Despite the fact that Americans spend over $60 billion per year trying to lose weight in the U.S., obesity in the United States has reached epidemic levels.

According to a late 2017 report by the Centers for Disease Control and Prevention, almost 40 percent of American adults and nearly 20 percent of adolescents are obese — the highest rates in U.S. recorded history. And while the problem is everywhere, it is growing faster in some places than others. Rural areas tend to have both higher obesity rates and much greater rates of what medical researchers term “severe obesity,” which is a BMI of 40 or more.

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