Dr. Michael Wayne

The Most Obese State in the U.S. – and What They’re Trying to Do About It

map24Over the last few days during this series on obesity, I’ve told you about obesity in the U.S. and how the rates have been increasing rapidly, and I also told you about the most obese cities in the U.S. – with Miami, Florida having the honor of being the most obese city.

Today I want to look at the most obese state in the U.S., a state that has held onto first place for the last five years. In 2008, Mississippi reported that 32.8% of their residents are obese.

So you could say that they are the leading High Density Lifestyle state.

It’s not an honor anyone wants to win, and unfortunately, as you saw in the article on Obesity in America, Mississippi has been at the forefront of obesity statistics since the CDC first began measuring the numbers in 1985.

Mississippi also has the highest number of obese children, with 44% of children ages 10-17 registering in that category.

Here is what some Mississippi state public policy makers and health advocates are suggesting for the state to do to reverse the trend:

1. Address the Environment

Personal choices about diet and activity are important. But in a state with a high poverty rate, if there’s no healthy food available at affordable prices, and no place to exercise or even take a walk, that’s a problem.

“I am not here to tell you to be healthy or force you to be healthy. I’m just here to give you an opportunity for it,” Chip Johnson, mayor of Hernando, Miss., said. ” I have to put that opportunity out there, and if the people don’t take advantage of it, that’s their choice.”

Johnson says Hernando, which is located about 12 miles south of Memphis, Tenn., has a population of 15,000 people and is in Mississippi’s Delta region.

“Mississippi is the fattest state in the fattest nation in the world at the fattest time in all of history, and the Delta is the fattest area of our state. So we’re right here, smack-dab in the middle of the fattest thing going on,” Johnson says.

2. Spring for Sidewalks

Gene McGee, mayor of Ridgeland, Miss., says his town (population: 23,000) mandates sidewalks for new subdivisions. “That hopefully encourages families or individuals to walk in the subdivisions,” McGee said.

In Hernando, Mayor Johnson says grants will pay for sidewalks to be installed in the city’s poorest neighborhood, and crumbling sidewalks elsewhere have also been upgraded.

Johnson says he’s seen more people walking on the new sidewalks. “It’s like that movie — if you build it, they will come,” he says.

3. Spruce Up Parks

“I think it’s very important to encourage communities to have facilities such as multi-use trails or parks that encourage physical activity,” says McGee, noting Ridgeland’s system of multi-use trails for biking, jogging, or walking.

Johnson says in Hernando, volunteers rehabbed an overgrown football field and track at a burned-down high school, turning it into a site for youth football and soccer and a place for neighborhood residents to walk and jog.

4. Reframe Obesity

Obesity shouldn’t be thought of as a personal failure or sheer gluttony, but as a “chronic medical condition,” says Gabrial Uwaifo, MD, FACP, FACE, an endocrinologist at the University of Mississippi in Jackson, Miss. Uwaifo wants obesity to be covered by insurance, not paid for out of pocket.

Deep fried bread - a southern delicacy

5. Step Away From the Deep Fryer

Uwaifo, who moved to Mississippi two years ago from the Washington, D.C., area, says he was surprised by how Mississippians eat.

“I was amazed at how virtually everything was fried,” Uwaifo says. “I’ve seen oranges dunked in oil” as well as fried bananas and apples.

Uwaifo says these eating habits are “dangerous for your heart, and it could add up over time.”

6. Launch a Public Health Blitz

That’s something Uwaifo wants to see happen. He likens it to the antismoking public campaign.

“Just the same way we finally got people to understand that the Marlboro Man looked good but all those cigarettes wasn’t good for him and will kill him eventually. That’s the sort of public health onslaught I think needs to be put out regarding food. People need to understand that we do end up being what we eat,” Uwaifo says, cautioning that messages should be tailored to different ethnic populations and age groups.

“It has to be handled sensitively and carefully. It cannot be one-size-fits-all,” Uwaifo says.

If Mississippi really steps up to the plate by making a major commitment to tackle obesity, the state could end up being an obesity underdog. Given the high rate of obesity, even small changes could make a “measurable impact,” Uwaifo notes.

7. Make Healthy Food Available and Affordable

This hasn’t been as simple as putting in sidewalks. Mississippi is one of the nation’s poorest states, and as Uwaifo points out, “as long as it’s far cheaper to get high-fat, high-carbohydrate, simple starchy things, whatever public education you put out there is not going to work. People finally have to work with what is in their pocket.”

Johnson points to a new farmer’s market — all with local food — on the Hernando town square on Saturday mornings that is proving popular. It’s within walking distance of poor neighborhoods and also draws people from up to 60 miles away, says Johnson, adding that the city’s poorest neighborhood also has a new community garden.

But he’s not happy with the choices at local stores in certain neighborhoods.

“We still don’t have healthy foods accessible in our lower-income neighborhoods,” Johnson says.

“People who don’t have a car and who walk to the corner market for their meals, well, their only options are the fried chicken and the fried pizza sticks and all that stuff sitting there in the counter. When you go in these corner stores, there’s no fresh vegetables. There may be a brown banana laying there, that’s the best you can hope for. So we’re trying to encourage that, and that part has not happened here yet,” Johnson says.

8. Walk the Walk

“Setting an example for people is very important,” says McGee, who is an avid cyclist, covering 100-150 miles per week on his bike. But he wasn’t always like that.

“When I started cycling, I was probably 35 pounds over what I am right now,” he says. Taking up cycling “helped me to lose weight, and it also taught me that to exercise, I’ve also got to eat right, and so I’ve learned to turn down those foods that aren’t good for you.”

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