WASHINGTON — Although still high, U.S. adult obesity rates decreased in four states, according to “The State of Obesity: Better Policies for a Healthier America,” a report issued Sept. 1 by the Trust for America’s Health (T.F.A.H.) and the Robert Wood Johnson Foundation (R.W.J.F.).

The annual report found adult obesity rates increased in Kansas and Kentucky but decreased in four states — Minnesota, Montana, New York and Ohio — marking the first time in the past decade that any states have experienced a decrease, the exception being a decline in Washington, D.C., in 2010.

Rates of obesity exceeded 35% in four states, were at or above 30% in 25 states, and at or above 20% in all states.

By comparison, during 2012, the rate of adult obesity exceeded 30% in 13 states, while 41 states had rates of at least 25%. Every state was above 20% during 2012.

As recently as 1991, no state had an obesity rate of more than 20%, and in 2000 no state was above 25%.

Louisiana, at 36.2%, surpassed Alabama (35.6%), Mississippi (35.6%), West Virginia (35.6%), Kentucky (34.6%) and Arkansas (34.5%) to claim the top spot among worst rated states for adult obesity. Other states exceeding the 30% rate were Kansas (34.2%), Oklahoma (33.9%), Tennessee (33.8%), Missouri (32.4%), Texas (32.4%), Iowa (32.1%), South Carolina (31.7%), Nebraska (31.4%), Indiana (31.3%), Michigan (31.2%), North Dakota (31%), Illinois (30.8%), Georgia (30.7%), Wisconsin (30.7%), South Dakota (30.4%), North Carolina (30.1%), Oregon (30.1%), Maine (30%) and Pennsylvania (30%).

Colorado once again was the best, coming in at 20.2%. Hawaii and the District of Columbia were the only two other areas below 23%, at 22.7% and 22.1%, respectively.

“Obesity remains one of the most significant epidemics our country has faced, contributing to millions of preventable illnesses and billions of dollars in avoidable healthcare costs,” said Richard Hamburg, interim president and chief executive officer, T.F.A.H. “These new data suggest that we are making some progress but there’s more yet to do. Across the country, we need to fully adopt the high-impact strategies recommended by numerous experts. Improving nutrition and increasing activity in early childhood, making healthy choices easier in people’s daily lives and targeting the startling inequities are all key approaches we need to ramp up.”

Other key findings from the report include:

• Nine of the 11 states with the highest rates of diabetes were in the South, and 22 of the 25 states with the highest rates of obesity were in the South and Midwest.

• Ten of the 12 states with the highest rates of diabetes were in the South.

• American Indian/Alaska natives had the highest adult obesity rate, 42.3%, of any racial or ethnic group.

• Adult obesity rates were at or above 40% for blacks in 40 states.

• Adult obesity rates were at or above 30% in 40 states and Washington, D.C., for blacks, 29 states for Latinos, and 16 states for whites.

The report did note that there is some evidence that the rate of increase has been slowing over the past decade. For instance, in 2005, 49 states experienced an increase in obesity rates, and in 2008, 37 states did. By 2010, 28 states reported an increase, a figure that dropped to 16 states in 2011, 1 in 2012 and 2 in 2014.

In addition, recent national data suggest that childhood obesity rates have stabilized at 17% over the past decade, the report noted.

“This year’s ‘State of Obesity’ report is an urgent call to action for government, industry, health care, schools, child care and families around the country to join in the effort to provide a brighter, healthier future for our children,” said Risa Lavizzo-Mourey, president and c.e.o. of R.W.J.F. “It focuses on important lessons and signs of progress, but those efforts must be significantly scaled to see a bigger turn around. Together, we can build an inclusive Culture of Health and ensure that all children and families live healthy lives.”

The full report is available here.