America’s Most Obese Counties

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Recent public health crises, namely the COVID-19 pandemic and the opioid epidemic, have overshadowed a longer-standing problem in the United States — obesity. Since the early 1960s, the share of American adults under age 75 who are considered obese more than tripled. Currently, an estimated 72.2 million Americans age 20 and up are obese, or 30% of the age group. 

Obesity status is determined by body mass index, or BMI — a ratio of height to body weight. Americans with a BMI of 30 or higher are considered obese, and as such, at greater risk of diabetes, stroke, hypertension, heart disease, breathing problems, certain cancers, and mortality, according to the Centers for Disease Control and Prevention. Obesity can also detract from overall quality of life and contribute to depression, anxiety, and other mental illnesses. 

Using data from County Health Rankings & Roadmaps, 24/7 Tempo identified the most obese counties in the United States. The U.S. has one of the highest obesity rates in the world, and in many counties on this list, over half of the adult population are obese. 

The majority of counties on this list are located in the South, including 14 counties in Mississippi and six in Alabama. 

Though many factors, including genetics, diet, and medical conditions, contribute to increased risk of obesity, regular physical activity is one of the best ways to help maintain a healthy weight. In all but two counties on this list, the share of adults who do not exercise regularly is higher than the 22.7% share of adults nationwide. Here is a look at the most physically active cities in America. 

By some measures, health outcomes are worse than average in most of these counties as well. For example, obesity is a leading risk factor for Type 2 diabetes, and in nearly all of the counties on this list, diabetes is more common than it is nationwide.