The U.S. has the highest rate of obesity in adults in the developed world, according to the Global Obesity Observatory. The percentage of U.S. adults defined as obese has reached an estimated 38.4% as of December 2023, according to a report from Gallup. That's an increase of 6 percentage points since 2019, before the COVID-19 pandemic took a toll on the health of Americans and people around the world. Obesity rates worldwide have also increased over the past several decades, with the World Health Organization reporting most people live in countries where starvation and malnutrition kill fewer people than obesity.
A common, though decreasingly used, measure of obesity is body mass index. This calculation uses a person's height and weight to roughly indicate whether a person might be underweight, overweight, or at a generally healthy weight.
Stacker examined data from the CDC's annual PLACES report, released in July 2023, to see which cities had the highest share of obese adults. Cities with at least 10,000 residents are ranked by the share of respondents with a body mass index greater than or equal to 30, calculated from self-reported weight and height. In the event of a tie, the overall population was used.
It's vital to note that the BMI metric is so broad (and limited by historical issues) that many health experts discourage using BMI to indicate overall health. Solely using BMI to diagnose obesity and assess one's health doesn't consider variants like age, sex, gender, race, and ethnicity, with the American Medical Association recommending clinicians use BMI alongside other measures. In recent years, the body roundness index, or BRI, has been proposed as a more suitable alternative. A study published in the Journal of the American Heart Association in September 2024 found that having a higher BRI puts people at a greater risk for cardiovascular disease over a six-year period.
Weight is not necessarily a health issue on its own; problems arise when excess fat or weight, and the nutritional imbalances related to it, bring about diseases that can become chronic and even fatal. The National Heart, Lung, and Blood Institute states that overweight and obese people are at higher risk of developing "heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems, and certain cancers."
According to the Centers for Disease Control and Prevention, the annual medical cost of treating obesity in the U.S. was nearly $173 billion in 2019. Not only can obese adults be burdened by medical bills, but they also may miss work more often due to health problems.
The connection between obesity, income, and educational level is considered "complex" by the CDC, as other variables, such as gender, race, and ethnicity, play a role in the statistics. However, the CDC reports overall, those with college degrees had lower obesity prevalence than people with less education.
Among U.S. states, obesity rates and poverty indexes also appear to be related. Most cities with high obesity rates rank low in average income and educational attainment—particularly those in lower-income areas of the South and Midwest.
