Adolescents in the United States continue to exhibit epidemic proportions of obesity and overweight, contributing to significant morbidity and mortality rates. Obesity and overweight are also found to be associated with other unhealthy behaviors in adolescents, such as physical inactivity and smoking. The Center for Disease Control and Prevention (CDC) reports the annual rates of adolescent obesity in the U.S.; however, comparative trends for the past two decades and comparisons of rates between general U.S. and Tennessee, a tobacco-producing state in the stroke belt, are not available. To compare trends in rates of BMI percentile, overweight, and obesity among adolescents, grades 9th through 12th, between the U.S. and Tennessee during 2003-2017 and identify critical factors associated with them. Both national and Tennessee BMI trends show different patterns from 1999 to 2017; further analysis of covariate factors will provide more information on this difference in trends. We expect to find little variation between the United States and Tennessee when comparing the age of high school obesity rates. However, previous trends in racial and ethnic disparities for BMI percentiles, obesity, and overweight suggest there will be differences among these variables. Preventable chronic diseases should not affect children. The outcomes of childhood obesity are too severe to ignore. Understanding the risk factors, risk behaviors, and prevalence of adolescent obesity is the first step in addressing this public health crisis.