-LRB- CNN -RRB- -- Mississippi has kept its U.S. heavyweight title for a fifth straight year , among both adults and children . Adult obesity rates went up in 23 states in the past year , a survey shows . The percentage of adults classified as obese went up in 23 states , but Mississippi , with 32.5 percent , stayed atop the latest annual rankings by the Robert Wood Johnson Foundation and the Trust for America 's Health . The same survey put the state 's adult obesity rate at 31.7 percent in 2008 . In addition , 44.4 percent of Mississippi children ages 10 to 17 are classified as overweight or obese , the study found . Doctors have linked obesity to increased risks of a variety of conditions , including diabetes , hypertension , arthritis and heart disease . Wednesday 's study found the current U.S. economic slump could worsen the problem by putting more nutritious food out of the reach of struggling families . See a map of obesity in the U.S. '' `` At the same time , safety-net programs and services are becoming increasingly overextended as the numbers of unemployed , uninsured and underinsured Americans continue to grow , '' the report states . `` For many people , too , worries over the recession are triggering increased depression , anxiety and stress , which often can be linked to obesity . '' Dr. Ed Thompson , Mississippi 's state health officer , called the report -- which was drawn from state figures -- `` old data rehashed . '' But he said the state is taking steps to address what he called `` a multifaceted problem , '' targeting schoolchildren in particular . Thompson said teachers not only are trying to educate students about the importance of good nutrition and exercise , they are changing schedules to increase the amount of physical activity students experience in a day . In addition , lower-calorie , lower-fat foods are replacing some high-calorie , high starch lunchroom staples , he said . `` We ca n't tell our children to eat wise dietary choices and then provide them with little except for poor dietary choices in their school cafeterias , '' Thompson said . Rounding out the top five states among adults were West Virginia , with 31.2 percent of its population considered obese ; Alabama , 31.1 percent ; Tennessee , 30.2 percent ; and South Carolina 29.7 percent . At the bottom of the rankings , Colorado had the lowest percentage of obese adults , with 18.9 percent . It was followed by Massachusetts , at 21.2 percent ; Connecticut , 21.3 ; Rhode Island , 21.7 ; and Hawaii , 21.8 . Even in those states , the obesity rate grew by fractions of a percent since 2008 , according to the study . Thompson said most adults know they should eat less and exercise . `` The hard part is getting people to actually practice these things , '' he said . `` Our work lives require less physical exertion than they used to , '' he said . `` With less physical activity , we should have adjusted our dietary consumption downward . '' While deep-fried Southern cooking is legendary , Mississippi also ranks high in poverty statistics and low in education -- two factors commonly related to obesity . But Thompson said education appears to be more closely related to obesity than poverty . `` We do see obesity among people who are in lower socioeconomic levels , but we see it in higher socioeconomic levels as well , '' he said . `` Being poor does not not make you obese , and being rich does not make you thin . '' The survey used the Body Mass Index standards set by the U.S. Centers for Disease Control and Prevention . The CDC defines someone as obese if they have a BMI -- a figure based on a ratio of height to weight -- of 30 or more , while anyone with a BMI between 25 and 30 is considered overweight . Calculate your Body Mass Index '' Adult obesity rates went up in 23 states in the past year , with 31 states now reporting rates over 25 percent . By comparison , no state topped 20 percent in 1991 , the survey 's authors reported .