"Although rates have dropped in Montana, Minnesota, New York, and Ohio, even those decreased rates are still high," Lieberman writes. "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." In 1980, no state has a rate above 15 percent, and in 1990, none was above 20 percent, Lieberman notes.
"Many societal changes have conspired to increase obesity rates," said Richard Hamburg, interim president of Trust for America's Health. "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." He also credited a rise in obesity with sedentary lifestyles—blamed largely on video games replacing physical activities—a lack of physical education in schools and more kids going to school via bus or car, instead of walking or biking.
Another reason is eating habits, Leiberman writes. Families eat out more often, consuming higher rates of sugar and fat. Also food deserts make it hard for some people, especially in rural areas, to eat healthy, and powerful marketing campaigns from food companies plays a part, especially advertisements that target children.
In North Carolina, the adult obesity rate has remained at about 30 percent for seven years, Richard Craver reports for the Winston Salem-Journal, in a good example of localizing the report. North Carolina, which is tied for 22nd for most obese state, is taking some efforts to try to educate about obesity, Craver writes. Kate Murphy, a senior communications officer with the state Department of Health and Human Services, credits the state's Eat Smart, Move More North Carolina movement with helping the state move up eight places in the 2016 edition of America’s Health Rankings for activity among adults. The movement is part of a seven-year DHHS plan (from 2013 to 2020) to address and reduce the number of obese adults and children.
Also, Novant Health Inc., which has 15 medical centers and 1,380 physicians in 530 locations in North Carolina, Virginia, South Carolina and Georgia, has a "Remarkable You" initiative that focuses on the implications of obesity, pre-diabetes and high blood pressure.