The 20 Most Obese Cities in the United States in 2019

Despite the stereotype, the USA is not, in fact, the fattest nation in the world. That particular “honor” goes to Kuwait, a nation where almost half the residents (42.8%, to be precise) are considered obese. Before you give yourself a pat on the back for missing out on the top spot, pause to consider the fact the US still makes it to a disreputable number 10 amongst the world’s fattest countries. While body positivity is a very just and noble cause, there’s a world of difference between having a few extra curves and being morbidly obese. A raised BMI (one of the indicators of obesity) can cause a vast range of health conditions, including heart disease, diabetes, arthritis, cancer, and respiratory difficulties.

Where once obesity was considered a sign of affluence, it’s now regarded as the new disease of the poor. While the well minted can afford the kind of fresh, healthy food that keeps them in size 6 pants, those in the lower socio-economic classes are often forced to make do with the kind of carb-heavy, calorie-dense snacks that are cheap to buy and quick to expand the waistline.

According to recent Behavioral Risk Factor Surveillance System (BRFSS) data, adult obesity rates in the US are now at almost epidemic proportions, with Mississippi, West Virginia, Arkansas, Louisiana, Kentucky, Alabama, Iowa, North Dakota, and Missouri all having an obesity rate of 35% plus. The rest of the States isn’t faring too much better, with only three states (Hawaii, District of Columbia, and Colorado) having an obesity percentage of less than 25. Within the worst offending states, there are a few cities where obesity is now so commonplace it’s the new normal.

Find out which cities are sitting on a health time bomb with our rundown of the 20 most obese cities in the United States.

20. Conway, South Carolina

South Carolina is in the grip of an obesity crisis. It’s adult obesity rate is currently 34.3% (a massive 21.1% rise on the 2000 level), while its obesity rate among high school students is an alarming 17.2%. The result of these frankly frightening stats is a very sick population: 13.3% of residents have diabetes, and 38. % have hypertension. If the trend continues, it’s expected that there’ll be 1,351,642 cases of heart disease, 780,823 cases of arthritis, and 188,245 cases of cancer by 2030. Of all South Carolina’s cities, Conway is one of the fattest (not quite the fattest, however: that particular title goes to Augusta, more on which coming up shortly). Not helping the situation is the fact that 15.9% of families and 20.2% of the population live below the poverty line, which, as we know, is considered one of the main drivers of obesity.

19. San Antonio, Texas

Texas, the land of the hearty appetite and the even heartier portion size. 34.8% of Texans are now medically obese, making it the 10th fattest state in the nation. While childhood obesity is on the decline (at least among the 2-4-year-old age group, which has seen a drop of 2% in obesity rates in recent years), other age groups are just getting bigger and bigger, despite receiving federal funding from the “Healthy Food Financing Initiatives.” As the Rivard Report notes, in Texas’s country seat of San Antonia, almost 71% of adults are obese or overweight, putting it 2nd in line to the title of the state’s fattest city.

18. Nashville, Tennessee

Music may be the food of love, but in the country music capital of Tennessee, it’s no replacement for deep-fried chicken. While Tennessee as a whole is not exactly winning any gold stars for its fit and trim population, Nashville is doing worse than most, leading to the introduction of various community health initiatives that aim to turn the tide on the escalating problem. As of 2019, there’s still a long way to go.

17. Louisville, Kentucky

36.6% of the residents of Kentucky are obese, and a good percentage of that number can be found in Louisville. While the health consequences of that depressing fact may be a downer for the city’s residents, it’s been a boon for doctors, with bariatric surgeons, obesity consultants, and diabetes specialists making a killing from the ever-growing ranks of the sick, fat, and unwell

16. Chattanooga, Tennessee

Another entry from Tennessee is Chattanooga, the fourth largest city in Texas by area, and the third-largest by pant size. “In the South, we tend to fry everything and load it up with a lot of sides that include a lot of added fats, as well,” Erlanger hospital dietitian Aimee Dyess said to The Times Free Press, which may explain the ever-widening girth of Chattanooga’s residents.

15. New Orleans, Louisiana

Louisiana ranks as the fourth fattest state in the nation, and a large part of that can be attributed to the expanding waistlines of the 391,006 residents of New Orleans. As Forbes notes, more than a quarter of the population of the city is physically inactive, 42.7% of adults struggle to eat even one piece of fruit a day, 31.5% of adults refuse to eat vegetables daily, and 64% of adults and 34% of high school students are overweight or obese.

14. Columbia, South Carolina

Another entry from South Carolina comes with Columbia, a city that has the fifth-highest percentage of adults who eat less than one serving of fresh fruit or vegetables a day. The end result of a citywide hatred of low calorie, nutrient-packed food? An ever-growing obesity crisis.

13. Little Rock, Arizona

In fairness, Arizona isn’t fairing too badly when it comes to overall obesity stats: with only 29.5% of its population considered obese, there are officially 34 states doing a whole lot worse in the obesity league table. Letting the side down is Little Rock; as the capital of the state, Little Rock is not only the most populous city in Arizona, it’s also the fattest. As the CDC notes, the worst affected demographic include low-income residents- a fact that isn’t helped by 16% of the city’s population living below the Federal poverty line.

12. Oklahoma City, Oklahoma

34.8% of Oklahoma’s residents are obese, and a good percentage of these live in Oklahoma City. Fortunately, the city is making inroads into the problem with to a new range of initiatives designed to get residents off their sofas and into the gym, As the Independent notes, the new focus on exercise has witnessed the creation of numerous walking trails, bike lanes, and an all-singing, all-dancing $100 million rowing and kayaking center.

11. Lafayette, Louisiana

A love of fast food, huge portions, and pint-sized gallons of soda have made the residents of Lafayette, Louisiana some of the fattest in the nation. The end result of all those high sugar snacks? A frightening statistic of $1 in $10 health care dollars being attributed to diabetes.

10. Augusta, South Carolina

In times gone by, South Carolina was a relatively fit and healthy state. In 1990, only 12 percent of residents were considered obese. Not so today. In 2019, 34.3% of residents are classified as obese and the numbers are showing no signs of reversing. The city of Augusta is one of the very fattest in the state, which may be explained (at least in part) by the fact the income per capita is 30% lower than the national average.

9. Baton Rouge, Louisiana

According to State of Obesity, Louisiana is the 4th fattest state in the US, with 36.8% of its residents falling into the dangerously obese category. In Baton Rouge, approximately 1 in 3 children is overweight or obese, a frightening figure that is only set to grow.

8. Toledo, Ohio

Ohio’s one and only entry comes with Toledo, a city where the rate of obesity is growing on an almost daily basis. Ivy Panada put the problem down to the limited availability of healthy food in state schools, and a lack of focus on education about exercise and diet. Whatever the reason, the end result is a population with an alarming 34% obesity rate.

7. Knoxville, Tennessee

By this point on our list, we can safely conclude that Tennessee has a huge obesity problem. At number 7, we have yet another entry from the flabby state in the shape of Knoxville. Around 178,874 people live in Knoxville, and of those, 34.4% are medically obese. 40.5% of those are in the 45-64 age demographic, 30.7% are aged 65+, 33.8% are between 26 and 44, and 25.2% are aged 18-25. Just as alarming as the adult obesity rate is the childhood obesity stats: 20.5% of high school students are obese, 15.6% of 10-17-year olds are overweight, and a damning 14.9% of 2-4-year-olds are officially fat.

6. Tulsa, Oklahoma

The 2nd (and fattest) city in Oklahoma to make our list is Tulsa. According to the research of Tulsa County Wellness Partnership, a major problem fueling the obesity crisis amongst the city’s kids is the lack of time they’re allowed for school lunches “If you’re not getting adequate time at lunch, we’ve found that students are not going to be eating the healthier choices like baby carrots or whole apples because they usually take longer to eat. They are going to go for the things that are easier to chew like the carbohydrates,” Lauren Bradley, a member of the partnership’s school outreach committee, told Tulsa Kids.

5. Mobile, Alabama

In Mobile, Alabama, a shocking 36.2% of the population are classified as obese. Bad though that sounds in isolation, what makes it all the more frightening is the speed obesity has gripped the city: in 2000, the obesity percentage was just 22.6%, while in 1990, it was a tiny 11.2%. If the current trend continues, State of Obesity predicts that there will be 661,673 cases of diabetes, 1,286,270 cases of hypertension, 1,458,880 cases of heart disease, and 200,226 cases of cancer by 2030. If those figures aren’t enough to get you pulling on your sneakers and hitting the gym, I don’t know what will.

4. Jackson, Mississippi

Surprisingly enough considering its ranking as the fattest state in the US, the only one of Mississippi’s cities to make our list is Jackson… which suggests it’s one very obese town, indeed. According to Publichealth.com, Jackson residents are the 2nd most inactive in any city in the US; given the correlation between low physical activity and increased BMI, it’s little wonder Jackson ranks as the 4th fattest city in the nation.

3. Memphis, Tennessee

Our final entry from Tennessee comes in the shape of the county seat of Shelby County, Memphis. “The obesity problem in Tennessee, more specifically in Memphis, is alarming,” Christian Huls, a personal nutritionist and owner of StraightForwardFitness, tells Memphis Mirror . “I’ve worked with obese parents and children, and the only way to fix it is through proper training and experience, which a lot of individuals in Memphis don’t ever get.”

2. Shreveport, Louisiana

Shreveport, Louisiana has become an almost permanent fixture on round ups of the nation’s fattest cities, a status which comes with some pretty alarming consequences. The city now has the fourth highest rate of diabetes and the second highest percentage of residents with high blood pressure in the country, two things which more than explains the $315.8 billion being spent annually on obesity-related medical treatment.

1. McAllen-Edinburg-Mission, Texas

Topping the charts (and the scale) is McAllen-Edinburg-Mission, Texas, officially the nation’s fattest city in 2019. A staggering 38.8 percent of the city’s population is considered obese, a figure that Live Science estimates costs the region more than $400 million in unnecessary health-care costs annually. By their reckoning, the city could save a staggering $250 million annually if it cut its obesity rate by just 15%. What could be a greater incentive for the city to invest in some new well-being initiatives than that?


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