Time to take a look in the mirror if you live in one of these cities in Texas.

Before you get mad at me, the The American College of Sports Medicine is the one that published this information. They took the top 100 biggest cities in America and broke down which ones need to work on their fitness choices in life. Another reason for Texas to laugh at Oklahoma. Oklahoma City was ranked the least healthiest city in all of America. Let's see where Texas ranks. 

How Do They Determine the Least Healthiest Cities?

The American College of Sports Medicine looked at five factors for the 100 biggest cities in the country.

1. Health behaviors: e.g., percentage of people bicycling or walking to work, daily fruit and vegetable intake, and meeting aerobic and strength activity guidelines
2. Health outcomes: e.g., physical and mental health reports, obesity rates, and pedestrian fatalities vs. the resident ratio
3. Built environment: e.g., percentage of days with good air quality, food insecurity rates, and parks vs. resident ratio
4. Recreational facilities: e.g., the number of basketball hoops, splash pads and pickleball courts vs. residents
5. Policy and funding: local Complete Streets policy (how a community maintains safe streets for all ages), and park expenditure per resident

Texas and Oklahoma Dominate the Top Ten Least Healthy

Almost half of the ten least healthy big cities in America were right here. Oklahoma City was named the least healthy of 2025, with Lubbock falling right behind them at two. San Antonio and Tulsa also managed to make their way into the top ten. Check out the full breakdown here for more.