Adult obesity rates increased in 16 states in the past year and did not decline in any state, according to F as in Fat: How Obesity Threatens America's Future 2011, a report from the Trust for America's Health and the Robert Wood Johnson Foundation. Twelve states now have obesity rates above 30%. Four years ago, only one state was above 30%.

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%.

This year, for the first time, the report examined how the obesity epidemic has grown over the past two decades. Twenty years ago, no state had an obesity rate above 15%.  Today, more than two out of three states, 38 total, have obesity rates over 25%. Since 1995, when data was available for every state, obesity rates have doubled in seven states and increased by at least 90% in 10 others. Obesity rates have grown fastest in Oklahoma, Alabama, and Tennessee, and slowest in Washington, D.C., Colorado, and Connecticut.

“Today, the state with the lowest obesity rate would have had the highest rate in 1995,” said Jeff Levi, Ph.D., executive director of Trust for America's Health . “There was a clear tipping point in our national weight gain over the last twenty years, and we can't afford to ignore the impact obesity has on our health and corresponding health care spending.”

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% in 15 states, 35% in 35 states, and 30% in 42 states and Washington, DC.
• Rates of adult obesity among Latinos were above 35% in four states (Mississippi, North Dakota, South Carolina, and Texas) and at least 30% in 23 states.
• Rates of adult obesity for Whites topped 30% in just four states (Kentucky, Mississippi, Tennessee, and West Virginia) and no state had a rate higher than 32.1%.
• Nearly 33% of adults who did not graduate high school are obese, compared with 21.5% of those who graduated from college or technical college.

More than 33% of adults who earn less than $15,000 per year were obese, compared with 24.6% of those who earn at least $50,000 per year.

"The information in this report should spur us all - individuals and policymakers alike - to redouble our efforts to reverse this debilitating and costly epidemic," said Risa Lavizzo-Mourey, M.D., M.B.A, RWJF president and CEO. "Changing policies is an important way to provide children and families with vital resources and opportunities to make healthier choices easier in their day-to-day lives."

This year's report also includes a series of recommendations from TFAH and RWJF on how policymakers and the food and beverage industry can help reverse the obesity epidemic.

The recommendations for policymakers include:

1. Protect the Prevention and Public Health Fund:  Trust for America's Health and the Robert Wood Johnson Foundation recommend that the fund not be cut, that a significant portion be used for obesity prevention, and that it not be used to offset or justify cuts to other Center for Disease Control and Prevention programs.
2. Implementing the Healthy, Hunger-Free Kids Act:  The organizations recommend that the U.S. Department of Agriculture issue a final rule regarding school meal regulations and issue strong standards for so-called "competitive" food and beverages - those sold outside of school meal programs, through à la carte lines, vending machines and school stores. 
3. Implementing the National Physical Activity Plan:  The organizations recommend full implementation of the policies, programs, and initiatives outlined in the National Physical Activity Plan.  This includes a grassroots advocacy effort; a public education program; a national resource center; a policy development and research center; and dissemination of best practices.
4. Restoring Cuts to Vital Programs:  The organizations recommend that the $833 million in cuts made in the fiscal year 2011 continuing resolution be restored and that programs to improve nutrition in child care settings and nutrition assistance programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children be fully funded and carried out.