Adam Richman travels across the United States to explore the culture and unique "big food" of one city in each episode. In some episodes, Richman takes on food challenges involving very hot and spicy (or piquant) foods (such as foods spiced with habanero peppers), and also large quantities of food, such as a 5-pound-sandwich challenge. He finds places in each city to indulge his appetite and visits local landmarks.
Richman interacts with local restaurateurs as they demonstrate the making of a house specialty or element of local cuisine. He gives a brief insight to the local community by talking to patrons at the establishments and asking about the most-talked about orders.
Episodes sometimes include a brief fantasy sequence where Richman pretends to be a character to psych himself up for the episode's big food challenge. The half-hour show culminates in Richman facing off against an established local food challenge.