West Virginians remain among the most obese in the United States, according to the 13th Annual State of Obesity Report.

The Mountain State has the 2nd highest obesity rate nationally at 35.6 percent, tied with Alabama and Mississippi. The states are behind only Louisiana with an obesity rate of 36.2 percent.

West Virginia has among the highest rates of diabetes.

"Obesity remains one of the biggest and costliest health threats to the country, increasing risks for a range of health problems like diabetes, heart disease, hypertension, arthritis and some forms of cancer," said Richard Hamburg, interim president and CEO of the Trust for America's Health.

The Trust for America's Health and the Robert Wood Johnson Foundation put out the yearly report on state-by-state rankings of obesity rates.

"The stakes could not be higher. The obesity epidemic is taking a toll on the country's health," said Dr. Donald Schwarz, vice president of program for the Robert Wood Johnson Foundation.

No state had an obesity rate above 20 percent in 1991, according to analysis using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System.

- West Virginia's diabetes rate was 14.5 percent, the 2nd highest in the USA.

- West Virginia's adult rate of hypertension was 42.7, the highest in the U.S. - Among black people, the adult obesity rate in West Virginia is 41.5 percent, the 10th highest rate in the U.S., while the adult obesity rate for white people is 35.2 percent, the highest in the U.S.

- For high school students in the Mountain State specifically, the 2015 obesity rate was 17.9 percent.

This year's report again included policy recommendations for addressing obesity covering investments in obesity prevention, early childhood policies and programs, and school-based and community-based policies and programs.

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