Obesity is defined as a body mass index (BMI) of 30 or more. For example, a person who is 5 feet 8 inches tall, and weighs 197 pounds, has a BMI of 30. An estimated 65% of Americans are now overweight or obese, compared to 1980 when 15% of Americans were obese.

According to the annual report recently released by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation, adult obesity rates have increased in 37 States. This is despite public service campaigns warning about the health risks associated with being overweight.

More than 25 percent of adults are obese in 28 States, up from 19 States last year. And more than 20 percent of adults are obese in every State except Colorado. In 1991, no State had an obesity rate greater than 20 percent.

Despite widespread recognition that obesity is endangering the health of millions of Americans, the country is still failing to respond adequately to the problem. The 5 States with the highest obesity rates are Mississippi (31.7 percent), West Virginia (30.6 percent), Alabama (30.1 percent), Louisiana (29.5 percent) and South Carolina (29.2 percent). The 5 States with the lowest obesity rates are Colorado (18.4 percent), Hawaii (20.7 percent), Connecticut (20.8 percent), Massachusetts (20.9 percent), and Vermont (21.1 percent).

The report stated that rates of type 2 diabetes, a disease typically associated with obesity, had increased in 26 States last year. Four States now have diabetes rates above 10 percent. Besides type 2 diabetes, obesity has been linked to coronary heart disease and stroke, osteoarthritis, gall bladder disease, liver disease, cancer and pregnancy complications, according to the U.S. National Institutes of Health.

While a number of promising policies designed to promote physical activity and good nutrition have been introduced in communities, the report’s findings suggest that these policies are not being implemented at levels sufficient to reduce obesity rates.