Objective To investigate the association between dietary patterns and obesity among adult residents in rural Hebei province, providing a theoretical foundation for formulating dietary interventions tailored to reducing the obesity rate in this population.

Methods The data were obtained from the Nutrition and Health Status Surveillance of Chinese Residents in 2022, including food frequency, personal information, health records, and physical examination results of permanent rural residents aged ≥ 18 years in Hebei province. Dietary patterns were identified through factor analysis. Multivariate logistic regression models were employed to examine the relationship between dietary patterns and the risk of obesity in rural adults.

Results Among the 2 479 rural residents aged ≥ 18 years included in the study, the prevalence rate of obesity was 25.78%. The obesity rate was higher in non-smokers (26.74%) than in smokers (22.20%). Additionally, the obesity rate was higher in the populations with hypertension (34.16%), diabetes (38.60%), and dyslipidemia (32.74%) than in non-diseased populations. Four distinct dietary patterns were extracted via factor analysis as the animal protein-snack pattern, vegetable-fruit pattern, staple food pattern, and pasta-alcohol pattern, with a cumulative variance contribution rate of 38.77%. Logistic regression analysis indicated that after adjusting for confounding factors, individuals in the high-intake group of animal protein-snack pattern had higher risk of obesity than those in the low-intake group (Q3 high group OR = 1.491, 95%CI: 1.177–1.889, P = 0.001).

Conclusions Dietary patterns are associated with obesity among rural adult residents in Hebei province, and a diet rich in animal protein-snack may elevate the risk of obesity.