Background: Obesity, as a risk factor for many noncommunicable diseases, is a common public health problem in developed and developing countries. Among Iranian children and adolescents, the prevalence of being overweight has increased by almost 50% in the past two decades.

Aims: To visualize the geographic differences in general and abdominal obesity risks and related determinants among Iranian children and adolescents.

Methods: Participants consisted of 14 880 students, aged 7-19 years, living in urban and rural areas of the Islamic Republic of Iran. Spatial patterns of obesity and its association with related risk factors were identified using Bayesian spatial modeling.

Results: The highest spatial risks of general obesity (odds ratio 1.21-1.66 for males and 1.81-2.02 for females) and abdominal obesity (odds ratio 1.20-1.82 for males and 1.25-1.78 for females) were observed in the north, northwest and southwest of the country. Risk of obesity was significantly higher in areas with a higher rate of urban residence, active current smokers and prolonged screen time.

Conclusion: Identification of high-risk regions for obesity and spatially related risk factors can be used as informative tools for decision-making and planning in health systems at national and subnational levels.