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 Tempo identified the most obese metropolitan area in each state. Four states — Delaware, New Hampshire, Rhode Island, and Vermont — have only one metro area. As a result, these areas rank as the most obese in their state by default only. 

Though each of the metro areas on this list ranks as the most obese in its respective state, obesity rates vary considerably in these places, from less than 25% to over 40%. 

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 most metro areas 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 metro areas as well. For example, obesity is a leading risk factor for Type 2 diabetes, and in the majority of metro areas on this list, diabetes is more common than it is across the state as a whole.

Click here to see the most obese metro in every state
Click here to read our detailed methodology