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 29.7% of the age group.
Obesity status is determined by body mass index, or BMI, a ratio of body weight to height. Americans with a BMI of 30 or higher are considered obese and are at greater risk of diabetes, stroke, hypertension, heart disease, breathing problems, certain cancers, and mortality, according to the CDC. 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 Wall St. identified the most obese county or county equivalent in each state.
Though each of the counties on this list ranks as the most obese in its respective state, obesity rates vary considerably in these places, from 25.8% to well over 50%.
While 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 nearly every county on this list, the share of adults who do not exercise regularly is higher than the comparable share of adults across the state as a whole. 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 the majority of counties on this list, diabetes is more common than it is across the state as a whole.
Click here to see the most obese county in every state
Click here to see our detailed methodology
Alabama: Macon County
> Adult obesity rate: 50.9% (Alabama: 36.1%)
> Adults who don’t exercise: 32.5% (Alabama: 29.3%)
> Adults with diabetes: 16.8% (Alabama: 14.5%)
> Adults reporting poor or fair health: 28.0% (Alabama: 21.4%)
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Alaska: Aleutians East Borough
> Adult obesity rate: 51.9% (Alaska: 31.9%)
> Adults who don’t exercise: 26.6% (Alaska: 19.3%)
> Adults with diabetes: 14.5% (Alaska: 8.3%)
> Adults reporting poor or fair health: 20.9% (Alaska: 15.6%)
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Arizona: Yuma County
> Adult obesity rate: 37.9% (Arizona: 27.9%)
> Adults who don’t exercise: 24.3% (Arizona: 21.2%)
> Adults with diabetes: 12.0% (Arizona: 9.6%)
> Adults reporting poor or fair health: 26.1% (Arizona: 18.6%)
Arkansas: St. Francis County
> Adult obesity rate: 48.2% (Arkansas: 35.0%)
> Adults who don’t exercise: 31.0% (Arkansas: 30.4%)
> Adults with diabetes: 15.4% (Arkansas: 13.5%)
> Adults reporting poor or fair health: 31.4% (Arkansas: 23.3%)
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California: Colusa County
> Adult obesity rate: 39.0% (California: 24.3%)
> Adults who don’t exercise: 26.2% (California: 17.7%)
> Adults with diabetes: 15.5% (California: 8.8%)
> Adults reporting poor or fair health: 24.2% (California: 17.6%)
Colorado: Logan County
> Adult obesity rate: 36.0% (Colorado: 22.4%)
> Adults who don’t exercise: 22.3% (Colorado: 14.8%)
> Adults with diabetes: 9.9% (Colorado: 6.6%)
> Adults reporting poor or fair health: 17.6% (Colorado: 13.8%)
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Connecticut: Windham County
> Adult obesity rate: 31.0% (Connecticut: 26.3%)
> Adults who don’t exercise: 24.0% (Connecticut: 19.9%)
> Adults with diabetes: 11.0% (Connecticut: 9.2%)
> Adults reporting poor or fair health: 15.5% (Connecticut: 13.0%)
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Delaware: Kent County
> Adult obesity rate: 38.4% (Delaware: 32.4%)
> Adults who don’t exercise: 30.9% (Delaware: 27.3%)
> Adults with diabetes: 13.9% (Delaware: 11.8%)
> Adults reporting poor or fair health: 21.0% (Delaware: 16.3%)
Florida: Gadsden County
> Adult obesity rate: 43.5% (Florida: 27.2%)
> Adults who don’t exercise: 35.3% (Florida: 25.8%)
> Adults with diabetes: 20.5% (Florida: 10.8%)
> Adults reporting poor or fair health: 26.8% (Florida: 19.5%)
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Georgia: Candler County
> Adult obesity rate: 53.7% (Georgia: 32.3%)
> Adults who don’t exercise: 28.1% (Georgia: 26.4%)
> Adults with diabetes: 15.4% (Georgia: 12.0%)
> Adults reporting poor or fair health: 28.1% (Georgia: 18.4%)
Hawaii: Hawaii County
> Adult obesity rate: 25.8% (Hawaii: 24.6%)
> Adults who don’t exercise: 19.9% (Hawaii: 19.6%)
> Adults with diabetes: 11.2% (Hawaii: 11.1%)
> Adults reporting poor or fair health: 17.1% (Hawaii: 15.4%)
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Idaho: Owyhee County
> Adult obesity rate: 40.2% (Idaho: 29.0%)
> Adults who don’t exercise: 26.6% (Idaho: 20.4%)
> Adults with diabetes: 15.5% (Idaho: 9.3%)
> Adults reporting poor or fair health: 24.4% (Idaho: 15.1%)
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Illinois: Vermilion County
> Adult obesity rate: 43.2% (Illinois: 29.7%)
> Adults who don’t exercise: 29.0% (Illinois: 21.6%)
> Adults with diabetes: 12.4% (Illinois: 9.9%)
> Adults reporting poor or fair health: 21.1% (Illinois: 15.9%)
Indiana: Martin County
> Adult obesity rate: 45.8% (Indiana: 33.9%)
> Adults who don’t exercise: 39.0% (Indiana: 26.7%)
> Adults with diabetes: 9.9% (Indiana: 12.1%)
> Adults reporting poor or fair health: 20.0% (Indiana: 18.2%)
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Iowa: Wayne County
> Adult obesity rate: 48.6% (Iowa: 34.3%)
> Adults who don’t exercise: 27.8% (Iowa: 22.6%)
> Adults with diabetes: 20.3% (Iowa: 9.9%)
> Adults reporting poor or fair health: 17.7% (Iowa: 13.5%)
Kansas: Osage County
> Adult obesity rate: 42.4% (Kansas: 33.0%)
> Adults who don’t exercise: 30.1% (Kansas: 23.9%)
> Adults with diabetes: 14.8% (Kansas: 10.5%)
> Adults reporting poor or fair health: 17.7% (Kansas: 16.3%)
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Kentucky: Owsley County
> Adult obesity rate: 46.7% (Kentucky: 34.6%)
> Adults who don’t exercise: 27.4% (Kentucky: 28.7%)
> Adults with diabetes: 13.5% (Kentucky: 12.7%)
> Adults reporting poor or fair health: 30.5% (Kentucky: 21.8%)
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Louisiana: Sabine Parish
> Adult obesity rate: 50.8% (Louisiana: 36.3%)
> Adults who don’t exercise: 33.2% (Louisiana: 28.0%)
> Adults with diabetes: 15.4% (Louisiana: 13.0%)
> Adults reporting poor or fair health: 23.9% (Louisiana: 21.4%)
Maine: Aroostook County
> Adult obesity rate: 37.7% (Maine: 29.8%)
> Adults who don’t exercise: 30.7% (Maine: 20.8%)
> Adults with diabetes: 15.0% (Maine: 10.4%)
> Adults reporting poor or fair health: 21.7% (Maine: 17.1%)
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Maryland: Somerset County
> Adult obesity rate: 41.9% (Maryland: 31.6%)
> Adults who don’t exercise: 32.5% (Maryland: 21.9%)
> Adults with diabetes: 15.9% (Maryland: 11.1%)
> Adults reporting poor or fair health: 23.8% (Maryland: 15.2%)
Massachusetts: Hampden County
> Adult obesity rate: 30.5% (Massachusetts: 25.0%)
> Adults who don’t exercise: 26.1% (Massachusetts: 20.0%)
> Adults with diabetes: 10.0% (Massachusetts: 8.7%)
> Adults reporting poor or fair health: 19.1% (Massachusetts: 13.5%)
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Michigan: Gratiot County
> Adult obesity rate: 45.6% (Michigan: 32.4%)
> Adults who don’t exercise: 23.0% (Michigan: 23.1%)
> Adults with diabetes: 10.2% (Michigan: 11.0%)
> Adults reporting poor or fair health: 20.7% (Michigan: 18.3%)
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Minnesota: Marshall County
> Adult obesity rate: 43.5% (Minnesota: 29.0%)
> Adults who don’t exercise: 29.1% (Minnesota: 19.6%)
> Adults with diabetes: 11.6% (Minnesota: 8.5%)
> Adults reporting poor or fair health: 14.6% (Minnesota: 12.9%)
Mississippi: Sunflower County
> Adult obesity rate: 53.7% (Mississippi: 39.1%)
> Adults who don’t exercise: 31.0% (Mississippi: 30.4%)
> Adults with diabetes: 24.6% (Mississippi: 14.6%)
> Adults reporting poor or fair health: 32.4% (Mississippi: 22.1%)
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Missouri: Dunklin County
> Adult obesity rate: 41.7% (Missouri: 32.5%)
> Adults who don’t exercise: 42.9% (Missouri: 25.5%)
> Adults with diabetes: 17.9% (Missouri: 11.4%)
> Adults reporting poor or fair health: 29.2% (Missouri: 19.5%)
Montana: Hill County
> Adult obesity rate: 39.3% (Montana: 27.1%)
> Adults who don’t exercise: 27.9% (Montana: 21.7%)
> Adults with diabetes: 11.0% (Montana: 8.9%)
> Adults reporting poor or fair health: 20.1% (Montana: 14.1%)
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Nebraska: Thurston County
> Adult obesity rate: 47.2% (Nebraska: 33.4%)
> Adults who don’t exercise: 29.2% (Nebraska: 22.7%)
> Adults with diabetes: 18.8% (Nebraska: 10.0%)
> Adults reporting poor or fair health: 23.5% (Nebraska: 13.8%)
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Nevada: Pershing County
> Adult obesity rate: 39.2% (Nevada: 27.1%)
> Adults who don’t exercise: 28.4% (Nevada: 22.5%)
> Adults with diabetes: 8.0% (Nevada: 10.5%)
> Adults reporting poor or fair health: 21.8% (Nevada: 19.1%)
New Hampshire: Coos County
> Adult obesity rate: 36.7% (New Hampshire: 28.6%)
> Adults who don’t exercise: 26.2% (New Hampshire: 20.8%)
> Adults with diabetes: 14.5% (New Hampshire: 9.6%)
> Adults reporting poor or fair health: 18.5% (New Hampshire: 12.8%)
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New Jersey: Salem County
> Adult obesity rate: 39.0% (New Jersey: 27.0%)
> Adults who don’t exercise: 32.6% (New Jersey: 26.6%)
> Adults with diabetes: 15.6% (New Jersey: 9.9%)
> Adults reporting poor or fair health: 19.0% (New Jersey: 15.5%)
New Mexico: Guadalupe County
> Adult obesity rate: 39.6% (New Mexico: 27.3%)
> Adults who don’t exercise: 28.9% (New Mexico: 19.0%)
> Adults with diabetes: 7.3% (New Mexico: 9.5%)
> Adults reporting poor or fair health: 23.6% (New Mexico: 20.3%)
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New York: Chenango County
> Adult obesity rate: 39.3% (New York: 26.4%)
> Adults who don’t exercise: 24.2% (New York: 23.4%)
> Adults with diabetes: 13.6% (New York: 10.1%)
> Adults reporting poor or fair health: 17.6% (New York: 16.3%)
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North Carolina: Bladen County
> Adult obesity rate: 49.1% (North Carolina: 32.3%)
> Adults who don’t exercise: 30.7% (North Carolina: 23.3%)
> Adults with diabetes: 22.3% (North Carolina: 11.5%)
> Adults reporting poor or fair health: 26.2% (North Carolina: 18.0%)
North Dakota: Rolette County
> Adult obesity rate: 45.5% (North Dakota: 33.9%)
> Adults who don’t exercise: 32.6% (North Dakota: 23.1%)
> Adults with diabetes: 16.8% (North Dakota: 9.4%)
> Adults reporting poor or fair health: 28.6% (North Dakota: 13.6%)
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Ohio: Jackson County
> Adult obesity rate: 42.8% (Ohio: 33.5%)
> Adults who don’t exercise: 35.0% (Ohio: 26.1%)
> Adults with diabetes: 18.9% (Ohio: 12.2%)
> Adults reporting poor or fair health: 22.5% (Ohio: 17.8%)
Oklahoma: Okfuskee County
> Adult obesity rate: 58.9% (Oklahoma: 34.5%)
> Adults who don’t exercise: 42.4% (Oklahoma: 27.8%)
> Adults with diabetes: 15.3% (Oklahoma: 12.3%)
> Adults reporting poor or fair health: 28.4% (Oklahoma: 20.9%)
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Oregon: Malheur County
> Adult obesity rate: 39.9% (Oregon: 29.3%)
> Adults who don’t exercise: 23.0% (Oregon: 17.3%)
> Adults with diabetes: 9.7% (Oregon: 9.7%)
> Adults reporting poor or fair health: 26.0% (Oregon: 18.2%)
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Pennsylvania: Armstrong County
> Adult obesity rate: 44.0% (Pennsylvania: 30.8%)
> Adults who don’t exercise: 34.0% (Pennsylvania: 22.0%)
> Adults with diabetes: 15.1% (Pennsylvania: 11.0%)
> Adults reporting poor or fair health: 18.7% (Pennsylvania: 17.6%)
Rhode Island: Kent County
> Adult obesity rate: 30.4% (Rhode Island: 28.5%)
> Adults who don’t exercise: 23.4% (Rhode Island: 23.5%)
> Adults with diabetes: 11.0% (Rhode Island: 10.1%)
> Adults reporting poor or fair health: 15.4% (Rhode Island: 16.5%)
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South Carolina: Union County
> Adult obesity rate: 46.8% (South Carolina: 34.0%)
> Adults who don’t exercise: 33.0% (South Carolina: 26.0%)
> Adults with diabetes: 15.9% (South Carolina: 13.3%)
> Adults reporting poor or fair health: 22.8% (South Carolina: 17.8%)
South Dakota: Ziebach County
> Adult obesity rate: 52.5% (South Dakota: 32.4%)
> Adults who don’t exercise: 27.2% (South Dakota: 22.0%)
> Adults with diabetes: 19.0% (South Dakota: 10.1%)
> Adults reporting poor or fair health: 30.4% (South Dakota: 13.4%)
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Tennessee: Lauderdale County
> Adult obesity rate: 47.4% (Tennessee: 33.3%)
> Adults who don’t exercise: 36.0% (Tennessee: 27.2%)
> Adults with diabetes: 21.5% (Tennessee: 12.5%)
> Adults reporting poor or fair health: 30.2% (Tennessee: 21.2%)
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Texas: Burleson County
> Adult obesity rate: 46.6% (Texas: 31.4%)
> Adults who don’t exercise: 27.4% (Texas: 23.2%)
> Adults with diabetes: 13.3% (Texas: 10.2%)
> Adults reporting poor or fair health: 21.1% (Texas: 18.7%)
Utah: San Juan County
> Adult obesity rate: 38.5% (Utah: 27.0%)
> Adults who don’t exercise: 23.0% (Utah: 16.7%)
> Adults with diabetes: 14.0% (Utah: 7.5%)
> Adults reporting poor or fair health: 25.4% (Utah: 14.8%)
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Vermont: Franklin County
> Adult obesity rate: 34.9% (Vermont: 27.0%)
> Adults who don’t exercise: 26.1% (Vermont: 18.4%)
> Adults with diabetes: 10.9% (Vermont: 8.8%)
> Adults reporting poor or fair health: 14.1% (Vermont: 12.8%)
Virginia: King and Queen County
> Adult obesity rate: 48.7% (Virginia: 30.5%)
> Adults who don’t exercise: 32.2% (Virginia: 22.2%)
> Adults with diabetes: 17.7% (Virginia: 10.7%)
> Adults reporting poor or fair health: 21.4% (Virginia: 16.6%)
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Washington: Pend Oreille County
> Adult obesity rate: 41.6% (Washington: 28.6%)
> Adults who don’t exercise: 27.7% (Washington: 16.4%)
> Adults with diabetes: 12.5% (Washington: 9.3%)
> Adults reporting poor or fair health: 18.8% (Washington: 15.0%)
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West Virginia: McDowell County
> Adult obesity rate: 44.9% (West Virginia: 37.8%)
> Adults who don’t exercise: 36.0% (West Virginia: 28.0%)
> Adults with diabetes: 17.0% (West Virginia: 15.1%)
> Adults reporting poor or fair health: 36.5% (West Virginia: 23.6%)
Wisconsin: Columbia County
> Adult obesity rate: 45.7% (Wisconsin: 31.7%)
> Adults who don’t exercise: 25.1% (Wisconsin: 20.3%)
> Adults with diabetes: 9.6% (Wisconsin: 9.5%)
> Adults reporting poor or fair health: 14.4% (Wisconsin: 14.8%)
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Wyoming: Weston County
> Adult obesity rate: 37.2% (Wyoming: 29.2%)
> Adults who don’t exercise: 25.5% (Wyoming: 23.1%)
> Adults with diabetes: 11.1% (Wyoming: 9.0%)
> Adults reporting poor or fair health: 16.9% (Wyoming: 15.3%)
Methodology
To determine the most obese county in every state, 24/7 Wall St. 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, 3,141 had boundaries that fell within one of the 50 states, while the rest were in the District of Columbia or Puerto Rico.
Counties with a 2019 five-year population estimate from the U.S. Census Bureau of less than 1,000 were excluded.
The remaining 3,105 places were ranked within their state 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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