AbstractIntroductionObesity is the most threatening non-infectious disease of our time, the basis of many chronic diseases, increasing the mortality rate. The Roma ethnic minority is particularly affected.Materials and methodsCross-sectional–questionnaire and physical–survey in rural settlements of Hungary, Romania, Slovakia, where Roma live with the non-Roma, Hungarian-speaking population (N = 1893).ResultsThe average BMI of the Hungarian (P < 0.001) and Romanian (P = 0.018) samples was significantly higher than that of the Slovak sample. In the case of Roma and non-Roma subjects, we found a significant difference in Hungary (P = 0.006) based on body composition, as well as in the case of visceral fat (P < 0.001). The extremely obese (<40 BMI) are mostly low educated in Romania and Hungary (P < 0.001), while those in normal weight have a tertiary education in Slovakia (P = 0.027). Hungarian Roma and non-Roma participants show significant differences in the physical activity dimension of the SF-36 questionnaire (P < 0.001), as well as in Romania (P < 0.001) and Slovakia (P = 0.002).ConclusionsIn summary, it can be stated that rural Roma subjects in Hungary are in the worst situation in terms of obesity in the three countries studied. In our study, the results in Slovakia clearly suggest a healthier lifestyle.