Is the message that the nation is getting too fat beginning to sink in?

The answer is “yes but,” says the Trust for America’s Health, a nonprofit, non-partisan group that aims to protect the health of communities and make disease prevention a national priority.

And a study of healthcare quality and quantity across the nation suggests some reasons why things are not improving uniformly.

Obesity is a disease, and for the last 13 years the Trust and the Robert Wood Johnson Foundation have monitored obesity rates in the country, focusing on the proportion of a state’s population that is obese. The study designates someone as obese whose body mass index (a measure based on height and weight) is 30 or higher.

This year’s results show that after a decade in which every state’s obese population rose, a few states have finally experienced a decrease.

“We’re seeing the rates plateau albeit at a very high level,” says Richard Hamburg, the interim president of the Trust. 

Although rates have dropped in Montana, Minnesota, New York, and Ohio, even those decreased rates are still high.

Twenty-six percent of adults in Minnesota were still considered obese, and nearly 30 percent were in Ohio. Even in the states with the lowest rates—Colorado, California, Utah, Montana, Hawaii and Massachusetts—rates remain between 20 and 25 percent.

Twenty-two of the 25 states with the highest adult obesity rates are in the South and Midwest, including Kansas and Kentucky, both of which experienced an increase.

To put this in perspective, Hamburg told me that in 1980 no state had a rate above 15 percent; in 1990 no rate was above 20 percent.

“Colorado is the healthiest state but exceeded the 20 percent rate years ago,” he said.

What happened?  Hamburg explained that many societal changes have conspired to increase obesity rates.

Children have less opportunity for physical activities; parents are no longer comfortable sending their kids out to play and telling them to come home by dark.

Other reasons?

• Sedentary activities like computer games have replaced physical activity.

• Many schools no longer offer physical education, and are not always open for physical activity after the school day ends.

• More kids arrive at school via car or bus. In 1969, 89 percent of kids walked or rode their bikes to school. By 2009, the number had dropped to 35 percent.

Eating habits are different, too, with families eating more often in restaurants, including fast food establishments, and consuming more added sugars and fats.

Many families eat at McDonalds or Burger King a few times a week, but even if they cooked at home, they might not be eating “healthy” because they don’t have access to fresh fruits and vegetables.

By Trudy Lieberman