Obesity is also not evenly distributed across the U.S. If you look at the rural/urban split it's more prevalent in rural areas[1], and if you look at the city breakdowns, the cities that foreigners are more likely to visit have lower obesity rates across the board [2].

So visiting the top-performing American cities (usually in the Northeast or West coast) understates the level of obesity in the country as a whole by a fair bit.

I had the realization that there are practically two different Americas after I took a road trip through the south after having lived in the Northeast for ~20 years.

[1] https://www.aafp.org/news/health-of-the-public/20180622mmwr-...

[2] https://wallethub.com/edu/fattest-cities-in-america/10532