Americans seem to pay endless attention to weight, spending billions of dollars on weight-loss products and services each year, reading a constant flow of stories about weight loss in the news and supporting many public policies aimed at slimming U.S. waistlines. But despite all this attention, Americans continue to grow ever fatter in most states. Adult obesity rates gained in 28 states in the past year, declining only in the District of Columbia, according to F as in Fat, a new report from the Trust for America's Health and the Robert Wood Johnson Foundation.

The report highlights alarming trends in obesity. Adult obesity rates rose above 25% in 28 states, a huge increase considering that no state had an obesity rate above 20% in 1991. Eight states have rates above 30% -- double the number from last year. Mississippi, for the sixth year in a row, had the highest rate of obese adults at 33.8%. Meanwhile, Colorado had the lowest rate at 19.1% and is the only state with a rate below 20%. A growing number of adults in 12 states say they don't engage in physical activity.

Children Also Get Heavier

Just as alarming are the childhood obesity rates and trends, with more than one-third of children ages 10 to 17 being obese (16.4%) or overweight (18.2%). Nationwide, less than one-third of all children ages 6 to 17 engage in vigorous activity, defined as at least 20 minutes of physical activity that makes the child sweat and breathe hard.

Why does all this obesity cause concern? Obesity is related to more than 20 major chronic diseases, according to the report. Currently, one in three adults has some form of heart disease, more than 80 million Americans have type 2 diabetes or are prediabetic and obese children are more than twice as likely to die prematurely, or before the age of 55, compared with those of healthy weight.

Obesity costs the U.S. as much as $147 billion annually in health care, with obesity-related medical costs making up 9.1% of all annual medical spending in 2006, according to a 2009 study from nonprofit RTI International and the Centers for Disease Control and Prevention. Overall, obese people spent 42% more for medical care than normal-weight people in 2006.

Public Policy Could Help

The F as in Fat report isn't all gloomy. It acknowledges that more public policies are attempting to address the high obesity rates. For example, President Obama's White House Task Force on Childhood Obesity has set a goal to reduce child obesity rates from 17% to 5% by 2030, a goal the report calls "bold." On top of the federal activity, 20 states have set stricter requirements for nutritional standards for school lunches, breakfasts and snacks, compared to only four states five years ago. And these are only a few of many such initiatives.

But it's far from enough considering the scale of the problem, the report says. The authors recommend increased support for obesity- and disease-prevention programs through the new health reform law's Prevention and Public Health Fund, as well as refocused and realigned federal policies and legislation, among other recommendations.

More Obesity Among Black and Low-Income Populations

The report also highlights troubling disparities among racial, ethnic, regional and income groups:
  • Southern states have highest obesity rates, while Northeastern and Western states have the lowest rates. The same regional trends are true for diabetes and hypertension.
  • Adult obesity rates topped 30% in 43 states for blacks, in 19 states for Latinos and in one state for whites.
  • Among individuals earning less than $15,000 per year, 35.3% were obese compared to 24.5% of adults earning $50,000 or more per year. Similarly, obesity rates were higher among those who never graduated from high school compared to adults with college degrees.
"Reversing the obesity epidemic will require individuals, families, schools, communities, businesses, government and every other sector of American society to reduce the barriers to healthy eating and active living," the report says. "Every American must have the chance to lead a healthy lifestyle."

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