Washington, Dc — The number of states that have an adult obesity rate of at least 30 percent has jumped from one to three. West Virginia and Alabama join Mississippi in that category, according to the fifth annual “F as in Fat: How Obesity Policies are Failing in America, 2008” report, which was released last month.

Mississippi has a 31.7 percent adult obesity rate, followed by West Virginia (30.6 percent) and Alabama (30.1 percent). Colorado is the leanest state with an 18.4 percent adult obesity rate, although that rate did increase over the previous year from 17.6 percent.

In fact, adult obesity rates increased in 37 states in the past year, according to the Trust for America's Health report, which was supported by a grant from the Robert Wood Johnson Foundation. Rates rose for a second consecutive year in 24 states and for a third consecutive year in 19 states. No state had a decrease.

The “F as in Fat” report also finds that rates of type 2 diabetes, a disease typically associated with obesity, grew in 26 states last year. Four states now have diabetes rates that are above 10 percent, and all 10 states with the highest rates of diabetes and hypertension are in the South. The report also found a relationship between poverty and obesity levels. Seven of the 10 states with the highest obesity rates are also in the top 10 for highest poverty rates.

Though many policies in health clubs and local and state governments have emerged to promote physical activity and good nutrition in communities, the report concludes that they are not being adopted or implemented at levels needed to turn around the obesity epidemic.

“America's future depends on the health of our country,” says Jeff Levi, executive director of Trust for America's Health. “The obesity epidemic is lowering our productivity and dramatically increasing our health care costs. Our analysis shows that we're not treating the obesity epidemic with the urgency it deserves.”

Other findings from the “F as in Fat: 2008” report:

  • Although all 50 states and the District of Columbia have passed laws related to physical education and/or physical activity in schools, only 13 states include enforceability language. Of these states, only four have sanctions or penalties if the laws are not implemented.

  • Although the Dietary Guidelines for Americans were updated in 2005, the U.S. Department of Agriculture (USDA) school meal program has yet to adopt the recommendations.

  • Eighteen states have enacted legislation requiring school meals to exceed USDA nutrition standards. However, only seven of these laws have specific enforcement provisions, and only two state laws include sanctions if the requirements are not met.

  • Ten states do not include specific coverage for nutrition assessment and counseling for obese or overweight children in their Medicaid programs.

  • Twenty states explicitly do not cover nutritional assessment and consultation for obese adults under Medicaid.

  • Only Georgia and Vermont have specific guidelines for treating obese adults in their Medicaid programs. In Nebraska and South Carolina, the Medicaid programs specifically state that obesity is not an illness and is, therefore, not covered.

  • Forty-five states allow using obesity or health status as a risk factor to deny coverage or raise premiums.

“The report shows the serious impact that the obesity crisis is having on our country's health and economic well-being,” says former President Bill Clinton, who co-leads the Alliance for a Healthier Generation, a partnership between the William J. Clinton Foundation and the American Heart Association. The group works to advance innovative approaches combating childhood obesity and helping children lead healthier lives.

The “F as in Fat” report concludes with several recommendations to help the country set a goal of reversing the childhood obesity epidemic by 2015. Some of those recommendations include:

  • Investing in effective community-based disease-prevention programs that promote increased physical activity and good nutrition.

  • Improving the nutritional quality of foods available in schools and child care programs.

  • Increasing the amount and quality of physical education and activity in schools and child care programs.

  • Increasing access to safe, accessible places for physical activity in communities. Examples include creating and maintaining parks, sidewalks and bike lanes, and providing incentives for smart growth designs that make communities more livable and walkable.

  • Improving access to affordable nutritious foods by providing incentives for grocery stores and farmers' markets to locate in underserved communities.

  • Encouraging limits on screen time for children through school-based curricula and media literacy resources.

  • Eliminating the marketing of junk food to kids.

  • Providing people with the information they need about nutrition and activity to make educated decisions, including point-of-purchase information about the nutrition and calorie content of foods.

  • Requiring public and private insurers to provide preventive services, including nutrition counseling.

The full report can be found at http://healthyamericans.org/reports/obesity2008/Obesity2008Report.pdf.

States with the Highest Rates of Adult Obesity

1. Mississippi (31.7 percent)

2. West Virginia (30.6 percent)

3. Alabama (30.1 percent)

4. Louisiana (29.5 percent)

5. South Carolina (29.2 percent)

6. Tennessee (29 percent)

7. Kentucky (28.4 percent)

8. (tie) Arkansas and Oklahoma (28.1 percent)

10. Michigan (27.7 percent)