TUESDAY, Aug. 19 (HealthDay News) — The obesity epidemic in America has gotten worse — not better — in the last year, despite public service campaigns warning about the health risks posed by carrying too much weight, a new report found.

Adult obesity rates increased in 37 states, while there were no decreases in any states, according to the annual report released Tuesday by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation.

The obesity rates rose for a second consecutive year in 24 states and for a third consecutive year in 19 states, according to the re

port, F as in Fat: How Obesity Policies Are Failing in America, 2008″.

More than 25 percent of adults are obese in 28 states, up from 19 states last year. And more than 20 percent of adults are obese in every state except Colorado. In 1991, no state had an obesity rate greater than 20 percent.

Eleven of the 15 states with the highest obesity rates are in the South. Northeastern and Western states have the lowest obesity rates.

“Despite widespread acknowledgement that obesity is endangering the health of millions of Americans, the country is still failing to respond clearly or comprehensively,” Dr. Risa Lavizzo-Mourey, president and chief executive officer of the Robert Wood Johnson Foundation, said in the news release. “We must work together, governments, schools and communities, to improve nutrition and increase physical activity for all ages. We must ensure that strong policies are implemented and enforced in every state, not only to help reverse existing obesity rates, but to prevent obesity among our nation’s children and generations to come.”

The five fattest states and their obesity rates are Mississippi (31.7 percent), West Virginia (30.6 percent), Alabama (30.1 percent), Louisiana (29.5 percent) and South Carolina (29.2 percent). The five slimmest states are Colorado (18.4 percent), Hawaii (20.7 percent), Connecticut (20.8 percent), Massachusetts (20.9 percent), and Vermont (21.1 percent), according to the report.

An estimated two-thirds of Americans are now overweight or obese. That compares to 1980, when the national average of obese adults was 15 percent.

Obesity is defined as a body mass index — BMI, a ratio of weight to height — of 30 or more. A person who is 5-feet, 8-inches tall and weighs 197 pounds has a BMI of 30.

The report said that rates of type 2 diabetes — a disease typically associated with obesity — increased in 26 states last year. Four states now have diabetes rates above 10 percent. And all 10 states with the highest rates of diabetes and high blood pressure are in the South.

Besides type 2 diabetes, obesity has been linked to coronary heart disease and stroke, cancer, osteoarthritis, gall bladder disease, liver disease and pregnancy complications, according to the U.S. National Institutes of Health.

The report also noted a relationship between poverty and obesity rates. It found that seven of the 10 states with the highest obesity rates are also among the 10 states with the highest poverty rates.

While a number of promising policies designed to promote physical activity and good nutrition have been introduced in communities, the report’s findings suggest that these policies aren’t being adopted or implemented at levels sufficient to reverse the obesity epidemic.

“America’s future depends on the health of our country. The obesity epidemic is lowering our productivity and dramatically increasing our health care costs. Our analysis shows that we are not treating the obesity epidemic with the urgency it deserves,” Jeffrey Levi, executive director of Trust for America’s Health, said in a news release. “Even though communities have started taking action, considering the scope of the problem, the country’s response has been severely limited. For significant change to happen, combating obesity must become a national priority.”

Among the report’s other findings:

• While 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 language to enforce the laws. Of these states, only four have sanctions or penalties if the laws are not implemented.
• While the Dietary Guidelines for Americans were updated in 2005, the U.S. Department of Agriculture school meal program has yet to adopt the recommendations.
• Eighteen states have enacted laws requiring school meals to exceed USDA nutrition standards. But, only seven of these laws have specific enforcement provisions, and only two state laws include sanctions if its requirements aren’t 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.

The report offered a series of recommendations to combat the obesity epidemic, including investing in community-based disease-prevention programs that promote 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; encouraging employers to provide workplace wellness programs; and requiring public and private insurers to provide preventive services, including nutrition counseling for children and adults.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about obesity.

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