Print edition: 
Almost every state is getting fatter, according to a nationwide report on obesity released Tuesday. But Missouri and Kansas are getting fatter faster than most of them.
The two states both moved up in the annual ranking, reported by two nonprofits, Trust for America's Health and the Robert Wood Johnson Foundation.
Missouri moved from 13th to 12th among fattest states, while Kansas went from 18th to 16th.
In Missouri, 29.3 percent of adults now are obese. In Kansas, it's 28.2 percent. In both states, obesity rates have more than doubled since 1992.
"This is the single biggest health problem that confronts the state... in terms of what it's costing us in shortened lives, unnecessary disease and preventable medical costs," said Jason Eberhart-Phillips, director of health for Kansas.
Tuesday's report averaged obesity rates from the past three years (2007-09) and compared them to the prior three years (2006-08).
Only the District of Columbia showed a significant decrease, while Kansas, Missouri and 28 other states showed a significant increase, the report said. Many other states showed smaller increases.
Mississippi, for the sixth straight year, topped out Tuesday's list with a 33.8 percent obesity rate. It was joined in the top 10 by eight other southern states. Colorado's obesity rate is the lowest at 19.1 percent.
Health officials said Missouri and Kansas are making efforts to fight obesity.
Pat Simmons, a nutrition specialist with the Missouri Department of Health and Senior Services, pointed to a two-year, $891,000 federal grant that has allowed the state to promote a program aimed at placing locally grown foods in schools and hospitals. The grant also promotes construction of roads better suited for pedestrians, bicyclists and drivers alike.
Rex Archer, Kansas City Health Department director, noted the City Council's recent effort to promote more community gardens.
And Eberhart-Phillips said the Kansas Board of Education's decision in May to remove foods with little nutritional value from schools by fall 2011 is one step in the right direction.
But Eberhart-Phillips and Archer said there is more that federal, state and local governments can do to reduce obesity, including taxing sugary drinks, providing incentives to grocery stores that locate in underserved areas and requiring restaurants to clearly label nutritional information on their menus.
Why us?
What makes Missouri and Kansas prone to putting on weight?
Joseph Donnelly, director for the Center of Physical Activity and Weight Management at the University of Kansas, said regional differences in eating habits may in some way be involved with the state rankings, but he did not put much stock in those differences.
"Even though the map seems to indicate that there are trends for north, south, east, west, I'm not overly impressed," Donnelly said. "We eat a lot of meat in the center of the country, but then down south they fry a lot of foods, eat a lot of fat and so forth. You might get a lot of things that way, but I wouldn't single out anybody. The entire country has gained weight.
"I don't think it's any different than any other place."
Jeff Levi, Trust for America's Health executive director, downplayed any factors that might be unique to the Midwest and focused instead on the lack of healthy eating options and a person's socioeconomic status — factors that, he said, greatly influence a person's weight nationwide.
According to the data released Tuesday, 35.3 percent of those who earn less than $15,000 per year are obese compared with 24.5 percent of adults earning $50,000 or more.
Walt Bodine, a Kansas City radio host and local food aficionado, said, for him, there's at least one strong local factor at play: good restaurants.
Bodine, who turns 90 in August, at one point weighed 220 pounds but has since trimmed to less than 150.
"I did it by getting scared," he said. "I got to thinking, 'Wait a minute, I'm gaining every day, every month.' "
Eberhart-Phillips, with the Kansas health department, identified "food deserts" in many areas of his state, where few options exist outside of fast-food chains and corner markets that carry a limited supply of fruits and vegetables.
"The choices that people make are based on the options that they have," he said, adding that it doesn't help that prices for snack foods and soda have generally gone down while produce and healthier options — such as low-fat milk and juice — have become more expensive.
Beyond the causes, the effects are clear.
Eberhart-Phillips said being overweight is strongly tied to a range of chronic diseases, including Type II diabetes and hypertension. Tuesday's report showed that nearly 1 in 10 adults in Kansas and Missouri have diabetes and at least one- quarter have high blood pressure.
By his calculation, every Kansan pays more than $500 per year in what he called a "diabetes tax" — through increased health insurance premiums and taxes for Medicaid and Medicare.
"If you're not fat, great," Eberhart-Phillips said. "But even if you aren't, you should be concerned about the obesity problem because you're paying for it every year."
