Obesity is a growing health concern in the United States. According to the Centers for Disease Control and Prevention (CDC), more than 1 in 3 adults were considered obese as of 2018. Obesity rates have been steadily climbing over the past few decades. This has led many to wonder – what is the fattest city in the U.S.?
How Obesity Rates Are Measured
The CDC tracks obesity rates by metropolitan statistical areas (MSAs), which are geographic entities defined by the U.S. Office of Management and Budget for use by Federal statistical agencies. An MSA consists of a core urban area with a substantial population, plus adjacent communities having a high degree of economic and social integration with the core.
Obesity rates reflect the percentage of the adult population with a body mass index (BMI) of 30 or higher. BMI is calculated using a person’s weight and height. A BMI of 30 or higher is considered obese.
The Top 10 Fattest U.S. Metro Areas
Here are the top 10 fattest metro areas in the United States as of 2021, along with their obesity rates:
| Metro Area | Obesity Rate |
|---|---|
| McAllen-Edinburg-Mission, TX | 38.8% |
| Jackson, MS | 38.8% |
| Memphis, TN-MS-AR | 36.8% |
| Knoxville, TN | 36.7% |
| San Antonio-New Braunfels, TX | 35.8% |
| Little Rock-North Little Rock-Conway, AR | 35.7% |
| Chattanooga, TN-GA | 35.1% |
| Mobile, AL | 35.1% |
| Shreveport-Bossier City, LA | 34.7% |
| Lafayette, LA | 34.6% |
As the data shows, McAllen-Edinburg-Mission, TX tops the list with an adult obesity rate of 38.8% in 2021. Not far behind is Jackson, MS, which ties McAllen for first place. Memphis, TN-MS-AR comes in third with 36.8%.
Interestingly, 6 out of the top 10 fattest metro areas are located in the South. This region has struggled with high obesity rates for many years. Southern cuisine, warm climates, lower incomes, and limited access to fresh foods likely contribute to the South’s obesity problem.
Factors Driving High Obesity Rates
Why do some metro areas struggle with significantly higher obesity rates than others? There are a few key factors at play:
Diet
Diet has a major influence over obesity rates. Areas where unhealthy eating is more common tend to have higher obesity. Southern diets heavy in fried and processed foods likely promote obesity in cities like Memphis and Jackson.
Income
Lower income areas often have limited access to healthy foods. Fresh produce and lean proteins can be expensive, putting healthier eating out of reach for many lower-income households.
Culture
Cultural attitudes and priorities around food, exercise, and weight can affect obesity rates. Areas where fitness and active lifestyles are less valued tend to have higher obesity.
Environment
The availability of parks, sidewalks, bike lanes and other recreational facilities in a city impacts how much residents exercise. Cities designed for cars rather than pedestrians and cyclists can contribute to sedentary lifestyles.
Health Consequences of Obesity
These high obesity rates are concerning because obesity is linked to multiple health problems, including:
- Heart disease
- Stroke
- Type 2 diabetes
- Certain cancers
- Joint problems
- Fatty liver disease
Obesity also increases risks associated with COVID-19 infection and severe illness. Addressing obesity at a population level is critical for improving health outcomes.
Strategies for Reversing Obesity Trends
Turning around these obesity rates will require coordinated efforts on multiple fronts, such as:
- Improving access to affordable healthy foods through financing incentives for grocery stores in underserved neighborhoods.
- Bringing nutrition education into schools to promote healthy eating from a young age.
- Incorporating more green spaces, sidewalks, bike lanes and recreational facilities into city planning to encourage physical activity.
- Running public health campaigns about obesity prevention and treatment.
- Making preventive health services like obesity screening and counseling more accessible.
Conclusion
Obesity remains a significant public health crisis in the U.S., with rates climbing over the past 20 years. Several Southern metro areas now have adult obesity rates over 35 percent. This puts residents at higher risk of many serious health conditions. Turning the tide will require a coordinated public health response targeting diet, exercise, community design, and access to preventive services. Without concerted efforts, these high obesity rates are likely to persist, continuing to impact population health for decades to come.