The States and Cities Struggling Most to Lose Weight

For millions of Americans, losing weight has turned into a years-long project with no finish line. People are cycling through diets, stalling on plateaus, and turning to Google for answers, and where they live may be associated with how hard they're searching.

Trimi analyzed a year of Google search volume across the 150 largest U.S. metros and all 50 states, then surveyed 1,003 Americans who are actively trying to lose weight. We wanted to know where the search for weight-loss help runs hottest, what keeps people from reaching their goals, and how many want prescription treatment but can't get it.

Key Takeaways

• El Paso, Texas, ranks No. 1 among major U.S. cities searching hardest for weight-loss help, with 5,127 searches per 100,000 residents.
• New York ranks No. 27, Los Angeles No. 49, and Chicago No. 64 among the 150 largest U.S. metros for weight-loss searches per capita.
• Colorado ranks No. 1 among U.S. states for weight-loss searches per capita, with 1,167 searches per 100,000 residents.
• The average American trying to lose weight has been at it for three years across five separate diets or programs.
• 86% of Americans trying to lose weight have hit a plateau where their progress has stalled.
• Of the 49% of Americans who want a prescription weight-loss medication, 77% are blocked by cost, insurance, or access.
• 60% of Americans trying to lose weight say access to these medications unfairly depends on where you live or what you can afford.

El Paso Leads the Country in the Search for Weight-Loss Help

We ranked the 150 largest U.S. metros by weight-loss searches per 100,000 residents, and the South and West dominated the top of the list.

Here's how the city rankings played out:

• Residents of El Paso search for weight-loss help more than any other major U.S. metro, at 5,127 searches per 100,000 people.
• Mobile, Alabama; Lafayette, Louisiana; Lexington, Kentucky; and San Antonio round out the top five, each above 3,900 searches per 100,000 residents.
• Southern and Western cities take 21 of the top 25 spots. The South holds 14, the West seven, and the Midwest four.
• Texas alone places four metros in the top 25.
• No Northeastern metro cracks the top 25, and eight of the 25 lowest-searching cities are in the Northeast.
• Riverside, California, searches the least of any major metro at 475 per 100,000 residents, roughly one-eleventh of El Paso's rate.
• Ozempic and Wegovy make up 80% of all weight-loss search volume across the 150 largest metros, and El Paso also leads all 150 metros in GLP-1 searches per capita.
• The biggest cities land mid-pack, with New York at No. 27, Los Angeles at No. 49, and Chicago at No. 64.

The state rankings told a slightly different story:

• Colorado ranks No. 1 among U.S. states, with 1,167 searches per 100,000 residents, despite having the lowest adult obesity rate in the country at 25%.
• The 10 states with the most weight-loss searches per capita have an average adult obesity rate of 31%, compared with 37% for the 10 states with the fewest.
• Across states, search demand shows a moderate negative association with obesity and a moderate positive association with cost of living.

Years of Effort, Five Diets Deep, and Stuck on a Plateau

Our survey found that most people trying to lose weight have put in serious effort, often for years, and still hit the same walls.

Here's what Americans told us about the effort so far:

• More than eight in 10 Americans trying to lose weight (81%) say it has been difficult, including 86% of baby boomers, 83% of Gen X, 80% of millennials, and 78% of Gen Z.
• Women find it harder than men, with 85% calling it difficult compared with 73% of men.
• The average American trying to lose weight has been at it for three years across five separate diets or programs.
• Nearly nine in 10 (88%) have tried cutting calories on their own, while 79% have tried exercise and 63% have tried a specific diet like keto or intermittent fasting.
• Nearly one-quarter (24%) have tried a prescription weight-loss medication, led by Gen X (30%) and baby boomers (28%), followed by millennials (22%) and Gen Z (16%).

The barriers are often more personal than practical:

• Just over two-thirds (67%) say hunger or cravings stand in their way, followed by stress or emotional eating (60%) and lack of motivation (57%).
• Hunger weighs heaviest on Gen Z, with 80% naming it as a barrier, compared with 70% of millennials, 58% of baby boomers, and 55% of Gen X.
• More women (64%) than men (52%) name stress or emotional eating as a barrier.
• One-third (33%) say cost stands in their way, rising to 49% of the uninsured and 45% of Medicaid enrollees, compared with 36% of Medicare enrollees and 28% of the privately insured.

Plateaus prove to be where many people lose momentum:

• 86% of Americans trying to lose weight have hit a plateau where their progress stalled.
• Nearly half of those who hit a plateau (46%) stop trying for a while, including 51% of Gen Z.
• Just over one-third (34%) push through and keep going, while 25% quit that diet or program entirely and 23% switch to a different approach.
• Overall, 55% of those who hit a plateau either stop trying for a while or abandon their approach entirely.
• Nearly one-third (32%) have made little or no progress or lost ground, including 42% of baby boomers. Women (37%) report this more often than men (24%).
• Just 2% say they have reached their goal.

Many Want Prescription Treatment, but Cost and Coverage Get in the Way

Interest in prescription weight-loss treatment runs high, but for most people who want it, getting it is another matter.

Here's where the access gap shows up:

• Of the 49% of Americans trying to lose weight who want a prescription weight-loss treatment, 77% are unable to get one. That's 38% of everyone we surveyed.
• Among those who want treatment, cost is too high for 33%, insurance won't cover it for 24%, 9% can't find a prescriber or supply, and 10% are blocked for another reason.
• Nearly half of all respondents (48%) say they would try a prescription medication if cost weren't a factor.
• Women are blocked from weight-loss medication more often than men, 42% versus 31%.
• The uninsured are blocked most often (48%), followed by Medicare (41%) and Medicaid (38%) enrollees and the privately insured (36%).

Many also feel the system wasn't built for them:

• 60% say access to these medications unfairly depends on where you live or what you can afford.
• 58% say these medications are out of reach for people like them.
• Nearly a quarter (24%) have spent $500 or more out of pocket pursuing weight-loss treatment in the past year.
• The privately insured are the most likely to hit that mark (29%), compared with 20% of Medicare enrollees, 13% of Medicaid enrollees, and 11% of the uninsured.

Where the Search for Weight-Loss Help Goes From Here

The average person trying to lose weight has spent three years and tried five diets or programs, and most have hit a plateau along the way. Where they search for help varies widely, from El Paso at the top to Riverside at the bottom. For many, access adds another hurdle. Nearly four in 10 wanted prescription treatment but couldn't get it, most often because of cost or insurance. For anyone weighing their options, a conversation with a licensed provider is the best place to start.

Methodology

Trimi commissioned a survey of 1,003 U.S. adults ages 18 and older who are actively trying to lose weight, fielded in 2026 through CloudResearch Connect and Prolific. Of respondents, 64% were women, 34% were men, and 2% identified another way or preferred not to say. Generationally, 18% were Gen Z (ages 18 to 29), 47% were Millennials (ages 30 to 45), 28% were Gen X (ages 46 to 61), and 7% were Baby Boomers (ages 62 and older). All findings describe this population, not the general public. Percentages are rounded to the nearest whole number and may not total 100. Select-all questions can exceed 100% and are reported as a share of all respondents, except for the plateau-reaction question, which is based on the 862 respondents who had hit a plateau. For the two write-in numeric questions (time spent trying and number of programs), means are reported with outliers removed using the interquartile range method. Subgroups below 5% of the sample are not headlined.

The city index scores the 150 largest U.S. metros on total Google Ads search volume across five terms (how to lose weight, how to lose belly fat, slow metabolism, Ozempic, and Wegovy) from September 2025 to August 2026. The state index scores each state on search volume across seven terms (why can't I lose weight, weight-loss plateau, slow metabolism, how to lose belly fat, weight-loss help, how to get Ozempic, and Ozempic cost) from August 2025 to July 2026. Volume is normalized to searches per 100,000 residents using U.S. Census Bureau Vintage 2025 population estimates and rescaled 0 to 100. Because the city and state rankings use different term baskets, they aren't compared with each other. A high score reflects high per-capita search demand, not a measure of health.

Obesity prevalence comes from the CDC's 2024 Behavioral Risk Factor Surveillance System (Tennessee uses 2023 CDC PLACES data). Physical inactivity, food access, sleep, uninsured rate, and cost-of-living data come from the CDC, USDA, County Health Rankings, and MERIC, with vintages from 2019 to 2024. Relationships between search demand and these measures are reported as Spearman rank correlations and describe association only, not causation. Search demand showed a moderate negative association with obesity (rho -0.49) and a moderate positive association with cost of living (rho +0.40). Inactivity, sleep, food access, and the uninsured rate showed no clear link.

Medical Disclaimer

This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before starting, adjusting, or discontinuing any medication. Individual results vary. GLP-1 medications require a prescription and should only be used under a licensed healthcare provider's supervision.

About Trimi

Trimi is a U.S. telehealth provider that connects patients with licensed providers and named 503A compounding pharmacies for GLP-1 treatment, with transparent all-in pricing and no membership fees. That vantage point gives the company a close view of the cost, access, and everyday decisions behind the GLP-1 conversation. (Trimi, at trytrimi.com, is a separate company from the similarly named TrimRx.)

Fair Use Statement

Feel free to share the findings from this study for any noncommercial use. We only ask that you link back to the full study so readers can see the complete results and methodology, and please credit Trimi as the source.