[Editor’s Note: A total of 38 states and not 40 have obesity rates above 25%. A minor headline change reflects this. Oregon’s and Wyoming’s obesity rates are exactly 25%.]

Obesity rates in 28 states ticked upward over the last year. Two-thirds of states report adult obesity rates above 25%, according to a new report.

Only 10 states, along with the District of Columbia, maintained an obesity rate of less than 25% last year, according to the report from Trust for America’s Health and the Robert Woods Johnson Foundation. Mississippi is once again the heaviest state with 33.8% of obese adults. The state with the lowest obesity rate last year is Colorado, with a 19.1% adult obesity rate. In 1991, no state had an obesity rate higher than 20%, according to Jeff Levi, executive director of Trust for America’s Health.

Obesity is a leading cause of the chronic conditions—including diabetes, heart disease and respiratory ailments—that affect up to 90% of seniors. The entire report is available online at the Trust for America’s Health website.