File - A group a runners in Boulder, Colorado. Colorado has one of the lowest obesity rates in the nation, but more than half the state’s residents are overweight or obese. (AP Photo)

File – A group a runners in Boulder, Colorado, a state with one of the lowest obesity rates in the nation. However, more than half of the state’s residents are overweight or obese. (AP Photo)

Many Americans kicked off 2015 with a pledge to lose weight over the next 12 months and U.S. obesity statistics suggest that’s a worthy goal for residents in every U.S. state.

The fattest states in America, according to the Centers for Disease Control (CDC), are Mississippi–where 35.1 percent of adults are obese–and West Virginia (35.1%) and the slimmest are Hawaii (21.8%) and Colorado (21.3%), but while there’s actually been a leveling off of the nationwide obesity rate, none of the 50 states have much to be proud of.

When the CDC first started collecting this data in 1995, not a single state had an obesity rate higher than 19 percent. Today, not a single state is lower than 20 percent.

“So while we’ve seen this leveling off over the last couple of years, the trajectory over the last 20 years has been pretty staggering,” said Jeffrey Levi, executive director of of Trust for America’s Health. “It’s a combination of what we eat, how we eat and how active we are.”


Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2013 (CDC map)

Obesity tends to be concentrated more in the southeast where there are strong cultural traditions centered around food. Levi says residents of states with the highest obesity rates are the least likely to be meeting the federal government’s guidelines of getting an hour of physical activity each day.

It’s a problem that’s straining the nation’s resources; chronic diseases associated with obesity account for almost three-fourths of America’s healthcare spending. But Levi does see some hopeful signs.

“We are seeing some successes in communities around the country in either stabilizing child obesity rates or actually reducing them, especially when there are aggressive efforts that combine what’s happening in schools, at home and in the community,” Levi said. “We’re seen communities turn the tide.”

Turning the tide

One community that is trying to turn the tide is Philadelphia, Pennsylvania, one of America’s poorest cities where 66 percent of adults and 40 percent of children are overweight or obese.

In 2010, the city launched Get Healthy Philly, an initiative that looks for creative ways to get the city’s health problems under control. Access to healthier foods is a key component of the plan. Chinese restaurant owners are encouraged to attend free cooking classes on how to lower sodium in the foods they serve. More than 200 Philadelphia Chinese restaurants currently participate in the program.

Clark Park Farmers' Market in Philadelphia, Pennsylvania. (Photo by Albert Yee for The Food Trust)

Clark Park Farmers’ Market in Philadelphia, Pennsylvania. (Photo by Albert Yee for The Food Trust, a Get Healthy Philly partner)

Officials also opened 10 farmer’s markets in low-income neighborhoods and offered vouchers to help residents buy the fresh local fruits and vegetables offered there. Vending machine snacks in public buildings were changed to meet certain nutritional standards.

City officials also mounted a successful 20-month media campaign to reduce consumption of sugary drinks by children.

Along the way, they discovered that the way they framed the issue for parents was critical to the success of their efforts.

“Focusing on obesity can be really tricky. It can turn some people off. They may not think it’s a problem for them so we’ve really tried to focus on the health effects,” said Dr. Giridhar Mallya, director of Policy and Planning for the Philadelphia Department of Public Health. “We learned that if we focused on diabetes, particularly this idea that kids are now developing the types of diabetes that only adults used to develop, that was new information for a lot of parents in Philadelphia, and it was very actionable information for them. Moms said to us, ‘You know, that makes me want to do something different for my family.’”

It helped that Philadelphia’s public schools were already on board. They’d been offering nutritious breakfasts, lunches and healthier snacks in vending machines for almost a decade. Students in about 200 public schools were participating in nutrition education programs.

Obesity in Philadelphia schoolchildren declined by 5 percent from 2006 to 2010, according to the CDC.

Poverty causes obesity

A woman walks through a blighted neighborhood, July 11, 2013, in Philadelphia. (AP Photo)

A woman walks through a blighted neighborhood, July 11, 2013, in Philadelphia. (AP Photo)

Being poor is one of the biggest causes of obesity. Philadelphia is the fifth largest city in the United States but has the highest rates of poverty.

Close to half of kids are either overweight or obese because they live and play in environments where the unhealthy choice is usually the default choice, according to Mallya, who says city officials wanted to change things so that the healthy choice would become the default choice.

They zeroed in on corner stores where children in low-income neighborhoods often drop in for high-calorie, low-cost snacks like chips and soda.

“We have to think about what we can do to reduce the availability, promotion, marketing, low price of unhealthy products, particularly sugary drinks, chips, candy, baked goods,” said Mallya. “Because ultimately, if we want to see progress on obesity, we need to address both sides of the equation.”

Healthy corner stores

More than 600 corner stores agreed to participate in Get Healthy Philly’s Healthy Corner Stores program by stocking fruits, vegetables and other healthy options along with the cakes, chips and soft drinks.

Olivares Food Market, a Latino-oriented corner store in South Philadelphia is one of them.

Fresh Corner Kiosk at a Healthy Corner Store in Philadelphia, Pennsylvania. (The Food Trust)

Fresh Corner Kiosk at a Healthy Corner Store in Philadelphia, Pennsylvania. (Photo courtesy The Food Trust, a Get Healthy Philly partner)

Owner Clara Olivares started by stocking six different fruits and vegetables including bananas, apples, oranges, cabbage and broccoli. After six months in the program, she was given a refrigerator to hold her healthy offerings.

Many of Olivares’ customers are students from the nearby middle school.

“Sometimes they’ll buy yogurt and a piece of fruit, especially in the morning when they are going to school,” she said, adding that the kids don’t always make the healthiest choices in the afternoon. Cakes, sodas, juices and chips are the most popular after-school snacks Olivares sells.

Still, Olivares says the fruits and vegetables have added to her business and she’s gotten creative with it. She makes and sells fruit salad–$2.50 for about two cups–and cuts up watermelon which costs $1.50 a cup. Mothers with families, the elderly and college students buy the most fruit and vegetables in Olivares’ store, but younger children are also starting to show an interest, something city health officials had been aiming for.

“Sometimes little kids will reach into the open fridge and grab an apple and ask the parents to buy it for them,” Olivares said, noting that the parents almost always buy the fruits for their children in these cases. “They used to grab a piece of cake.”