West Virginia's adult obesity rate is tied with Mississippi as the highest in the nation, according to the annual State of Obesity report released Thursday.

The 16th-annual report, released by the Trust for America's Health, had charted West Virginia's adult obesity rate at 39.5%. That's up from 2018's report that measured the rate at 38.1%.

West Virginia had the highest rate in each of the last two reports, funded by the Wood Johnson Foundation. West Virginia was second in adult obesity rate in 2014 and 2015. The state also tied Mississippi in 2013 for first.

This year's report marks the first time adult obesity rates rose above 35% in nine states. In 1985, the report said, no state had an adult obesity rate higher than 15%. West Virginia and Mississippi were the only states above 30% in 2006, but by 2015, half the country was above 30%.

The report also notes an increase in the percentage of adults with diabetes in the state, at 16.2%, up from 15.2% in last year's report.

The full rankings are at the bottom of this article.

“These latest data shout that our national obesity crisis is getting worse,” said John Auerbach, President and CEO of Trust for America’s Health. “They tell us that almost 50 years into the upward curve of obesity rates we haven’t yet found the right mix of programs to stop the epidemic. Isolated programs and calls for life-style changes aren’t enough. Instead, our report highlights the fundamental changes that are needed in the social and economic conditions that make it challenging for people to eat healthy foods and get sufficient exercise.”

West Virginia (20.3%) ranked behind only Mississippi (26.1%) for the highest childhood obesity rate in youth ages 10-17.

The report recommends various policy changes to address obesity in America, including sugary drink taxes and expanded SNAP and WIC Nutrition Support Programs.

It also attributes obesity as a factor in higher national healthcare spending - as much as $149 million annually. Half of that, the report said, is paid for by Medicare and Medicaid.

The report notes West Virginia University's work with Early Childcare and Education providers to incorporate more nutrition, movement and healthy habits in the classroom.

Adult obesity rankings (Highest to lowest):

1. Tie: Mississippi and West Virginia (39.5%)

3. Arkansas (37.1%)

4. Louisiana (36.8%)

5. Kentucky (36.6%)

6. Alabama (36.2%)

7. Iowa (35.3%)

8. North Dakota (35.1%)

9. Missouri, (35.0%)

10. - Tie: Oklahoma and Texas (34.8%)

12. - Tie: Kansas and Tennessee (34.4%)

14. South Carolina (34.3 %)

15. - Tie: Indiana and Nebraska (34.1%)

17. Ohio (34.0%)

18. Delaware (33.5%)

19 - Tie: Michigan, North Carolina (33.0)

21. Georgia (32.5%)

22. New Mexico (32.3%)

23. Wisconsin (32.0%)

24. Illinois (31.8%)

25. - Tie: Maryland and Pennsylvania (30.9%)

27. Florida (30.7%)

28 - Tie: Maine and Virginia (30.4%)

30. Tie: Minnesota and South Dakota (30.1%)

32. Oregon (29.9 %)

33. New Hampshire (29.6%)

34. Three-way Tie: Alaska, Arizona and Nevada (29.5%)

37. Wyoming (29.0%)

38. Washington (28.7%)

39. Idaho (28.4%)

40. Utah (27.8%)

41. Rhode Island (27.7%)

42. New York (27.6%)

43. Vermont (27.5%)

44. Connecticut (27.4%)

45. Montana (26.9%)

46. California (25.8%)

47. - Tie: Massachusetts and New Jersey (25.7%)

49. Hawaii (24.9%)

50. District of Columbia (24.7%)

51. Colorado (23.0%)