07/09/2011 01:45 am ET

20 Years Of Obesity: Tracking Changes, Finding Solutions

News about the obesity epidemic seems to be everywhere. Clearly it has become a serious issue for every neighborhood, city, county and state, as it hampers productivity and quality of life. We even have popular television shows focused exclusively on helping people lose weight.

Yet, we haven't seen tangible results in our obesity rates ... yet. According to "F as in Fat: How Obesity Threatens America's Future 2011," a report from Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF), adult obesity rates increased in 16 states in the past year and did not decline in any state. Twelve states now have obesity rates above 30 percent. Four years ago, only one state was above 30 percent.

Still, over the last two years, we've seen an unprecedented level of support for obesity-prevention programs, most notably within in the Patient Protection and Affordable Care Act of 2010 and the American Recovery and Reinvestment Act of 2009. In addition, there have been numerous community efforts (some of which are highlighted in the report) that have taken root across the country to combat food deserts and help empower people to be as healthy and productive as possible.

When you look at the myriad of changes at the local, state and federal levels (including new standards for physical activity and school lunches), the momentum is there to help people make the healthy choices that will reverse the tide of this epidemic.

But it will be a while until we see the impact of these changes. In the meantime, we continue to see wide disparities across the country much of which can be tracked by economic and racial status. The obesity epidemic continues to be most dramatic in the South, which includes nine of the 10 states with the highest adult obesity rates. States in the Northeast and West tend to have lower rates.

Mississippi maintained the highest adult obesity rate for the seventh year in a row, and Colorado has the lowest obesity rate and is the only state with a rate under 20 percent.

We now have the ability to look back two decades to see how obesity has changed in America. Twenty years ago, no state had an obesity rate above 15 percent. Today, more than two out of three states -- 38 total -- have obesity rates over 25 percent, and just one has a rate lower than 20 percent.

Since 1995, when data was available for every state, obesity rates have doubled in seven states and increased by at least 90 percent in 10 others. Obesity rates have grown fastest in Oklahoma, Alabama and Tennessee, and slowest in Washington, D.C., Colorado and Connecticut.

To underscore the point -- today, the state with the lowest obesity rate would have the highest rate in 1995. Our slimmest population would be the fattest just 15 years ago -- and that's startling.

As obesity increases, so do related (serious) health problems, including diabetes and high blood pressure. New data in the report shows how rates of both have risen dramatically over the last two decades. Since 1995, diabetes rates have doubled in eight states. Then, only four states had diabetes rates above 6 percent. Now, 43 states have diabetes rates over 7 percent and 32 have rates above 8 percent. Twenty years ago, 37 states had hypertension rates over 20 percent. Now, every state is over 20 percent, with nine over 30 percent.

Racial and ethnic minority adults, and those with less education or who make less money, continue to have the highest overall obesity rates:

  • Adult obesity rates for Blacks topped 40 percent in 15 states, 35 percent in 35 states, and 30 percent in 42 states and D.C.
  • Rates of adult obesity among Latinos were above 35 percent in four states (Mississippi, North Dakota, South Carolina and Texas) and at least 30 percent in 23 states.
  • Meanwhile, rates of adult obesity for Whites topped 30 percent in just four states (Kentucky, Mississippi, Tennessee and West Virginia) and no state had a rate higher than 32.1 percent.
  • Nearly 33 percent of adults who did not graduate high school are obese, compared with 21.5 percent of those who graduated from college or technical college.
  • More than 33 percent of adults who earn less than15,000 per year were obese, compared with 24.6 percent of those who earn at least 50,000 per year.

We've taken the first step by identifying the problem. Finding solutions isn't as easy.

Yes, we all know we need to eat less and move more. But obviously that's easier said than done.

Reversing the obesity epidemic needs to start with individuals taking responsibility. But willpower alone won't do it. People don't make decisions in vacuums. We're going to have to make healthier choices easier for Americans -- giving all of us more opportunities and options.

We can help people help themselves. When we improve sidewalks or school lunches, we give more Americans the chance to stay active and healthy. The report lays out some key recommendations of how to provide this support, including:

  1. Protecting the Public and the Prevention Fund, which provides new resources for federal programs that fight obesity;
  2. Implementing the Healthy, Hunger-Free Kids Act which could lead to sweeping changes in food in schools around the country;
  3. Implementing the National Physical Activity Plan which would help provide more resources and information to the public to support activity; and
  4. Restoring cuts to a range of federal nutrition assistance programs.

Additionally, the food and beverage industry should adopt strong, consistent standards for food marketing similar to those proposed in April 2011 by the Interagency Working Group -- a group composed of representatives from the Federal Trade Commission, CDC, Food and Drug Administration and the USDA -- and work to implement the other recommendations set forth in the 2005 Institute of Medicine report on food marketing to children and youth.

The full report with state rankings in all categories is available on TFAH's website at and RWJF's website at The report was supported by a grant from RWJF.