WASHINGTON — We're getting fatter. In 1995, no state had an obesity rate of more than 20 percent. Now, all but one does.
An annual obesity report by two public health groups looked for the first time at state-by-state statistics during the past two decades. The state that has the lowest obesity rate now — Colorado, with 19.8 percent of adults considered obese — would have had the highest rate in 1995.
"When you look at it year by year, the changes are incremental," says Jeffrey Levi, executive director of the Trust for America's Health, which writes the annual report with the Robert Wood Johnson Foundation. "When you look at it by a generation, you see how we got into this problem."
The study, based on 2010 data, says a dozen states top 30 percent obesity, most of them in the South. Mississippi topped the list for the seventh year in a row, with Alabama, West Virginia, Tennessee and Louisiana close behind. Kentucky ranked sixth at 31.5 percent. Just five years ago, in 2006, Mississippi was the only state topping 30 percent.
No state decreased its level of obesity, which is defined as a body mass index of 30 or more. The body mass index is a measurement based on a calculation using a person's weight and height. A person who is 5 feet 5 inches and weighs 150 pounds would have a body mass index of 25, for example, but if that person weighed 180 pounds the BMI would be 30.
Although body mass index isn't always the best indicator for someone with a lot of muscle, such as an athlete, it is considered the best way to measure the general population. The authors of the study say it allows them to measure large numbers of people because those surveyed can easily provide their height and weight. (To determine your body mass index, go to NHLBIsupport.com/bmi.)
There was a bit of good news: Sixteen states reported increases in their obesity rates, down from 28 states that reported increases last year. Levi says those increases have been slowing gradually, most likely due to greater public awareness and government attempts to give schools and shoppers better access to healthier foods.
"We're leveling off to some degree at an unacceptably high level," Levi said.
First lady Michelle Obama has tackled the issue with her Let's Move campaign, pushing for healthier school lunches, more access to fruits and vegetables and more physical activity. Republicans in Congress have pushed back somewhat against some of those programs, however, saying a rewrite of school lunch rules is too costly and questioning an Obama administration effort to curb junk food marketing aimed at children.
As in previous years, the study showed that racial and ethnic minorities, along with those who have less education and make less money, have the highest obesity rates. Adult obesity rates for African-Americans topped 40 percent in 15 states, while whites topped 30 percent in only four states. About a third of adults who did not graduate from high school are obese; about a fifth of those who graduated from college are considered obese.
Dr. Mary Currier, Mississippi's state health officer, says her state has struggled to drop its No. 1 status.
"We live in an area of the country where eating is one of the things we do, and we eat a lot of fried foods," she said. "Trying to change that culture is pretty difficult."
Scarlet Shoemaker, who oversees a project to reduce obesity in Greenup County, Ky., said, "Health is not a priority. For a lot of families, a bigger priority is just getting a paycheck and getting food on the table, regardless of the quality. You can buy a lot more chips than you can fresh vegetables. People's weight is not usually on the radar."
Kentucky at a glance
Obesity ranking: 6, with 31.5 percent of adults.
Diabetes ranking: 6, with 10.5 percent of adults (tie with Oklahoma). Kentucky had the third-highest increase in diabetes rates from 1995 to 2010.
Hypertension ranking: 7, with 31.6 percent of adults (tie with Arkansas).
Physical inactivity ranking: 6, with 29.8 percent of adults not engaging in exercise or physical activity in the past 30 days.
Obese children ranking: 3, with 21 percent of children ages 10-17.
Poverty ranking: 5.
Gender breakdown of obese adults: 32.6 percent of men, 30.4 percent of women.
Overweight or obese adults: 67.1 percent.