The newest State of Obesity report shows West Virginia and Mississippi led the nation in 2018 for adult obesity rates, with a rate of 39.5 percent. 

Nine states in the nation have an obesity rate above 35 percent, including Alabama, Arkansas, Iowa, Kentucky, Louisiana, Missouri and North Dakota, according to the report released Thursday from Trust for America's Health. 

"As recently as 2012, no state had an adult obesity rate over 35 percent," the report said. "And within the last five years (2013 and 2018), 33 states had statistically significant increases in their rates of adult obesity."

The new national average for obesity is 30.9 percent, and the nation's lowest rate is found in Colorado at 23 percent. 

The report said obesity has serious health consequences including increased risk for type 2 diabetes, high blood pressure, stroke and many types of cancers. In West Virginia, 43.5 percent of adults have hypertension and 16.2 percent of adults have diabetes. 

Obesity is estimated to increase national health care spending by $149 million annually (about half of which is paid for by Medicare and Medicaid), the report said, and being overweight or obese is the most common reason young adults are ineligible for military service.

Seventy-two percent of West Virginia adults are considered either obese or overweight, and 28.1 percent of adults are physically inactive. 

“These latest data shout that our national obesity crisis is getting worse,” John Auerbach, President and CEO of Trust for America’s Health, said in a release. “They tell us that almost 50 years into the upward curve of obesity rates we haven’t yet found the right mix of programs to stop the epidemic.

"Isolated programs and calls for life-style changes aren’t enough. Instead, our report highlights the fundamental changes that are needed in the social and economic conditions that make it challenging for people to eat healthy foods and get sufficient exercise.”

The State of Obesity report highlights three indicators for obesity — rural areas, low income levels and low educational attainment. 

• According to 2016 Behavioral Risk Factor Surveillance System (BRFSS) data, adult obesity rates were 19 percent higher in rural regions than they were in metro areas. said West Virginia had nearly 689,000 residents living in rural areas in 2018. 

• Generally, the higher a family’s income the less likely its members will have obesity, the report said. A U.S. Census estimate from July 2018 showed 19.1 percent of West Virginians are living in poverty. 

• The report said individuals with lower education levels are more likely to have obesity. BRFSS national data from 2017 showed 35.6 percent of adults with less than a high school education had obesity compared with 22.7 percent of college graduates. The U.S. Census report from July 2018 estimated 85.9 percent of West Virginians had a high school diploma or higher degree, and 19.9 percent had a bachelor's degree or higher.

While the report focused primarily on adult statistics, it also included National Survey on Children's Health (NSCH) and WIC data about childhood and young adult obesity rates as well. 

Nationwide in 2016, WIC reported 13.9 percent of low-income children ages 2 to 4 were obese, and NSCH reported 15.8 percent of children ages 10 to 17 were obese. The report said in West Virginia, the 16.4 percent of low-income children ages 2 to 4 are obese (data from 2014), and 20.3 percent of children ages 10 to 17 are obese (data from 2016) . 

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The report says promoting healthier food for children through WIC food packages and taxing sugary drinks could help combat the epidemic. 

Overall, obesity rates for children enrolled in WIC (Special Supplemental Nutrition Program for Women, Infants and Children) continues to decline, from 15.9 percent in 2010 to 13.9 percent in 2016. In 2009, the U.S. Department of Agriculture updated WIC food packages to more closely meet recommended national dietary guidelines including the addition of more fruits, vegetables and whole grains and reduced fat levels in milk and infant formula.

A number of U.S. cities and the Navajo Nation have passed local taxes on sugary drinks that are showing promise as a means to change consumers’ beverage habits, the report said. Studies of a 1-cent per ounce tax in Berkeley, Calif. and a 1.5 cent per ounce tax in Philadelphia, Pa., found that the consumption of sugary drinks decreased significantly after the tax was imposed.

“Policies such as these are proving effective in changing behavior. But, no single solution — however promising — is sufficient. Obesity is a complex problem and will need multi-sector, multi-factor solutions,” Auerbach said. “Creating the conditions that allow people to more easily make healthy choices is central to preventing obesity, as is prioritizing investment in those communities most affected by the crisis."  

The report also includes 31 recommendations for policy action by federal, state and local government, across several sectors, designed to improve access to nutritious foods and provide safe opportunities for physical activity, while minimizing harmful marketing and advertising tactics.

Among the report’s recommendations for policies to address the obesity crisis are:

• Encourage safe physical activity by funding Safe Routes to Schools (SRTS), Complete Streets, Vision Zero and other pedestrian safety initiatives through federal transportation and infrastructure funding. Locally, Beckley, Mount Hope and Oak Hill have adopted Complete Streets policies. 

• Expand the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) to age 6 for children and for two years postpartum for mothers and fully fund the WIC breastfeeding Peer Counseling Program.

• Ensure that CDC has enough funding to grant every state appropriate funding to implement evidence-based obesity prevention strategies (currently, CDC only has enough funding to work with 16 states).

• Make it more difficult to market unhealthy food to children by ending federal tax loopholes and business costs deductions related to the advertising of such foods to young audiences.

• Fully fund the Student Support and Academic Enrichment program and other federal programs that support student physical education.

• Ensure that anti-hunger and nutrition-assistance programs, like the Supplemental Nutrition Assistance Program (SNAP), WIC, and others follow the Dietary Guidelines for Americans and make access to nutritious food a core program tenet.

• Strengthen and expand school nutrition programs beyond federal standards to include universal meals, flexible breakfasts and eliminate all unhealthy food marketing to students.

• Enforce existing laws that direct most health insurers to cover obesity-related preventive services at no-cost sharing to patients.

• Cover evidence-based comprehensive pediatric weight management programs and services in Medicaid.

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The report, based in part on newly released data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, and analysis by Trust For America's Health, provides an annual snapshot of obesity rates nationwide. The State of Obesity series and this report were made possible by funding from the Robert Wood Johnson Foundation.

For more information or the full report, visit  

— Email: and follow on Twitter @WendyHoldren

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