The Robert Wood Johnson Foundation, a health focused philanthropy, published the 14th annual State of Obesity report on Thursday, Aug. 31. The study finds rates of adult obesity stabilizing but the rates remain high overall.

Overall, rates of obesity in adults have stabilized, with the top five states (West Virginia, Mississippi, Alabama, Arkansas and Louisiana) maintaining rates higher than 35 percent. The adult obesity rate decreased in Kansas from 2015 to 2016 and increased in four states — Colorado, Minnesota, Washington and West Virginia — according to the study.

The study shows that almost 32 percent of adults in North Dakota were obese in 2016, which is up from 31 percent in 2015. The neighboring states of Minnesota, Montana and South Dakota fare better, with all three states maintaining rates lower than 30 percent. The study highlights policy action that North Dakota is taking to prevent and reduce obesity, despite increasing rates.

“The programs in place are not conducive to creating lower obesity rates,” says Dr. Abby Gold, professor and vice chair with the NDSU Department of Public Health. “Many strategies deal with what to do at a community level to promote a healthy lifestyle.”

“However, North Dakota has unique infrastructure demands as a rural state, as there is not as much access to the same resources one might find in a more urban community to foster healthy behaviors,” Gold said.

“Obesity rates in the (United States) and North Dakota are high because hyper-caloric and nutrient-poor food is cheap (and easily accessible). Additionally, a majority of Americans are less physically active than ever, and chronic stress and lack of sleep also play a significant role in high obesity rates,” says Nathaniel Johnson, doctoral student in nutrition and exercise science.

Gold addresses NDSU as an insight into obesity rates for the state, saying, “As a learning institution, the school needs to show people what is healthy for a community, and having a food court with numerous unhealthy choices as the source of food on campus, is not the best example.”

Recent policy actions fail to address the issue that there are “very few resources in rural communities to foster those healthy behaviors,” Gold said. She highlights that easy access to healthy foods, more outdoor spaces for engaged activity, and changes to the food industries and institutions in North Dakota are necessary to improving the obesity rates across the state.