Objective: To provide cross-cultural comparisons of health and behavior in obese individuals. Methods: We analyzed data from the 2006 National Health and Wellness Survey, a cross-sectional Internet-based survey conducted annually in the United States and EU (FR, DE, UK, SP and IT). When weighted, the sample is representative of the country's adult population in terms of key sociodemographic characteristics. The survey gathers information regarding demographics, health conditions, quality of life, and health care use. Adults were classified as overweight/obese (OWOB) based on BMI >= 25. Comparisons between groups were conducted using the Chi-square test with a significance level of p <0.05. Results: Almost 70% (144M) of the United States population is OWOB, compared to just over half of Europeans (131M). In both regions the OWOB populations were typically married and employed, with a mean age of 48 yrs (USA) and 51 yrs (EU) (p <0.05). Both had high rates of cardiovascular co-morbidities and a family history of obesity or diabetes. The majority reported having less than very good health and "some/little/no" energy in the past four weeks. Most had seen a health care provider in the past six months (82% USA vs. 87% EU; p <0.05). Although many claimed to be taking steps to lose weight (62% US vs. 50% EU; p <0.05), most reported weight gain over the past 6 months (30% US vs. 28% EU, p <0.05). Only a small portion reported taking a weight-loss prescription (1.9% US vs. 3.5% EU, p <0.05); but most of the remainder would consider taking one (45% US vs. 36% EU, p <0.05). Conclusion: The obesity problem is more evident in the United States. Americans exhibit higher rates of obesity at a younger age but have fewer provider visits and use of prescriptions, suggesting potential solutions to the problem.