New Report: Adult Obesity Rates Rise in 37 States, Obesity …

   New Report: Adult Obesity Rates Rise in 37 States, Obesity
     Rates Now Exceed 25% in More Than Half of States

Media Contacts: Liz Richardson (202) 223-9870 x 21 or lrichardson@tfah.org or Laura Segal
(202) 223-9870 x 27 or lsegal@tfah.org

Washington, D.C. August 19, 2008 ­ Adult obesity rates increased in 37 states in the past year,
according to the fifth annual F as in Fat: How Obesity Policies Are Failing in America, 2008
report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation
(RWJF). Rates rose for a second consecutive year in 24 states and for a third consecutive year in
19 states. No state saw a decrease. Though many promising policies have emerged to promote
physical activity and good nutrition in communities, the report concludes that they are not being
adopted or implemented at levels needed to turn around this health crisis.

More than 25 percent of adults are obese in 28 states, which is an increase from 19 states last
year. More than 20 percent of adults are obese in every state except Colorado. In 1991, no state
had an obesity rate above 20 percent. In 1980, the national average of obese adults was 15
percent. Now, an estimated two-thirds of American adults are overweight or obese, and an
estimated 23 million children are either overweight or obese (the report does not include new
state-level data for children this year).

The F as in Fat report finds that rates of type 2 diabetes, a disease typically associated with
obesity, grew in 26 states last year. Four states now have diabetes rates that are above 10 percent,
and all 10 states with the highest rates of diabetes and hypertension are in the South. The report
also found a relationship between poverty and obesity levels. Seven of the 10 states with the
highest obesity rates are also in the top 10 for highest poverty rates.

"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're not
treating the obesity epidemic with the urgency it deserves," said Jeff Levi, Ph.D., executive
director of TFAH. "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 F as in Fat report is a follow-up analysis of the annual Behavioral Risk Factor Surveillance
Survey (BRFSS) by the federal Centers for Disease Control and Prevention (CDC). The latest
survey results showed Mississippi with the highest rate of obesity and Colorado with the lowest
rate. Eleven of the 15 states with the highest obesity rates are in the South. Northeastern and
Western states continue to have the lowest obesity rates. F as in Fat provides a trend analysis of
the BRFSS data using a methodology recommended by the CDC. Rankings are based on three
years of data (2005-07) that are averaged for each state's obesity rate. This methodology reflects
a truer representation of the data for comparative purposes in order to rank states and examine
changes over time.

The report also provides an annual review of state and federal policies aimed at reducing or
preventing obesity in children and adults. It shows that many policies are missing critical
components or require a more comprehensive approach to be truly effective. Among the
examples highlighted:



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    ·   While all 50 states and the District of Columbia have passed laws related to physical
        education and/or physical activity in schools, only 13 states include enforceability
        language. Of these states, only four have sanctions or penalties if the laws are not
        implemented.
    ·   While the Dietary Guidelines for Americans were updated in 2005, the U.S. Department
        of Agriculture (USDA) school meal program has yet to adopt the recommendations.
    ·   Eighteen states have enacted legislation requiring school meals to exceed USDA nutrition
        standards. However, only seven of these laws have specific enforcement provisions, and
        only two state laws include sanctions if its requirements are not met.
    ·   Ten states do not include specific coverage for nutrition assessment and counseling for
        obese or overweight children in their Medicaid programs (Early and Periodic Screening,
        Diagnostic and Treatment (EPSDT) benefits).
    ·   Twenty states explicitly do not cover nutritional assessment and consultation for obese
        adults under Medicaid.
    ·   Only Georgia and Vermont have specific guidelines for treating obese adults in their
        Medicaid programs. In Nebraska and South Carolina, the Medicaid programs specifically
        state that obesity is not an illness and is therefore not covered.
    ·   Forty-five states allow using obesity or health status as a risk factor to deny coverage or
        raise premiums. Only five states do not allow using obesity or health status to deny
        coverage or raise premiums.

"Despite widespread acknowledgement that obesity is endangering the health of millions of
Americans, the country is still failing to respond clearly or comprehensively," said Risa Lavizzo-
Mourey, M.D., M.B.A., RWJF president and C.E.O. "We must work together, governments,
schools and communities, to improve nutrition and increase physical activity for all ages. We
must ensure that strong policies are implemented and enforced in every state, not only to help
reverse existing obesity rates, but to prevent obesity among our nation's children ­ and
generations to come."

"The report shows the serious impact that the obesity crisis is having on our country's health and
economic well-being," said former President Bill Clinton, who co-leads the Alliance for a
Healthier Generation, a partnership between the William J. Clinton Foundation and the American
Heart Association that works to advance innovative approaches combating childhood obesity and
helping children live healthier lives. "We need to continue to work to create a real push towards
reversing the obesity epidemic. It is time we make it a national priority," President Clinton added.

The F as in Fat report concludes with a recommendation that the country set a national goal of
reversing the childhood obesity epidemic by 2015. To help achieve that goal, the report's top
recommendation calls on the federal government to convene partners from state and local
governments, businesses, communities, and schools to create and implement a realistic,
comprehensive National Strategy to Combat Obesity. Some key policy recommendations
include:

    ·   Investing in effective community-based disease-prevention programs that promote
        increased physical activity and good nutrition;
    ·   Improving the nutritional quality of foods available in schools and childcare programs;
    ·   Increasing the amount and quality of physical education and activity in schools and
        childcare programs;



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    ·   Increasing access to safe, accessible places for physical activity in communities.
        Examples include creating and maintaining parks, sidewalks and bike lanes and providing
        incentives for smart growth designs that make communities more livable and walkable;
    ·   Improving access to affordable nutritious foods by providing incentives for grocery stores
        and farmers' markets to locate in underserved communities;
    ·   Encouraging limits on screen time for children through school-based curricula and media
        literacy resources;
    ·   Eliminating the marketing of junk food to kids;
    ·   Encouraging employers to provide workplace wellness programs;
    ·   Requiring public and private insurers to provide preventive services, including nutrition
        counseling for children and adults; and
    ·   Providing people with the information they need about nutrition and activity to make
        educated decisions, including point-of-purchase information about the nutrition and
        calorie content of foods.

The full report with state rankings in all categories is available on TFAH's Web site at
www.healthyamericans.org and RWJF's Web site at www.rwjf.org. The report was supported
by a grant from RWJF.

                     STATE-BY-STATE ADULT OBESITY RANKINGS

Note: 1 = Highest rate of adult obesity, 51 = lowest rate of adult obesity. Rankings are based on
combining three years of data (2005-2007) from the U.S. Centers for Disease Control and
Prevention's Behavioral Risk Factor Surveillance System to "stabilize" data for comparison
purposes. This methodology, recommended by the CDC, compensates for any potential anomalies
or usual changes due to the specific sample in any given year in any given state. States with
statistically significant (p