While obesity is now recognized as a major health concern in Ghana, the major drivers, causal factors, and their spatial variation remain unclear. Nutritional changes and lack of physical activity are frequently blamed but the underlying factors, particularly cultural values and practices, remain understudied. Using hot spot analysis and spatial autocorrelation, this research investigates the spatial patterns of obesity in Ghana and the explanatory factors. We also use focus group discussions to examine the primary cultural factors underlying these patterns. The results show that wealth, high education, and urban residence are the best positive predictors of obesity, while poverty, low education, and rural residence are the best (negative) predictors of obesity. Consequently, improving the socioeconomic status, for example, through higher levels of education and urbanization may increase obesity rates. Furthermore, the cultural preference for fat body as the ideal body size drives individual aspiration for weight gain which can lead to obesity. Thus, reducing obesity rates in Ghana is impossible without addressing the underlying cultural values.