%

On paper, Atlanta is the capital of Georgia, but it’s also one of the great fast-food capitals of the world.

Chick-fil-A and taco chain Moe’s Southwest Grill both got their start in the city. Arby’s, Sonic Drive-In and Jimmy John’s subs all have their head office in Atlanta as part of Inspire brands. And of course, no combo meal is complete without a Coca-Cola, and that company is also headquartered in Atlanta.

It’s not all about the big city, though. Datafiniti compiled a list of small cities with the most fast-food restaurants per capita, and a staggering six of the 20 were in Georgia — more than any other state.

9. Missouri

Kansas City, Missouri - city in the United States. Downtown skyline.
Tupungato / Shutterstock
Schools are cracking down on obesity.
  • Fast-food rate: 4.9 restaurants per 10,000 people
  • Obesity rate: 30% to 35%

A small city in this Midwestern state briefly became the center of national debate on food freedoms. In 2018, the Richmond School District announced a ban on fast food during school hours, saying it was unhealthy and disruptive.

“In an era when so many students are overweight and not physically fit … allowing fast food to be delivered to the school is antithetical to the messages of wellness and nutrition that schools are teaching,” officials wrote on Facebook.

The decision upset plenty of parents but was addressing a serious problem in Missouri and elsewhere. The CDC says childhood obesity affects nearly 1 in 5 Americans between ages 2 and 19.

10. South Carolina

Greenville, South Carolina, USA downtown buildings.
Sean Pavone / Shutterstock
The state is trying to address obesity.
  • Fast-food rate: 4.9 restaurants per 10,000 people
  • Obesity rate: 30% to 35%

The state’s fast-food lovers were outraged last year at the revelation that McDonald’s was creating a “South Carolina Stack” burger that wouldn’t be available in South Carolina. It wasn’t available anywhere in the U.S. for that matter — only the U.K.

Once the ingredients were revealed and the reviews came in, however, many decided the burger wouldn’t have met the state’s high standards for fast food, anyway.

While South Carolina has one of the biggest obesity problems in the nation, it’s also received high marks in recent years for its attempts to combat that problem. One long-standing program sees doctors prescribe entry to one of the state’s parks, free of charge, so patients can get some fresh air and exercise.

About the Author

Caitlin Cochrane

Caitlin Cochrane

Staff Writer

Caitlin Cochrane is a staff writer with MoneyWise, and has an educational background in human resource management and professional writing. When she is not writing, she is at home drinking tea and playing with her bunnies.

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