America’s 13 most obese cities have one thing in common

They’re all in the South.

WalletHub just released its 2025 ranking of the most overweight and obese cities in America, and the results follow a clear pattern.

Twelve of the top 13 cities sit below the Mason-Dixon line. The one exception is Oklahoma City. These aren’t random results.

The cities share something in common beyond geography: limited access to fresh food, fewer parks, and some of the highest rates of diabetes and heart disease in the country.

The reasons these cities ended up on this list explain why getting off it is so hard.

McAllen Takes First Place Again

McAllen, Texas, ranked as America’s most obese city for the second straight year.

About 45% of adults in this Rio Grande Valley metro area are obese, with another 31% overweight but not obese.

That means roughly three out of four residents carry excess weight. The 775,000-person metro area also has the highest rate of physically inactive adults in the country.

McAllen ranks eighth for diabetes and fourth for heart disease. The numbers have barely budged since researchers started tracking them over a decade ago.

Half the Valley Is Food Desert

The McAllen area’s weight problem connects directly to what residents can and cannot access.

About half of the Rio Grande Valley qualifies as a food desert, meaning residents live too far from grocery stores that sell fresh produce.

The area has over 1,180 quick-service restaurants in Hidalgo and Cameron counties alone. McAllen also has the second-lowest percentage of residents living near parks or recreational facilities.

When the nearest vegetables require a 10-mile drive but fast food sits on every corner, the math works against you.

Little Rock Moves Up to Second

Little Rock, Arkansas, climbed from fifth place in 2024 to second this year.

The city has the fourth-highest rate of childhood obesity in the country, with nearly 23% of kids ages 10 to 17 classified as obese and another 17% overweight.

Little Rock also has the fourth-highest percentage of adults with high blood pressure and the fifth-highest heart disease rate.

The city ranks near the bottom for health educators per capita, meaning fewer professionals are available to help residents change course.

Jackson Has Fewest Active Adults

Jackson, Mississippi, has the second-highest rate of physically inactive adults in America. Around 37% of the capital city’s adults are obese.

Jackson also ranks sixth for high blood pressure and second for adults who have had a stroke. The city struggles with access to healthy food, and many neighborhoods lack sidewalks or safe places to walk.

Mississippi as a state has the second-highest adult obesity rate in the country at 40. 4%, and Jackson sits right at the center of that problem.

Mobile Ranks High for Health Problems

Mobile, Alabama, came in fourth overall, but its real trouble shows up in the health consequences category.

The city ranks second in the nation for obesity-related health problems, including rates of high cholesterol, diabetes, and high blood pressure.

Mobile has the eighth-highest share of obese adults and sits in a state where 35% of the population has obesity.

The combination of weight and related diseases puts Mobile among the cities facing the steepest health challenges.

Knoxville Leads Nation in Diabetes

Knoxville, Tennessee, ranked fifth overall, but it holds a grimmer distinction.

The city has the highest percentage of diabetic adults in America, 2. 5 times higher than Bridgeport, Connecticut, which has the lowest rate.

Knoxville also tops the charts for adults with high cholesterol.

The city ranks 23rd for obesity rates alone, which means its spot in the top five comes mainly from how severely weight-related diseases have spread through the population.

Shreveport Tops Blood Pressure Rankings

Shreveport, Louisiana, has the highest share of adults with high blood pressure in the country, 1. 8 times higher than San Jose, California.

The city also ranks second for high cholesterol and third for overall health consequences. Shreveport actually improved from 2024, when it ranked second overall.

The city dropped to sixth, but the underlying numbers remain serious.

Shreveport and nearby Bossier City have about 250,000 residents dealing with some of the worst cardiovascular risk factors in America.

Augusta and Lafayette Fill Spots Seven and Eight

Augusta, Georgia, came in seventh, ranking third in the nation for the percentage of obese adults. The city that hosts the Masters each April struggles with food access and limited fitness resources.

Lafayette, Louisiana, landed at eighth. It has the second-lowest rate of fruit and vegetable consumption in the country and the third-highest rate of high blood pressure.

Louisiana placed three cities in the top 17, more than any other state except Texas.

Fayetteville and Birmingham Close Out Top Ten

Fayetteville, Arkansas, jumped to ninth place with the fourth-highest rate of obesity among adults. The city has the second-highest projected obesity rate for 2030, meaning the problem is expected to get worse.

Birmingham, Alabama, ranked tenth. Most Birmingham residents rely on convenience stores for groceries, which limits access to fresh produce.

The city ranks fifth for food and fitness problems and tenth for health consequences. Alabama placed two cities in the top ten.

Memphis and Oklahoma City Follow Behind

Memphis, Tennessee, has the second-highest percentage of obese adults in America, behind only McAllen.

More than 70% of Memphis residents are either obese or overweight. The city also ranks sixth for physically inactive adults.

Oklahoma City tied for fifth in the share of obese adults and came in 12th overall. It is the only city in the top 13 that sits outside the traditional South.

Oklahoma City ranked 16th for food and fitness problems, slightly better than most cities above it on the list.

San Antonio Rounds Out the Top Thirteen

San Antonio, Texas, is the second-largest city on this list and the 13th most obese metro area in the country. The city ranks sixth for obesity rates and seventh for health consequences.

San Antonio has the third-highest rate of diabetic adults and the fourth-highest rate for diabetes-related hospitalizations.

Texas placed three cities in the top 20, including McAllen at first and El Paso at 20th. The state’s border cities face especially steep challenges with food access and healthcare resources.

Same Problems Keep These Cities on the List

The 13 cities on this list share patterns that go beyond just weight.

Limited grocery stores, fewer parks, high poverty rates, and stretched healthcare systems show up again and again.

Nationally, obesity costs the healthcare system about $173 billion a year and leads to $4.3 billion in lost productivity.

These cities carry a big share of that burden. The rankings change slightly each year, but the same names keep appearing.

Until food access and fitness infrastructure improve, the map of obesity in America will keep looking the same.

This article was created with AI assistance and human editing.

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