The United States has the highest rate of obesity in adults in the developed world, according to the Global Obesity Observatory. The share of adults in the United States defined as obese has reached an estimated 40.3%, according to a September 2024 report from the National Center for Health Statistics. This marks a slight increase from 10 years earlier. On top of that, rates of severe obesity have gone up by more than 200% between the time periods of 2001-2004 and 2021-2023, according to a study published in The Lancet in April 2025.
With that said, this study is based on body mass index, a common but increasingly unpopular measure of obesity. 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.
Though many factors appear to influence obesity, data from the Department of Agriculture's Economic Research Service suggests location could play a significant role. According to an August 2025 report, obesity rates ticked up by 0.5% in rural areas between March 2022-2023 and March 2023-2024, despite an overall decline of 0.2% seen across the U.S. The largely rural Midwest also recorded a 0.5% increase in obesity during the same time period. Rates of obesity in urban areas of the country, meanwhile, dropped by 0.3%.
However, that's not to say that all cities have low obesity rates. Stacker examined data from the Centers for Disease Control and Prevention's annual PLACES report, released in August 2024 and reflective of 2022 data, 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. All data is age-adjusted. 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 CDC, 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.
