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Montanans are among the country's skinnier residents, while Mississippi, Alabama and West Virginia residents are the fattest, according to federal figures released Tuesday. But Montanans shouldn't let the ranking go to their heads. "If you look at the total data, then we're still increasing each year," said Crystelle Fogle of Shepherd, public health nutritionist for the Montana Department of Public Health and Human Services. "Everybody is in the same boat." Genetic backgrounds don't appear to give Montanans an advantage, Fogle said. Plus, "I don't think our eating habits are any better." However, Montanans appear to be more active outdoors than average, taking part in warm-weather and cold-weather activities, she said. Fogle is the health agency's liaison to the state's Nutrition and Physical Activity Program, formerly the Obesity Prevention Program. Only eight states — all from New England and the Rocky Mountains — had adult obesity rates of less than 20 percent during the years 2002 to 2004, according to the Centers for Disease Control and Prevention. Montana was ranked fifth skinniest, tied with Vermont, each with 19.1 percent of residents rated obese. A man of average height, 5-feet-9, is considered obese at 203 pounds, or at least 41 pounds above normal; a woman of average height, 5-feet-4, is considered obese at 174 pounds, or at least 34 pounds above normal. Colorado had the fewest obese adults at 16.4 percent, followed by Massachusetts at 17.8 percent, Rhode Island at 18.6 percent and Connecticut at 18.9 percent. Overall trends are distinctly negative, however. Obesity rates rose last year in every state but Oregon. An advocacy group that analyzed the figures, Trust for America's Health, called on the government and the private sector to get more involved in Americans' battle with expanding waistlines. The group said federal data showed the percentage of obese adults for 2002-04 stood at 22.7 percent nationally. The percentage for the previous cycle, 2001-03, was 22 percent. The state exhibiting the largest increase in obesity was Alabama. There, the rate increased 1.5 percentage points to 27.7 percent. Oregon's rate held steady at 21 percent. The South fared worst in the report, which covered 49 states. The five states with the highest percentage of obese adults were Mississippi, Alabama, West Virginia, Louisiana and Tennessee. Hawaii was not included in the report. Southern eating habits may be to blame, including a lot of fried food, Fogle said. The states with the lowest percentage of obese adults were Colorado, Massachusetts, Rhode Island, Connecticut, Vermont and Montana. An official with the Trust for America's Health, Shelley A. Hearne, said the United States is stuck in a "debate limbo" about how the government should confront obesity. She used the report to call for more government action on several fronts, such as ensuring that land use plans promote physical activity; that school lunch programs serve healthier meals; and that Medicaid recipients get access to subsidized fitness programs, such as aerobics classes at the local YMCA. "We have a crisis of poor nutrition and physical inactivity in the U.S., and it's time we dealt with it," said Hearne, executive director of the organization. Radley Balko, a policy analyst at the Cato Institute, said he is wary of the call for more government action on obesity. The institute is a think tank that prefers free-market approaches to problems. "I think obesity is a very personal issue," Balko said. "What you eat and how often you exercise, if that comes within the government's purview, it's difficult to think of what's left that isn't." Health policy analysts maintain that obesity increases the burden on taxpayers because it requires the Medicare and Medicaid programs to cover the treatment of diseases caused by obesity. The report issued Tuesday said taxpayers spent $39 billion in 2003 for the treatment of conditions attributable to obesity. The Trust for America's Health recommended mandatory screening for obesity among Medicaid recipients, as well as nutritional counseling. "Better prevention and disease management programs will result in cost savings to the system as a whole," the report stated. Balko said it's not clear the government really knows how to persuade people to make better decisions. He said open-ended entitlement programs, such as Medicaid and Medicare, don't provide much of a financial incentive for people to watch their weight. The government just picks up the cost of treating diseases for those patients, regardless of the amounts, he said. He prefers that the government give Medicaid and Medicare recipients an incentive to open medical savings accounts, which would allow them to save money when they did not access the health care system. "If they knew they only had so much to spend, or what they did not spend could be saved, then maybe you could instill a certain sense of responsibility and ownership," Balko said. Adults with a body mass index of 30 or more are considered obese. The equation used to figure body mass index is body weight in kilograms divided by height in meters squared. The measurement is not a good indicator of obesity for muscular people who exercise a lot. |