A new report reveals the U.S. cities with the highest obesity rates amid increasing nationwide prevalence and most of them are in the South.

The analysis from WalletHub compared 100 of the most-populated metro areas across 19 key indicators. These indicators were grouped into three categories: 1) obesity and overweight, 2) health consequences, and 3) food and fitness.

According to the Centers for Disease Control and Prevention, obesity affects over 41.9% of Americans, leading to higher healthcare costs and serious chronic diseases.

“In the most overweight and obese cities, residents often lack easy access to healthy food and recreation opportunities,” said WalletHub Analyst Chip Lupo.

McAllen, Texas, ranks as the most obese city, followed by Little Rock, Jackson, and Mobile, while the least obese cities include Honolulu, Seattle, Denver, and San Francisco.

Here are the rankings for the most and least obese cities:

Most obese cities

1. McAllen, TX

2. Little Rock, AR

3. Jackson, MS

4. Mobile, AL

5. Knoxville, TN

6. Shreveport, LA

7. Augusta, GA

8. Lafayette, LA

9. Fayetteville, AR

10. Birmingham, AL

Least obese cities

100. Honolulu, HI

99. Seattle, WA

98. Denver, CO

97. San Francisco, CA

96. Boston, MA

95. Minneapolis, MN

94. San Jose, CA

93. Colorado Springs, CO

92. New York, NY

91. Portland, OR

90. Sacramento, CA

Did any Alabama cities make the list?

Among Alabama cities, Mobile ranks as the fourth most obese city in the U.S., with Birmingham closely following in 10th place and Huntsville at 32nd.