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
Source: Rivers Langley; SaveRivers / Wikimedia Commons
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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Source: Public Domain / Wikimedia Commons
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%)
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%)
Source: JERRYE & ROY KLOTZ M.D. / Wikimedia Commons
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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Source: jmoor17 / iStock Unreleased via Getty Images
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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Source: DenisTangneyJr / Getty Images
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%)
Source: JERRYE & ROY KLOTZ MD / Wikimedia Commons
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%)
Source: raksybH / iStock via Getty Images
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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Source: Public Domain / Wikimedia Commons
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%)
Source: Boogich / iStock via Getty Images
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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Source: icetsarina / Flickr
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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Source: Nyttend, Public domain, via Wikimedia Commons
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%)
Source: Public Domain / Wikimedia Commons
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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Source: Scott Romine / Wikimedia Commons
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%)
Source: Ichabod / Wikimedia Commons
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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Source: W.marsh / Wikimedia Commons
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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Source: Judy Darby / iStock via Getty Images
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%)
Source: apelletr / Getty Images
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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Source: David Wilson / Flickr
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%)
Source: takomabibelot / Flickr
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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Source: Andrew Filer from Seattle (ex-Minneapolis), CC BY-SA 2.0 , via Wikimedia Commons
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%)
Source: Mike Norton / Flickr
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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Source: BOB WESTON / iStock via Getty Images
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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Source: Public Domain / Wikimedia Commons
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%)
Source: phleum / iStock via Getty Images
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%)
Source: BOB WESTON / Getty Images
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%)
Source: BOB WESTON / iStock via Getty Images
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%)
Source: Andrew Filer / Flickr
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%)
Source: Pigdogx, CC BY-SA 4.0 , via Wikimedia Commons
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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Source: Gary Halvorson, Oregon State Archives / Wikimedia Commons
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%)
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%)
Source: 23185977@N08 / Flickr
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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Source: library_of_congress / Flickr
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%)
Source: Jeff the quiet / Public Domain / Wikimedia Commons
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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Source: BOB WESTON / iStock via Getty Images
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%)
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%)
Source: AlexMcGuffie / Getty Images
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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Source: Mfwills, CC BY-SA 3.0 , via Wikimedia Commons
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%)
Source: Jennifer Blount / iStock via Getty Images
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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Source: Craig Baker / iStock via Getty Images
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%)
Source: Magnolia677 / Wikimedia Commons
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%)
Source: By Royalbroil - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=37939147 / Wikimedia Commons
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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Source: Acroterion, CC BY-SA 4.0 , via Wikimedia Commons
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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