If America’s shorelines begin shrinking at an alarming rate, it may not be due to global warming. It may just be that we’re so fat we’re in danger of sinking an entire continent.

Okay, a hyperbole perhaps, but the report just out, from non-profits Robert Wood Foundation and Trust for America’s Heath (TFAH), has the feel of an environmental armageddon. And the title says it all: “F as in Fat: How Obesity Threatens America’s Future.” As a nation we should hang our heads, stare down at our shoes–if we can see them–and be grounded for a terrible report card.

Hitting the gym wouldn’t hurt either.

This is the sixth consecutive year that such a report has come out, but this is the first report to take a retrospective look state-by-state over the past 20 years when data from all states became available. As is the case for an increasing number of Americans, it don’t look pretty. Chew on this: going back 20 years there wasn’t a single state with an obesity rate above 15 percent. Today, there isn’t a single state that’s below 15 percent (data is combined for years 2008 to 2010).

Yeah.

And, if you think 15 percent is a lot, 12 states had obesity rates of at least 30 percent! More than two-thirds of the US has an obesity rate over 25 percent, and only one state has a rate lower than 20 percent. No, it’s not health-crazed California, but ski mecca Colorado. Executive director of TFAH Jeff Levi poignantly observes, “Today, the state with the lowest obesity rate would have had the highest rate in 1995.”

So which states really need to start pulling their inordinately-substantial weight? Look to the south. Out of the ten most obese states only two were not located in the southeast. Oklahoma and Michigan had obesity rates of 31.4 percent and 30.5 percent and ranked 7th and 10th, respectively. To make up the top ten they join, from high to low rank: Mississippi, Alabama, West Virginia, Tennessee, Louisiana, Kentucky, South Carolina, and Arkansas.

Must be all that good home cookin’.

When we take a closer look at the data it becomes a little more, well, black-and-white. The study showed that minorities and people who come from low income households or are less educated have the highest rates of obesity. Adult obesity among blacks exceeded 40 percent in 15 states, 35 percent in 35 states, and 30 percent in 40 states. Among latinos, adult obesity was above 35 percent in four states and exceeded 30 percent in 23 states. Meanwhile, adult obesity among whites reached 30 percent in only four states (Kentucky, Mississippi, Tennessee, and West Virginia). Thirty-three percent of adults who did not graduate high school are obese, while obesity among people with a college or technical college degree is 21.5 percent. And 33 percent of people who earn less than $15,000 per year were obese, compared with 24.6 percent of those who make at least $50,000 per year.

“The information in this report should spur us all–individuals and policymakers alike–to redouble our efforts to reverse this debilitating and costly epidemic,” said RWJF’s president and CEO Risa Lavizzo-Mourey in a press release. “Changing policies is an important way to provide children and families with vital resources and opportunities to make healthier choices easier in their day-to-day lives.”

The children actually provide the report’s only silver lining. Well, more of a dull, gray color that you can barely make out. According to Dr. Francine Kauffman, an obesity specialist at Children’s Hospital Los Angeles, the rate of obesity among children hasn’t changed much in the past 20 years. That rate is currently at 16.4 percent. Somewhat reassuring until we recall that in 1980 only 6.5 percent of children were obese.

The prognosis is not good for Americans and their expanding girth. Obesity leads to a myriad of health complications, most notably type 2 diabetes. In type 2 diabetes the body doesn’t produce enough insulin and consequently can’t properly regulate blood sugar levels. Elevated blood sugar levels can lead to kidney failure, heart disease, nerve complications, stroke, blindness, and amputation. In 1995, when all states had an obesity rate of less than 15 percent only 4 states had a diabetes rate above 6 percent. Today, 43 states have a diabetes rate over 7 percent. Last year 18.8 million people were diagnosed with type 2 diabetes and it’s estimated that another 7 million people developed the disease but went undiagnosed. That’s 25.8 million people, or 8.3 percent of the US population, with diabetes. Sound scary? How about this: at least half of Americans are expected to be diabetic or pre-diabetic by 2020.

The Center for Disease Control called American society “‘obesogenic,’ characterized by environments that promote increased food intake, nonhealthful foods, and physical inactivity.” While it’s hard to argue these claims, ours is not the only country that’s been putting on a few pounds as of late. According to a recent report by the Paris-based Organization for Economic Cooperation and Development (OECD) the rate of obesity among European Union countries had doubled over the past 20 years. But whereas Colorado, the slimmest of US states is 19.8 percent obese, EU countries together average just 15 percent. In fact, the only country that could challenge us in a sumo wrestling match is the UK. With an obesity rate of 24.5 percent, they’d be one of the slimmer US states. They’re the fattest of the EU’s 27 countries. Compared to Americans, Europe remains slim and chic.

As Lavizzo-Mourey urged, it’s time to take some action. The study lists several recommendations for policymakers, including regulating meals in schools, implementing the National Physical Activity Plan to encourage Americans to get off the couch and exercise, and restore programs that improve nutrition in child care settings. Despite the harrowing data, I’m not going to hold my breath for policymakers. Many of them are instinctively against setting government regulations that would tell people what to do in general, never mind tell them what they can and can’t eat. But if you ask me, that seems inconsistent given our commitment to sin taxes. If cigarettes and booze can be disproportionately taxed, why not Big Macs? In 2009 obesity cost the US $147 billion–or, about 10 percent of total health care costs. Didn’t someone say gluttony was a sin? Anyway, I generally don’t think you can talk someone into behaving differently. Hit ‘em where it hurts, in the wallet. We’ll offset some of those health care costs and maybe shed a few pounds while we’re at it. Sounds to me like a recipe for success.