Background: Obesity is a complex multifactorial disease associated with debilitating chronic comorbidities and increased healthcare costs. Due to an array of factors such as weight bias and discrimination, patients with obesity are also more likely to be unemployed and to earn less than their counterparts without obesity. This study aimed to evaluate patterns of financial toxicity among patients with obesity. Methods: Using the National Health Interview Survey from 2013 to 2018, patient demographics and self-reported financial metrics were collected or calculated for patients with obesity (body mass index of 30 or greater), including financial hardship from medical bills, financial distress, food insecurity, and cost-related medication (CRM) non-adherence. Multivariable logistic regression was used to assess factors associated with increased financial hardship. Results: 72,254 patients with obesity were included in this study. 22.3% faced some financial hardship due to medical bills, of which 55.8% could not pay these bills. Obesity was associated with higher odds of financial hardship from medical bills (odds ratio OR 1.27, 95% confidence interval CI 1.23-1.32) with similar trends for financial distress (OR 1.13, 95% CI 1.09-1.17), food insecurity (OR 1.19, 95% CI 1.14-1.24)=, and CRM non-adherence (OR 1.23, 95% CI 1.18-1.28, p<0.001 for all). Financial hardship among patients with obesity was also associated with being male (OR 1.28, 95% CI 1.21-1.35), Black (OR 1.31, 95% CI 1.22-1.41), uninsured (OR 2.11, 95% CI 1.96-2.27), and in poor self-reported health (AOR 5.88, 95% CI 5.18-6.67, p<0.001 for all). Conclusions: A substantial proportion of adults with obesity struggle with paying their medical bills and suffer from high rates of financial distress, food insecurity, and CRM non-adherence. Further research into the causal and potentially actionable mechanisms that lead patients with obesity to experience financial toxicity should be pursued. Public policy reform may represent a critical lever to ease the burden of financial hardship for these patients.