HAMLIN, W.Va. -- On Monday nights, Peggy Lucas joins about a dozen other women to face the scales and share their stories about an old adversary - their weight.
The 57-year-old retired social worker from West Hamlin has battled her weight since she was a teenager.
"I would starve myself to death, and 164 pounds was the least I could ever get down to," Lucas said at a Weight Watchers meeting in Hamlin. "I'd go days and drink nothing but water. And then I'd eat one meal on Sunday, I'd gain five or six pounds and I'd starve it off again."
Lucas believes that over the years she has lost and regained nearly as much as her current weight of about 330 pounds. She's attended Weight Watchers meetings on and off since 1969. She took the drug Redux before it was pulled from the market.
"We have a mental problem, people that are morbidly obese, we do," said Lucas, who suffers from diabetes and high blood pressure. "It's just like we're feeding a demon."
In West Virginia, second in the nation in adult obesity, Lucas is far from alone. According to the Centers for Disease Control and Prevention, West Virginia's rate was 24.6 percent, while Mississippi led the nation with 25.9 percent. The U.S. rate was 20.9 percent.
Those 2001 rates were based on self-reporting, however. A more scientific study based on weight measurements puts the U.S. obesity rate at about 30 percent, a figure health experts believe is more accurate. There was no similar study of individual states.
Obesity is measured with a height-to-weight ratio called the body mass index, or BMI.
At Lucas' height of 5 feet 7 inches and weight of 330 pounds, she is considered severely obese. She's one of 34 percent of the Lincoln County adults who fall into the obese category, meaning they have a BMI of 30 or more.
Lincoln and Boone counties share West Virginia's highest obesity rate, according to the state Department of Health and Human Resources.
Convenience foods, bigger portions and less exercise all contribute to the problem.
"Our biology is geared up to eat when food's available, and rest," said Dr. James Hill, director of the Center for Human Nutrition at the University of Colorado in Denver. "We've created an environment where there's always food available and you never have to be physically active."
Colorado had the nation's lowest obesity rate in 2001 at 14.4 percent, but, like other states, is still seeing an increase from years past.
Dr. Mary Armstrong, medical director for Mississippi's Office of Health Promotion, said the United States has become a "nation of convenience."
"We need to get back out there and enjoy the activities that get us moving and going, and not worry about getting that parking space that's right next to the door," Armstrong said. "Take the stairs instead of the elevator."
Mississippi is pushing several initiatives that include educating adults and working with schools on their physical activity and nutrition programs.
In West Virginia, Joel Halverson of the West Virginia University Health Sciences Center is trying to unravel the mystery of why some areas have a higher rate of obesity than others. But so far he has no answers.
In rural Lincoln County, some say a lack of exercise facilities is a factor.
Karen Morton, a 47-year-old paralegal, started gaining weight after high school, "when I started sitting at a desk and not getting any exercise."
The former cheerleader and majorette found that getting exercise became more difficult after she left her job in Charleston to work in Boone and Lincoln counties, where "there's no place to go work out."
"When I get home from work it's either too dark to go walking, or it's too cold," she said.
The Lincoln County Primary Care Center's new WELL Center is trying to improve the situation. So far, about 150 people have paid a $10 monthly fee to use the center's treadmills, stationary bicycles and weights. Aerobics, dance and stretching classes and a diabetic cooking school and support group are also offered.
Eating smaller, healthier portions is a challenge too, in a place where tradition calls for biscuits and gravy and bacon, said Brian Crist, the center's chief executive officer.
"Overeating is like an addiction, like being on drugs or smoking or anything else, and most of the time you need help to deal with it," Morton said.
Lucas, who would "love to see 200 (pounds) again," has had trouble with her goal, and is considering gastric bypass surgery.
Still, the group meetings help.
"It's just good to get out and talk to people and see what they've done and see what things have helped them through the week," she said. "I know I'll have good weeks and bad weeks, but I'm still going to go."