Photo by Sean Pavone/Shutterstock via Stacker

The U.S. has the highest rate of obesity in adults in the developed world, according to the Global Obesity Observatory. Still, obesity rates worldwide have 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 that many health experts discourage using BMI to indicate overall health. In June 2023, the American Medical Association announced a new policy that clarifies how BMI should be used after an AMA Council on Science and Public Health report highlighted BMI’s limitations and historical issues. Solely using BMI to diagnose obesity and assess one’s health doesn’t consider variants like age, sex, gender, race, and ethnicity, with the AMA recommending clinicians use BMI alongside other measures. 

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.A driver makes their way through high winds and rain July 23, 2008 in San Benito, Texas

Dave Einsel // Getty Images

#50. San Benito, Texas

– Total population: 24,250
– Share of adults with obesity: 47%The townscape of Coffeyville with a grain elevator and a power plant.

Sabrina Janelle Gordon // Shutterstock

#49. Coffeyville, Kansas

– Total population: 10,297
– Share of adults with obesity: 47.1%A view of buildings in Minden, Louisiana.

Sabrina Janelle Gordon // Shutterstock

#48. Minden, Louisiana

– Total population: 13,084
– Share of adults with obesity: 47.1%Street view of downtown Marietta with cars parked at curb.

Wendy van Overstreet // Shutterstock

#47. Marietta, Ohio

– Total population: 14,085
– Share of adults with obesity: 47.1%Front of Portsmouth Naval Shipyard Museum in Portsmouth, Virginia.

Wangkun Jia // Shutterstock

#46. Portsmouth, Virginia

– Total population: 95,535
– Share of adults with obesity: 47.1%The Willacy County Courthouse and War Memorial.

Roberto Galan // Shutterstock

#45. Raymondville, Texas

– Total population: 11,284
– Share of adults with obesity: 47.2%Bussey Brake Reservoir in Bastrop, Louisiana.

Jarred Armfield // Shutterstock

#44. Bastrop, Louisiana

– Total population: 11,365
– Share of adults with obesity: 47.3%A road in Bogalusa, Louisiana with gas stations surrounding it.

Jahi Chikwendiu // The Washington Post via Getty Images

#43. Bogalusa, Louisiana

– Total population: 12,232
– Share of adults with obesity: 47.3%View of downtown business district of Selma, Alabama.

James Kirkikis // Shutterstock

#42. Selma, Alabama

– Total population: 20,756
– Share of adults with obesity: 47.3%Train tracks and road in Lima, Ohio.

Bravo Charlie Productions // Shutterstock

#41. Lima, Ohio

– Total population: 38,777
– Share of adults with obesity: 47.4%Palm trees during bright sunset at Donna Victoria Palms PV Resort in Donna, Texas.


#40. Donna, Texas

– Total population: 15,798
– Share of adults with obesity: 47.6%The Mad and Great Miami Rivers in Dayton, Ohio.

Beeline Aerial // Shutterstock

#39. Dayton, Ohio

– Total population: 141,542
– Share of adults with obesity: 47.6%A view of the lake and a boathouse at a park in Hamilton County Ohio

BullpenAl // Shutterstock

#38. Hamilton, Ohio

– Total population: 62,371
– Share of adults with obesity: 47.7%Y shaped bridge in Zanesville, Ohio with the town and grain elevators in the background.

CEW // Shutterstock

#37. Zanesville, Ohio

– Total population: 25,488
– Share of adults with obesity: 47.8%The city of Warren, Ohio on October 17, 2019.

Eleonore SENS / AFP via Getty Images

#36. Warren, Ohio

– Total population: 41,592
– Share of adults with obesity: 47.8%View of owntown of Canton, Ohio.

Henryk Sadura // Shutterstock

#35. Canton, Ohio

– Total population: 73,557
– Share of adults with obesity: 47.8%The Ironton-Russell Bridge crosses the Ohio River between Ironton, Ohio and Russell, Kentucky.

The American Explorer // Shutterstock

#34. Ironton, Ohio

– Total population: 11,129
– Share of adults with obesity: 47.9%The Hempstead County Courthouse in Hope, Arkansas.

Roberto Galan // Shutterstock

#33. Hope, Arkansas

– Total population: 10,122
– Share of adults with obesity: 48%Texas state flag waving against a clear blue sky.


#32. La Homa, Texas

– Total population: 11,909
– Share of adults with obesity: 48%Aerial view shows the Gateway Arch near the Mississippi River in St. Louis, Missouri. Jennings is in St. Louis County.

DANIEL SLIM/AFP // Getty Images

#31. Jennings, Missouri

– Total population: 14,710
– Share of adults with obesity: 48%A wheat field in Atmore.

Carol M. Highsmith/Buyenlarge // Getty Images

#30. Atmore, Alabama

– Total population: 10,194
– Share of adults with obesity: 48.1%Aerial view of Birmingham, Alabama. Fairfield is a part of the Birmingham metro.

Isabella Pino/REDA&CO/Universal Images Group // Getty Images

#29. Fairfield, Alabama

– Total population: 11,117
– Share of adults with obesity: 48.1%Historic Ashtabula Harbor lift bridge raised on a sunny Summer Day.

redtbird02 // Shutterstock

#28. Ashtabula, Ohio

– Total population: 19,124
– Share of adults with obesity: 48.1%The Flats, east bank of Cleveland.

Mikhalis Makarov // Shutterstock

#27. East Cleveland, Ohio

– Total population: 17,843
– Share of adults with obesity: 48.2%A plaque next to a bridge in Greenwood, Mississippi.

jmanaugh3 // Shutterstock

#26. Greenwood, Mississippi

– Total population: 15,205
– Share of adults with obesity: 48.3%Aerial view of Muskegon in Michigan.

Jacob Boomsma // Shutterstock

#25. Muskegon, Michigan

– Total population: 38,406
– Share of adults with obesity: 48.4%Mississippi state flag flies against a soft, pink and blue overcast sky.

Michael Wade/Icon Sportswire // Getty Images

#24. McComb, Mississippi

– Total population: 12,786
– Share of adults with obesity: 48.5%Akron, Ohio, USA downtown city skyline in the daytime..

Sean Pavone // Shutterstock

#23. Akron, Ohio

– Total population: 199,138
– Share of adults with obesity: 48.5%Kings Mill Covered Bridge over the Olentangy River in Marion, Ohio.

Ralf Broskvar // Shutterstock

#22. Marion, Ohio

– Total population: 36,837
– Share of adults with obesity: 48.6%The old downtown section of Middletown, Ohio.

Kilmer Media // Shutterstock

#21. Middletown, Ohio

– Total population: 48,694
– Share of adults with obesity: 48.6%Downtown York, Pennsylvania off Beaver street in the Historic District.

Christian Hinkle // Shutterstock

#20. York, Pennsylvania

– Total population: 43,718
– Share of adults with obesity: 49%A sunset view of the Newell Toll Bridge.

The American Explorer // Shutterstock

#19. East Liverpool, Ohio

– Total population: 11,300
– Share of adults with obesity: 49.3%Ohio flag flying against blue sky with fluffy clouds.


#18. Trotwood, Ohio

– Total population: 24,431
– Share of adults with obesity: 49.6%The Highland Park Ford Plant.

BD Images // Shutterstock

#17. Highland Park, Michigan

– Total population: 11,776
– Share of adults with obesity: 49.7%Flower painted pedestrian crossing in Forrest City.

Nina Alizada // Shutterstock

#16. Forrest City, Arkansas

– Total population: 15,382
– Share of adults with obesity: 49.7%Setting sun back lights a lighthouse shining.

Kenneth Keifer // Shutterstock

#15. East Chicago, Indiana

– Total population: 29,698
– Share of adults with obesity: 49.7%Youngstown, Ohio, USA downtown skyline at twilight.

Sean Pavone // Shutterstock

#14. Youngstown, Ohio

– Total population: 66,982
– Share of adults with obesity: 49.7%Ohio River & Portsmouth Ohio Bridge.

Hawkeye Dronography // Shutterstock

#13. Portsmouth, Ohio

– Total population: 20,226
– Share of adults with obesity: 50.3%Downtown street in Clarksdale, Mississippi.

Bennekom // Shutterstock

#12. Clarksdale, Mississippi

– Total population: 17,962
– Share of adults with obesity: 50.5%The cochrane bridge.

Cavan-Images // Shutterstock

#11. Prichard, Alabama

– Total population: 22,664
– Share of adults with obesity: 50.6%B.B. King Museum in Indianola, Mississippi.

Nina Alizada // Shutterstock

#10. Indianola, Mississippi

– Total population: 10,683
– Share of adults with obesity: 50.9%Aerial View of Saginaw, Michigan during Summer.

Jacob Boomsma // Shutterstock

#9. Saginaw, Michigan

– Total population: 51,497
– Share of adults with obesity: 51.1%Main Street in dowtonw Benton Harbor.

Suzanne Tucker // Shutterstock

#8. Benton Harbor, Michigan

– Total population: 10,168
– Share of adults with obesity: 51.6%Aerial View of Downtown Flint, Michigan in Summer.

Jacob Boomsma // Shutterstock

#7. Flint, Michigan

– Total population: 102,434
– Share of adults with obesity: 51.7%Sunny view of the Cahokia Mounds Museum Society.

Kit Leong // Shutterstock

#6. Cahokia, Illinois

– Total population: 15,243
– Share of adults with obesity: 51.9%Yazoo City Corp limit sign.

Chad Robertson Media // Shutterstock

#5. Yazoo City, Mississippi

– Total population: 11,403
– Share of adults with obesity: 52.1%Aerial View of Downtown Gary, Indiana and its Steel Mill.

Jacob Boomsma // Shutterstock

#4. Gary, Indiana

– Total population: 80,294
– Share of adults with obesity: 52.3%Fall foliage at Lobdell Lake in Genesee County, the same county where Beecher is located.

Xinhua/Joel Lerner // Getty Images

#3. Beecher, Michigan

– Total population: 10,232
– Share of adults with obesity: 53.8%The bright red Muskegon Pier Lighthouse.


#2. Muskegon Heights, Michigan

– Total population: 10,857
– Share of adults with obesity: 55.5%An empty Casio Queen parking lot in East St. Louis.

Wspin // Shutterstock

#1. East St. Louis, Illinois

– Total population: 27,005
– Share of adults with obesity: 57.9%

Story editing by Jeff Inglis. Copy editing by Kristen Wegrzyn. Photo selection by Clarese Moller.


Stacker is a news organization that produces and distributes data journalism to the world’s news organizations. Founded in 2017, Stacker combines data analysis with rich editorial context, drawing on authoritative sources and subject matter experts to drive storytelling. This article has been republished pursuant to a CC BY-NC 4.0 License.