By 2035, more than half the world is expected to have a body mass index that categorizes them as overweight or obese, according to a recent report from the World Obesity Federation.

“A major challenge in weight management treatment is coverage,” Colleen Tewksbury, Ph.D., MPH, RD and assistant professor in nutrition science at University of Pennsylvania School of Nursing, told Wallethub. “Obesity prevention and treatment are often full of hurdles for both clinicians and patients. While there has been significant progress in expanding access, most reports estimate only 1% of those clinically eligible receive weight management treatment (behavioral, medications, surgery) with insurance coverage cited as the primary barrier.”

More than 40% of U.S. adults are obese, according to the Atlanta-based Centers for Disease Control and Prevention. Those “extra pounds have inflated the costs of obesity-related medical treatment to approximately $190.2 billion a year and annual productivity losses due to work absenteeism to around $4.3 billion,” the financial website wrote.

To determine 2023′s most overweight cities in America, WalletHub compared 100 of the most populated metro areas across three key dimensions: obesity and overweight; health consequences; and food and fitness.

It then evaluated those dimensions using 19 relevant metrics, each of which was graded on a 100-point scale, with a score of 100 representing the “fattest.”

Although the two Georgia cities on the list dropped a couple of spaces on the ranking, one’s overall score was actually higher than last year.

The Atlanta-Sandy Springs-Alpharetta area finished 2023 ranked No. 50 (down two spots from 2022), but it’s overall score of 71.93 was higher than last year’s 71.26.

The Augusta-Richmond County area fell four spots but remained in the top 20. At No. 13, its overall score of 80.86 was down from last year’s 82.42.

This year’s fattest city was McAllen-Edinburg-Mission, Texas, with an overall score of 85.93. All 20 of WalletHub’s “fattest” cities are in the South.

You can read the full report here.

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