In Reply Gearon and Backholer raise an interesting observation in the original analysis of our article,1 which was the prevalence of class III obesity (body mass index [calculated as weight in kilograms divided by height in meters squared] ≥40) among non-Hispanic black women had increased the fastest among all obesity subclasses and race/ethnicity groups from 1988 to 1994 and 2007 to 2012 in the United States. Thus, Gearon and Backholer proposed to complement population-based obesity prevention approaches with prioritizing interventions targeting severely obese non-Hispanic black women to eliminate the racial disparity in obesity.