Mississippi has topped the charts for the fifth year in a row as the state with the highest obesity among both children and adults.

The latest annual rankings by the Robert Wood Johnson Foundation and the Trust for America's Health, a nonprofit public health group have shown that in 31 states more than one in four adults are obese.

The report also showed that obesity rates among adults rose in 23 states over the past year, and no state experienced a significant decline.

Jeff Levi, executive director of the Trust said, "The obesity epidemic clearly goes beyond being an individual problem."

Dr. James Marks vice president Robert Wood Johnson said, it's a national crisis that "calls for a national strategy to combat obesity. The crest of the wave of obesity is still to crash."

According to the study the top rankers after Mississippi with 32.5 % were West Virginia, with 31.2%; Alabama, 31.1%; Tennessee, 30.2%; and South Carolina 29.7%.

The lowest numbers were in Colorado with 18.9%; followed by Massachusetts, at 21.2%; Connecticut, 21.3%; Rhode Island, 21.7%; and Hawaii, 21.8%.

The study said even in the lowest ranked states the obesity rates registered an increase by fractions of a percent since 2008. A sobering fact was that in 1991, no state had more than a 20% obesity rate while today, the only one state Colorado doesn't.                                             

The dubious honor of the highest rate of overweight and obese children is also held by Mississippi at 44.4 %, followed by Arkansas, 37.5%; and Georgia, 37.3%.                                             

Among fat boomers Alabama tops followed by Michigan where 36 % of 55- to 64-year-olds are obese. Colorado has the lowest rate, 21.8%.

Dr. Ed Thompson, Mississippi's state health officer said the state is taking steps to address "a multifaceted problem," targeting schoolchildren in particular.                                   

Teachers are trying to educate students about the importance of good nutrition and exercise, changing schedules to increase the amount of physical activity students experience in a day and introducing lower-calorie, lower-fat foods to replace some high-calorie, high starch lunchroom staples, he said.

"We can'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.

Thompson said, "Our work lives require less physical exertion than they used to. With less physical activity, we should have adjusted our dietary consumption downward."

Obesity also translates to a higher cost as costly interventions like knee replacements and diabetes care and dialysis are needed. Medicare spends anywhere from $1,400 to $6,000 more annually on health care for an obese senior than for the non-obese, Levi said.

"There isn't a magic bullet. We don't have a pill for it," said Levi. "It's not going to be solved in the doctor's office but in the community, where we change norms."

His group is pushing for healthier option reforms like building sidewalks so people can walk their neighborhoods instead of drive, and providing healthier school lunches to help fight the childhood obesity.

Marks said there are hints of improvements as last year's report found obesity rates rising in 37 states compared with 23 this time around. "We're still getting fatter, but maybe a little more slowly than before."