The study by Trust for America's Health lists Missouri as the 13th most obese state, with 27.4 percent of its adult population obese and 63.3 percent either obese or overweight. Arkansas, after its obesity rate declined last year, rose this year to 28.1 percent, tying it with Oklahoma as the 8th most obese state.

The report says part of the challenge is figuring out how to best fix the problem when government resources are tight. In Missouri, a state initiative is working to promote healthy living.

Mississippi led the nation with a 31.7 percent obesity rate. Colorado had the smallest rate of obesity, 18.4 percent.