The 50 Most Obese Cities in America

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Almost half of adults in the U.S. are projected to be obese, not just overweight, by 2030, according to estimates published in December 2019 in the New England Journal of Medicine. Nearly one in four people will be morbidly obese, meaning carrying about 100 pounds over one’s normal body weight.

In the age of a coronavirus pandemic, this is especially worrisome as obesity, which decreases lung capacity, may triple the risk of hospitalization due to a COVID-19 infection, according to the Centers for Disease Control and Prevention.

24/7 Tempo analyzed county-level data from the 2020 County Health Rankings & Roadmaps report (CHR), a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute to determine the 50 most obese cities in the U.S. We aggregated county-level statistics to metropolitan statistical areas.

Many of the metro areas with high obesity rates also tend to have low-income populations. People with lower incomes are less able to afford proper medical care as well as a healthy lifestyle and have less access to healthy foods or gyms. Only one of the 50 cities with the highest obesity rates on this list has a median annual household income that is higher than the U.S median of $65,712.

Though the underlying causes of obesity are many, some are within one’s control and others, like genetics, are not. The health outcomes of being obese are clearer. One of them is diabetes. All but three of the most obese cities on our list have an adult diabetes rate lower than the U.S. rate of 10.3%..

Obesity is associated with a reduced quality of life, chronic conditions such as hypertension, and diseases such as heart disease and cancer that are among  the leading causes of death. Only seven of the 50 metro areas on the list have a lower share of adults reporting being in poor or fair health than the U.S. average of 17.2%.

Health experts have pointed to several lifestyle factors that are likely contributing to the excess weight problem, among them a sedentary lifestyle and the consumption of high-calorie diets, including large sugary beverages — here are 45 popular fast-food single items with more than 1,000 calories.

Keeping active has been shown to help people maintain a healthy weight. Nationwide, 23.0% of adults report exercising on a regular basis. Of the 50 most obese cities on our list, only two metro areas have a lower share of adults who don’t exercise regularly. 

To determine the most obese cities in the U.S., 24/7 Tempo reviewed obesity data for all 384 metro areas in the country. The obesity rates — the share of adult residents who report a body mass index of 30 or greater — came from the 2020 County Health Rankings & Roadmaps (CHR), a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

 The age-adjusted percentage of the total population 20 years and over diagnosed with diabetes in 2016, the latest year for which data is available, also came from the 2020 CHR.

 Age-adjusted rates of diabetes were provided at the county level, which were then aggregated to the metropolitan level using a weighted average, based on the percentage of the 2019 one-year population of each county within each metro area. Population figures, as well as median household income and poverty rate, came from the American Community Survey 2019 1-Year Estimates.