The obesity epidemic in America has gotten worse in the last year, despite the many public service campaigns promoting physical activity and warning about the health risks posed by being overweight, according to a new study.

According to an annual report released this week by nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation, over the past year adult obesity rates increased in 37 states, while there were no decreases in any states.

The survey, F as in Fat: How Obesity Policies Are Failing in America, 2008, showed that there’s a growing obesity epidemic in the U.S. They found that today more than 20 percent of adults are obese in every state except Colorado, where the number is 18.4 percent. More than 25 percent of adults are obese in 28 states, up from 19 states last year. In 1991 no state had an obesity rate above 20 percent.

The five fattest states and their obesity rates are:
Mississippi (31.7 percent)
West Virginia (30.6 percent)
Alabama (30.1 percent)
Louisiana (29.5 percent)
South Carolina (29.2 percent)

The five slimmest states and their obesity rates are:
Colorado (18.4 percent)
Hawaii (20.7 percent)
Connecticut (20.8 percent)
Massachusetts (20.9 percent)
Vermont (21.1 percent)

Perhaps as a consequence of America’s widening waistlines, another disturbing trend emerged: an increase was found in the percentage of adults with Type-2 diabetes, a weight-related disease. The survey found higher incidence of diabetes in 26 states. Diabetes has been linked to a variety of health problems including coronary heart disease, stroke, cancer and pregnancy complications, according to the U.S. National Institutes of Health.

The two foundations also reviewed state and federal policies aimed at reducing obesity in children and adults. They found that while all 50 states have some sort of law addressing the issue of obesity on the books, only 13 states back up these regulations with enforcement policies.

For example, Georgia and Vermont were the only two states with specific guidelines for treating obese adults in their Medicaid programs. The report also notes that 20 states do not cover nutritional assessments for obese adults under Medicaid. In Nebraska and South Carolina, the Medicaid programs specifically state that obesity is not a disease and treatment cannot be covered.

Among the report’s key findings:

• Number of states in which adult obesity rates went up: 37

• Number of states in which adult obesity rates went down: 0

• Number of states in which at least 1 in 4 adults is obese: 28

• Number of states in which there was no specific coverage for nutrition assessment and counseling for obese or overweight children in their Medicaid programs: 10

• Number of states which explicitly do not cover nutritional assessment and consultation for obese adults under Medicaid: 20

• Number of states in which laws require school meals to exceed USDA nutrition standards: 18

The full report also offers solutions to fight the obesity epidemic, including ways for state and national laws to enforce stricter programs.

"America’s future depends on the health of our country. The obesity epidemic is lowering our productivity and dramatically increasing our health-care costs. Our analysis shows that we are not treating the obesity epidemic with the urgency it deserves," Jeffrey Levi, executive director of Trust for America’s Health, said in a news release. "Even though communities have started taking action, considering the scope of the problem, the country’s response has been severely limited. For significant change to happen, combating obesity must become a national priority."

The full report can be downloaded from the Robert Wood Foundation website. Click here to read F as in Fat: How Obesity Policies are Failing in America.

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