Introduction: Recent trends show that obesity has spread to more countries and that the emergence of obesity has further accelerated. Although the urban elite are usually the first to experience the obesity epidemic, obesity risks are shifting to the middle and lower classes. Methods: These results are based on data from published surveys conducted in all regions of the world. Our selection criteria for presenting data from other surveys were size, sampling design, and geographic area. This study focuses on adults and, as such, the World Health Organization cutoffs for adult body mass index (BMI) are used to delineate obesity. Results: Overall, the results show that the highest levels of obesity (Grade II and above) are in the Middle East, Western Pacific, and Latin America. In contrast, countries in sub-Saharan Africa and Asia have some of the lowest prevalences for overweight and obesity. Apart from a few exceptions, there is less Grade II and above obesity in South Asia versus other regions. Results from sub-Saharan Africa confirm previous studies indicating high levels of obesity in rural as well as urban areas. Data on trends in body composition exist for a small number of lower and middle income countries. In many regions the obesity prevalence is higher for women than for men. Where we have trends data (e.g. Brazil in Latin America; China, Indonesia and Vietnam in Asia; Mauritius in Africa; Nauru and Western Samoa in the South Pacific; and Russia), we find significant increases in obesity occurring. Conclusions: Diet and activity patterns have shifted in comparable ways in many countries and as such, diet and activity may contribute to the obesity epidemic in a similar way across all populations. The policies and programs that alter these patterns may be best understood by examining settings around the world.