A new national health study gives Iowans poor marks for their efforts to try and keep in shape. According to the report from Trust for America’s Health, Iowa is among 22 states with an adult obesity rate at or above 35%. Nadine Gracia, director of government relations for the trust, says Iowans are in worse condition than in most other states.

“For the state of Iowa, that rate of adult obesity is a little over 37%, which is steady from the previous year,” Gracia says, “but what’s really important is actually to look more so at the longer-term trends, because we know that it can fluctuate year to year.” While 22 states had adult obesity rate at or above 35% this year, Gracia says there were 19 states in that category last year, including Iowa, while a decade ago, there were -no- states at that level. She says it’s a dangerous trend for the nation, and for Iowa.

“So if we look back even a decade ago, the rates were about 29%,” Gracia says. “That means that there’s a significant amount of the population that does have obesity. We know that obesity is an important health issue to address because it also increases the risk of other health conditions like type two diabetes, heart disease, many forms of cancer and stroke.” The lessons for getting fit are familiar — they revolve around diet and exercise — but Gracia says it doesn’t stop there.

“It really involves much more than individual behavior,” Gracia says. “There are structural, economic, social issues that contribute to obesity, in fact, many factors contribute to obesity. When we look at issues such as poverty, for example, financial hardships that families may be having, just even living paycheck to paycheck and ensuring that they can put healthy, nutritious food on the table.”

The trust’s “State of Obesity” report shows West Virginia has the highest rate of adult obesity at 41%, while Colorado has the lowest rate at 25%.

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