A new report issued on Thursday says Americans have become increasingly obese over the last 20 years. The report, by Trust for America’s Health, a nonpartisan advocacy group, and the Robert Wood Johnson Foundation, tracks the level of obesity in the 50 states since 1990.

Titled “F as in Fat: How Obesity Threatens America’s Future 2011,” the report offers a stark picture of how much more obese Americans are today than they were two decades ago, and it offers numerous policy recommendations to address the problem. The costs of obesity, whether in rising health care coverage for companion diseases like diabetes or for wider seats on buses and airplanes, have been documented throughout the course of the nation’s epidemic.

Obesity rates among adults now exceed 25 percent in more than two-thirds of the states, according to the report, and these rates climbed in 16 states over the last year. None of the states had a decline. The states with the highest rates tended to be in the South, with Colorado boasting the lowest obesity rate, under 20 percent.

The report also features the efforts of different communities to combat obesity, whether by encouraging more physical activity among their residents or by helping them find healthier food choices. In a continuing series, The Big Picture, articles published in The Times have examined, among other things, anti-obesity programs financed with grants issued by the Robert Wood Johnson foundation and federal and local governments.

But it can be difficult to see quick results, particularly for more recent initiatives, cautioned Jeffrey Levi, the executive director for the trust and a professor of health policy at George Washington University. A decline in obesity rates “is going to take time,” he said.

And, as my colleague, Stephanie Strom, observed in a recent article about the efforts to combat obesity that are taking place in Louisville, a place where many residents are severely overweight, progress can be difficult to come by: “Successes on one front are countered by setbacks on another, and signs that the needle has moved overall are slight and mostly anecdotal.”

Mr. Levi also argues that residents may see changes in health outcomes, like lower rates of diabetes, before the states show any declines in obesity rates because losing only 10 percent of an individual’s body weight can dramatically improve someone’s health. The data aren’t sensitive enough to show whether someone who remains obese has lost weight, he said.

There is also some reason to be optimistic about the efforts taking place, according to Mr. Levi, who said the good news was that more states didn’t see an increase in their levels of obesity. A few years ago, about twice as many states experienced an increase in obesity rates than did over the last year, he said.

“You have to level off before you start declining, and we’re starting to see it,” Mr. Levi said.

Related articles on obesity in a continuing series can be found on The Big Picture page.

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