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.
Click here to see America’s most obese counties
Click here to see our detailed methodology
50. Lafayette County, Arkansas
> Adult obesity rate: 46.4%
> Adults who don’t exercise: 32.2% — 548th highest of 3,106 counties
> Adults with diabetes: 18.9% — 167th highest of 3,106 counties
> Adults reporting poor or fair health: 28.5% — 177th highest of 3,106 counties
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49. Bienville Parish, Louisiana
> Adult obesity rate: 46.5%
> Adults who don’t exercise: 26.7% — 1,492nd highest of 3,106 counties
> Adults with diabetes: 21.0% — 70th highest of 3,106 counties
> Adults reporting poor or fair health: 28.6% — 173rd highest of 3,106 counties
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48. Scotland County, North Carolina
> Adult obesity rate: 46.5%
> Adults who don’t exercise: 28.4% — 1,157th highest of 3,106 counties
> Adults with diabetes: 19.7% — 117th highest of 3,106 counties
> Adults reporting poor or fair health: 28.1% — 201st highest of 3,106 counties
47. Burleson County, Texas
> Adult obesity rate: 46.6%
> Adults who don’t exercise: 27.4% — 1,354th highest of 3,106 counties
> Adults with diabetes: 13.3% — 1,075th highest of 3,106 counties
> Adults reporting poor or fair health: 21.1% — 1,240th highest of 3,106 counties
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46. Bullock County, Alabama
> Adult obesity rate: 46.6%
> Adults who don’t exercise: 42.4% — 17th highest of 3,106 counties
> Adults with diabetes: 29.5% — the highest of 3,106 counties
> Adults reporting poor or fair health: 31.4% — 65th highest of 3,106 counties
45. Owsley County, Kentucky
> Adult obesity rate: 46.7%
> Adults who don’t exercise: 27.4% — 1,353rd highest of 3,106 counties
> Adults with diabetes: 13.5% — 1,039th highest of 3,106 counties
> Adults reporting poor or fair health: 30.5% — 91st highest of 3,106 counties
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44. Perry County, Alabama
> Adult obesity rate: 46.8%
> Adults who don’t exercise: 35.9% — 205th highest of 3,106 counties
> Adults with diabetes: 20.5% — 90th highest of 3,106 counties
> Adults reporting poor or fair health: 34.6% — 29th highest of 3,106 counties
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43. Union County, South Carolina
> Adult obesity rate: 46.8%
> Adults who don’t exercise: 33.0% — 446th highest of 3,106 counties
> Adults with diabetes: 15.9% — 484th highest of 3,106 counties
> Adults reporting poor or fair health: 22.8% — 908th highest of 3,106 counties
42. Butler County, Alabama
> Adult obesity rate: 46.8%
> Adults who don’t exercise: 40.3% — 39th highest of 3,106 counties
> Adults with diabetes: 19.5% — 127th highest of 3,106 counties
> Adults reporting poor or fair health: 27.9% — 220th highest of 3,106 counties
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41. Warren County, North Carolina
> Adult obesity rate: 46.9%
> Adults who don’t exercise: 25.2% — 1,285th lowest of 3,106 counties
> Adults with diabetes: 12.6% — 1,333rd highest of 3,106 counties
> Adults reporting poor or fair health: 25.8% — 446th highest of 3,106 counties
40. Haywood County, Tennessee
> Adult obesity rate: 47.0%
> Adults who don’t exercise: 30.9% — 739th highest of 3,106 counties
> Adults with diabetes: 17.7% — 264th highest of 3,106 counties
> Adults reporting poor or fair health: 28.7% — 169th highest of 3,106 counties
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39. Greene County, Mississippi
> Adult obesity rate: 47.1%
> Adults who don’t exercise: 30.2% — 836th highest of 3,106 counties
> Adults with diabetes: 14.0% — 910th highest of 3,106 counties
> Adults reporting poor or fair health: 22.7% — 928th highest of 3,106 counties
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38. East Carroll Parish, Louisiana
> Adult obesity rate: 47.1%
> Adults who don’t exercise: 19.8% — 362nd lowest of 3,106 counties
> Adults with diabetes: 22.1% — 46th highest of 3,106 counties
> Adults reporting poor or fair health: 40.5% — 3rd highest of 3,106 counties
37. Thurston County, Nebraska
> Adult obesity rate: 47.2%
> Adults who don’t exercise: 29.2% — 1,003rd highest of 3,106 counties
> Adults with diabetes: 18.8% — 169th highest of 3,106 counties
> Adults reporting poor or fair health: 23.5% — 789th highest of 3,106 counties
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36. Choctaw County, Alabama
> Adult obesity rate: 47.2%
> Adults who don’t exercise: 33.7% — 362nd highest of 3,106 counties
> Adults with diabetes: 17.9% — 240th highest of 3,106 counties
> Adults reporting poor or fair health: 26.4% — 387th highest of 3,106 counties
35. Claiborne County, Mississippi
> Adult obesity rate: 47.4%
> Adults who don’t exercise: 38.7% — 74th highest of 3,106 counties
> Adults with diabetes: 18.6% — 187th highest of 3,106 counties
> Adults reporting poor or fair health: 35.8% — 20th highest of 3,106 counties
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34. Lauderdale County, Tennessee
> Adult obesity rate: 47.4%
> Adults who don’t exercise: 36.0% — 193rd highest of 3,106 counties
> Adults with diabetes: 21.5% — 59th highest of 3,106 counties
> Adults reporting poor or fair health: 30.2% — 103rd highest of 3,106 counties
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33. Southampton County, Virginia
> Adult obesity rate: 47.4%
> Adults who don’t exercise: 33.6% — 379th highest of 3,106 counties
> Adults with diabetes: 16.3% — 444th highest of 3,106 counties
> Adults reporting poor or fair health: 20.3% — 1,392nd highest of 3,106 counties
32. Johnson County, Georgia
> Adult obesity rate: 47.4%
> Adults who don’t exercise: 38.4% — 79th highest of 3,106 counties
> Adults with diabetes: 22.4% — 40th highest of 3,106 counties
> Adults reporting poor or fair health: 25.4% — 508th highest of 3,106 counties
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31. Desha County, Arkansas
> Adult obesity rate: 47.5%
> Adults who don’t exercise: 34.8% — 272nd highest of 3,106 counties
> Adults with diabetes: 9.5% — 703rd lowest of 3,106 counties
> Adults reporting poor or fair health: 33.4% — 42nd highest of 3,106 counties
30. St. John the Baptist Parish, Louisiana
> Adult obesity rate: 47.5%
> Adults who don’t exercise: 32.4% — 529th highest of 3,106 counties
> Adults with diabetes: 12.3% — 1,403rd highest of 3,106 counties
> Adults reporting poor or fair health: 23.4% — 813th highest of 3,106 counties
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29. Wayne County, Mississippi
> Adult obesity rate: 47.9%
> Adults who don’t exercise: 39.5% — 55th highest of 3,106 counties
> Adults with diabetes: 23.4% — 22nd highest of 3,106 counties
> Adults reporting poor or fair health: 26.5% — 371st highest of 3,106 counties
28. Jasper County, Mississippi
> Adult obesity rate: 48.1%
> Adults who don’t exercise: 33.0% — 442nd highest of 3,106 counties
> Adults with diabetes: 20.9% — 77th highest of 3,106 counties
> Adults reporting poor or fair health: 27.1% — 303rd highest of 3,106 counties
27. Franklin County, Iowa
> Adult obesity rate: 48.1%
> Adults who don’t exercise: 28.1% — 1,214th highest of 3,106 counties
> Adults with diabetes: 15.8% — 510th highest of 3,106 counties
> Adults reporting poor or fair health: 16.3% — 793rd lowest of 3,106 counties
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26. St. Francis County, Arkansas
> Adult obesity rate: 48.2%
> Adults who don’t exercise: 31.0% — 730th highest of 3,106 counties
> Adults with diabetes: 15.4% — 579th highest of 3,106 counties
> Adults reporting poor or fair health: 31.4% — 68th highest of 3,106 counties
25. Hertford County, North Carolina
> Adult obesity rate: 48.5%
> Adults who don’t exercise: 41.7% — 20th highest of 3,106 counties
> Adults with diabetes: 25.2% — 10th highest of 3,106 counties
> Adults reporting poor or fair health: 26.9% — 322nd highest of 3,106 counties
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24. Wayne County, Iowa
> Adult obesity rate: 48.6%
> Adults who don’t exercise: 27.8% — 1,263rd highest of 3,106 counties
> Adults with diabetes: 20.3% — 93rd highest of 3,106 counties
> Adults reporting poor or fair health: 17.7% — 1,103rd lowest of 3,106 counties
23. King and Queen County, Virginia
> Adult obesity rate: 48.7%
> Adults who don’t exercise: 32.2% — 560th highest of 3,106 counties
> Adults with diabetes: 17.7% — 272nd highest of 3,106 counties
> Adults reporting poor or fair health: 21.4% — 1,168th highest of 3,106 counties
22. Gates County, North Carolina
> Adult obesity rate: 48.9%
> Adults who don’t exercise: 35.8% — 209th highest of 3,106 counties
> Adults with diabetes: 15.8% — 501st highest of 3,106 counties
> Adults reporting poor or fair health: 19.5% — 1,530th lowest of 3,106 counties
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21. Bladen County, North Carolina
> Adult obesity rate: 49.1%
> Adults who don’t exercise: 30.7% — 774th highest of 3,106 counties
> Adults with diabetes: 22.3% — 44th highest of 3,106 counties
> Adults reporting poor or fair health: 26.2% — 404th highest of 3,106 counties
20. Leake County, Mississippi
> Adult obesity rate: 49.2%
> Adults who don’t exercise: 35.2% — 243rd highest of 3,106 counties
> Adults with diabetes: 21.9% — 51st highest of 3,106 counties
> Adults reporting poor or fair health: 29.6% — 125th highest of 3,106 counties
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19. Wilkinson County, Mississippi
> Adult obesity rate: 49.4%
> Adults who don’t exercise: 34.2% — 324th highest of 3,106 counties
> Adults with diabetes: 11.9% — 1,533rd highest of 3,106 counties
> Adults reporting poor or fair health: 36.1% — 14th highest of 3,106 counties
18. Warren County, Georgia
> Adult obesity rate: 49.5%
> Adults who don’t exercise: 21.8% — 610th lowest of 3,106 counties
> Adults with diabetes: 21.7% — 56th highest of 3,106 counties
> Adults reporting poor or fair health: 28.3% — 191st highest of 3,106 counties
17. Scott County, Mississippi
> Adult obesity rate: 49.8%
> Adults who don’t exercise: 32.6% — 507th highest of 3,106 counties
> Adults with diabetes: 24.3% — 13th highest of 3,106 counties
> Adults reporting poor or fair health: 30.5% — 96th highest of 3,106 counties
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16. Wilcox County, Alabama
> Adult obesity rate: 49.8%
> Adults who don’t exercise: 34.6% — 293rd highest of 3,106 counties
> Adults with diabetes: 18.7% — 181st highest of 3,106 counties
> Adults reporting poor or fair health: 32.1% — 56th highest of 3,106 counties
15. Noxubee County, Mississippi
> Adult obesity rate: 49.8%
> Adults who don’t exercise: 31.6% — 641st highest of 3,106 counties
> Adults with diabetes: 12.6% — 1,305th highest of 3,106 counties
> Adults reporting poor or fair health: 30.5% — 93rd highest of 3,106 counties
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14. Clay County, Mississippi
> Adult obesity rate: 50.2%
> Adults who don’t exercise: 31.9% — 590th highest of 3,106 counties
> Adults with diabetes: 17.0% — 341st highest of 3,106 counties
> Adults reporting poor or fair health: 26.6% — 357th highest of 3,106 counties
13. Troup County, Georgia
> Adult obesity rate: 50.3%
> Adults who don’t exercise: 31.3% — 679th highest of 3,106 counties
> Adults with diabetes: 12.6% — 1,328th highest of 3,106 counties
> Adults reporting poor or fair health: 22.0% — 1,050th highest of 3,106 counties
12. Buffalo County, South Dakota
> Adult obesity rate: 50.4%
> Adults who don’t exercise: 27.2% — 1,405th highest of 3,106 counties
> Adults with diabetes: 18.4% — 216th highest of 3,106 counties
> Adults reporting poor or fair health: 34.6% — 31st highest of 3,106 counties
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11. Simpson County, Mississippi
> Adult obesity rate: 50.6%
> Adults who don’t exercise: 31.9% — 592nd highest of 3,106 counties
> Adults with diabetes: 18.1% — 232nd highest of 3,106 counties
> Adults reporting poor or fair health: 27.2% — 289th highest of 3,106 counties
10. Holmes County, Mississippi
> Adult obesity rate: 50.7%
> Adults who don’t exercise: 40.7% — 33rd highest of 3,106 counties
> Adults with diabetes: 20.5% — 85th highest of 3,106 counties
> Adults reporting poor or fair health: 37.0% — 10th highest of 3,106 counties
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9. Sabine Parish, Louisiana
> Adult obesity rate: 50.8%
> Adults who don’t exercise: 33.2% — 421st highest of 3,106 counties
> Adults with diabetes: 15.4% — 578th highest of 3,106 counties
> Adults reporting poor or fair health: 23.9% — 729th highest of 3,106 counties
8. Macon County, Alabama
> Adult obesity rate: 50.9%
> Adults who don’t exercise: 32.5% — 520th highest of 3,106 counties
> Adults with diabetes: 16.8% — 371st highest of 3,106 counties
> Adults reporting poor or fair health: 28.0% — 212th highest of 3,106 counties
7. Jefferson County, Mississippi
> Adult obesity rate: 50.9%
> Adults who don’t exercise: 36.3% — 182nd highest of 3,106 counties
> Adults with diabetes: 16.7% — 379th highest of 3,106 counties
> Adults reporting poor or fair health: 37.9% — 7th highest of 3,106 counties
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6. Aleutians East Borough, Alaska
> Adult obesity rate: 51.9%
> Adults who don’t exercise: 26.6% — 1,527th highest of 3,106 counties
> Adults with diabetes: 14.5% — 807th highest of 3,106 counties
> Adults reporting poor or fair health: 20.9% — 1,275th highest of 3,106 counties
5. Ziebach County, South Dakota
> Adult obesity rate: 52.5%
> Adults who don’t exercise: 27.2% — 1,400th highest of 3,106 counties (tied)
> Adults with diabetes: 19.0% — 152nd highest of 3,106 counties
> Adults reporting poor or fair health: 30.4% — 98th highest of 3,106 counties
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4. Humphreys County, Mississippi
> Adult obesity rate: 53.2%
> Adults who don’t exercise: 28.5% — 1,144th highest of 3,106 counties
> Adults with diabetes: 15.8% — 515th highest of 3,106 counties
> Adults reporting poor or fair health: 36.3% — 13th highest of 3,106 counties
3. Candler County, Georgia
> Adult obesity rate: 53.7%
> Adults who don’t exercise: 28.1% — 1,219th highest of 3,106 counties
> Adults with diabetes: 15.4% — 576th highest of 3,106 counties
> Adults reporting poor or fair health: 28.1% — 204th highest of 3,106 counties
2. Sunflower County, Mississippi
> Adult obesity rate: 53.7%
> Adults who don’t exercise: 31.0% — 727th highest of 3,106 counties
> Adults with diabetes: 24.6% — 12th highest of 3,106 counties
> Adults reporting poor or fair health: 32.4% — 52nd highest of 3,106 counties
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1. Okfuskee County, Oklahoma
> Adult obesity rate: 58.9%
> Adults who don’t exercise: 42.4% — 15th highest of 3,106 counties
> Adults with diabetes: 15.3% — 622nd highest of 3,106 counties
> Adults reporting poor or fair health: 28.4% — 182nd highest of 3,106 counties
Methodology
To determine America’s most obese counties, 24/7 Tempo reviewed adult obesity rates from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report.
The adult obesity rate is defined as the share of adults 20 years and older who report a body mass index of 30 kg/m2 or higher. While the CHR report is from 2021, obesity rate figures published in the report are from 2017.
Of the 3,220 counties or county equivalents, 3,142 had boundaries that fell within one of the 50 states or the District of Columbia.
Counties with a 2019 five-year population estimate from the U.S. Census Bureau of less than 1,000 were excluded.
The remaining 3,106 places were ranked based on the adult obesity rate. Additional information on the share of adults who report no leisure-time physical activity, the share of adults diagnosed with diabetes, and the share of adults who report fair or poor health are also from the 2021 CHR.
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