A new study shows that Yakima is one of the fattest places in America — fourth in the nation.

According to the Gallup-Healthways Well-Being Index Survey, more than 35 percent of people living in Yakima are overweight.

Katie Wolff, chief clinical dietician at Yakima Valley Memorial Hospital, said large portion sizes and a lower-income population are two factors. Many people do not understand the ways you can still eat healthy on a low-income budget.

But Wolff also said personal choices and accountability play a big role.

"It really makes me think we need to look in the mirror and say what's going on in our city, and how can we improve it," Wolff said. "And give people maybe more opportunities or just educate to what is out there."

The Hungtinton-Ashland area of West Virginia and Kentucky had the highest obesity rate at nearly 40 percent. Boulder, Colo., had the lowest obesity rate, with just around 12 percent of its population considered obese.