TUPELO Mississippi has more companies at the top end of the scale.

Now there are seven states where overweight adults make up 35 percent or more of the population.

Mississippi weighed 37.3 percent of adults with a body mass index of 30 or higher – equivalent to about 30 pounds overweight. But West Virginia has the top spot with 38.1 percent of adults who qualify as obese.

"It's definitely not slower," said Tupelo bariatric surgeon Dr. Will Cauthen.

Only two states – Colorado and Hawaii – and the District of Columbia had obesity rates of less than 25 percent.

The Centers for Disease Control report, which was updated last week, is based on the self-reported height and weight of phone surveys in 2017.

"These numbers are likely to be underestimated because people tend to overestimate body size and underestimate weight," said John Hall, director of the Mississippi Center for Obesity Research and physiology professor at the University of Mississippi Medical School.

It's not just that people are a bit overweight. More and more adults are 100 pounds or more over healthy weight ranges.

"The trends for severe obesity are even more alarming," Hall said. "Severe obesity is rising equally fast."

Cauthen is concerned that people do not fully understand the extra weight or risk involved.

"Many of them do not consider themselves obese," Cauthen said. "It has become commonplace."

Obesity is a risk for heart disease, strokes, diabetes, certain cancers and arthritis. It puts enormous strain on people, families and the entire medical system.

"We get to the point that it's not sustainable," said Cauthen.

There has been progress in improving the treatment of some conditions related to obesity.

"We have a better idea of ​​how to treat high blood pressure associated with obesity," Hall said.

But researchers are still wrestling with the big question of why it's so hard to lose weight and keep it off.

"We learn a lot about how the brain counteracts weight loss," Hall said.

Bariatric surgery, especially Roux-en-Y, and vertical gastric sleeve procedures have been very effective in treating diabetes and hypertension in remission for morbidly obese patients.

Insurance coverage in Mississippi is improving, but key pieces are missing. Medicaid does not cover the procedure. Mississippi's Blue Cross Blue Shield does not cover the process in its commercially available product, though it manages plans for state and federal employees who include the operation.

"We have the second largest population of obese adults, but citizens here have no access to life-changing operations," Cauthen said. "It is unhappy."



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