Both Georgia and South Carolina continue to get fatter, according to an annual report, and South Carolina remains among the highest for not only obesity but diabetes and hypertension.
Although no state decreased in obesity rates, only 16 increased, compared to 28 the year before, according to the report.
Trust for America's Health and the Robert Wood Johnson Foundation released the study F as in Fat: How Obesity Threatens America's Future 2011 on Thursday with a look back at rates 15 and 20 years ago.
In 1995, Georgia was 34th in obesity with a rate of 13.8 percent, but has since had the sixth-highest increase among states, shooting up nearly 15 percentage points, to 28.7 percent, according to the report.
Georgia remains at 17th-heaviest,. South Carolina was tied for eighth in 1995 with an obesity rate of 16.6 percent and since then has had the 10th-highest increase of 14.3 percentage points to 30.9 percent obesity. It still ranks eighth in obesity, a slight increase from ninth in last year's report. South Carolina is among a dozen states with an adult obesity rate of over 30 percent.
Not surprisingly, South Carolina is also eighth-highest in diabetes rate, at 10.4 percent, and ninth-highest in hypertension, at 31.5 percent, looking at an average of rates between 2008 and 2010.
Georgia, however, has seen some of the highest rates of increase in those diseases, with the fifth-highest increase in diabetes since 1995, from 4.2 percent to 9.7 percent, and the seventh-highest increase in hypertension, from 20.5 percent to 29.5 percent, according to the report.
While fewer states are getting worse, many in the South continue to struggle, and part of that is probably higher poverty rates, which lead to higher rates of obesity, said Dr. James Marks, senior vice president of the Robert Wood Johnson Foundation.
"We have subsidized certain foods like corn that become the source for high fructose corn syrup and so the foods that have the high sugar associated with corn syrup are now the cheapest," he said. "So if you are on a limited budget, you will often go towards those foods, which are cheap and less healthy for you.
Part of the problem is that cities have been built up to be less walkable or amenable to exercise and too many people, particularly lower-income people, live in neighborhoods where there is no grocery store or access to healthier fresh foods, said Jeff Levi, the executive director of Trust for America's Health.
"All of the willpower in the world isn't going to overcome that problem," he said.
South Carolina had the seventh-lowest level of fruit and vegetable consumption, looking at 5 or more servings a day, with less than 20 percent reaching that level, according to the report.
The state has taken some measures recently, such as passing a law this year that lets state employees pay lower premiums or pursue other financial incentives if they participate in employee insurance programs to promote health and disease prevention, including obesity.
South Carolina Gov. Nikki Haley had vetoed the legislation but the Legislature overrode it. All of these measures are probably too recent to have made a dent in rates yet, said Dan Bornstein, the project coordinator for the National Physical Activity Plan headquartered at the University of South Carolina Arnold School of Public Health.
"The curve-bending takes a long time to see," he said. "So even though there may be some state-level actions that have been taken it's too early to judge the effectiveness of them."
And as with that plan, which provides evidence-based recommendations for increasing opportunities for physical activity, it will take everyone working together to address it, Bornstein said.
"We've all really got skin in the game," he said. "It is costing us all a lot of money to not come at it from a preventive perspective."
Morris News Service Reporter Sarita Chourey contributed to this report.