Access to obesity medicine specialists and endocrinologists for the obese population in US counties, is there a rural-urban divide?

Chuang S, Khetpal V, Lu F, Wu WC. Access to obesity medicine specialists and endocrinologists for the obese population in US counties, is there a rural-urban divide? Current problems in cardiology. 2026 Jun 1; 51(6):103304, DOI: 10.1016/j.cpcardiol.2026.103304.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.    Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions

Search for Abstract from PubMed

---

Abstract:

Given the obesity epidemic, access to obesity specialists such as endocrinologists and obesity medicine physicians is paramount to avoid long-term complications, but geographic distribution of obesity specialists in United States (US) counties with respect to obesity prevalence is unclear. A cross-sectional analysis was conducted on 3230 US counties categorized by metropolitan status using data from the US Census, CDC Atlas, and NPI registry. 240 counties were excluded due to incomplete data, yielding 2990 counties. Predictors of obesity specialists per 100 K adults with obesity was determined using regression analysis. By county, the median demographic composition was: 50.0% men, 82.3% White, and 41.6 years old. The average percentage of adults with obesity was 37.5% (SD 4.5%) and the average number of obesity specialists per 100k adults with obesity was 5.3 (SD 13.7). However, substantial variation exists by metropolitan status on the ratio of obesity specialists/100 K adults with obesity, that ranged from 29.3 (SD 27.6) in large central metro, 9.1 (SD 17.6) in fringe metro, 10.1 (SD 18.3) in medium/small metro to 2.0 (SD 7.2) in non-metro counties, P < 0.001 for trend. Approximately 70% of US counties lacked obesity specialists. Regression modeling adjusted for demographics, socioeconomic status, and total physicians per county showed nonmetropolitan status as a negative independent predictor of obesity specialist presence. With a majority of US counties lacking access to obesity specialists and nonmetropolitan status negatively predicting access, we highlight the need for more obesity specialists in those communities or the general upskilling of primary physicians to treat obesity.