While a new report shows that childhood obesity rates have stabilized over the past decade, the problem persists in South Carolina, where young people rank second in the nation for obesity and adults rank 10th.

States with the highest adult obesity rates in the country:

States with the highest adult obesity rates in the country:

1. Mississippi and West Virginia (tied): 35.1 percent

3. Arkansas: 34.6 percent

4. Tennessee: 33.7 percent

5. Kentucky: 33.2 percent

6. Louisiana: 33.1 percent

7. Oklahoma: 32.5 percent

8. Alabama: 32.4 percent

9. Indiana: 31.8 percent

10. South Carolina: 31.7 percent

Source: "The State of Obesity"

The report issued by the Trust for America's Health and the Robert Wood Johnson Foundation found that 21.5 percent of young people in South Carolina between ages 10 and 17 are considered obese, according to 2011 data. Among the same age group, only Mississippi had a slightly higher rate - 21.7 percent.

South Carolina's adult obesity rate is now almost 32 percent. That's up from 25 percent a decade ago and 12 percent in 1990. The state's adult obesity rate has not changed since last year.

The new "State of Obesity" report was formerly published as the annual "F as in Fat" report.

"We are starting to see signs of progress," wrote Dr. Lisa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation, and Jeffrey Levi, executive director of the Trust for America's Health. "After decades of alarming increases, this year's report shows us that childhood obesity rates have stabilized in the past decade."

The authors call that trend encouraging, but Southern states still rank among the county's worst, and low-income individuals and racial and ethnic minorities are disproportionately represented in the statistics. All but two of the top 10 states with the highest adult obesity rates in the country are in the South.

"I don't know why it's so endemic in this state," said Dr. Ken Mitchell, director of the Roper St. Francis bariatric surgery program.

Howeve, he suspects a combination of factors is to blame - children eat poorly at school and don't get enough exercise. "You still see a lot of kids living out of vending machines," he said.

Mitchell, who moved to Charleston from North Carolina in 2010, said one big difference between the states is the fact that the South Carolina health insurance plan for state employees won't cover bariatric surgery - reducing the size of the stomach with a gastric band or through removal of a portion of the stomach. In North Carolina, he regularly performed the procedure on state employees, particularly during summer months when teachers take vacation.

"I just crossed the state line and it's a completely different atmosphere," he said. "When I came here, that's something that was foreign to me - that the state insurance plan still requires people to pay out of pocket for their morbid obesity."

The S.C. Department of Health and Environmental Control will unveil a new statewide obesity initiative in Columbia on Sept. 24.

"We pulled together a diverse group of partners to look at this problem from many different angles," said DHEC spokesman Mark Plowden, in a prepared statement.

"The new state action plan mobilizes partners from across the state to implement innovative strategies to address obesity risk factors in the places where South Carolinians live, work, play, and learn," he said. "The action plan not only focuses on long-term solutions, but short-term strategies that we can implement immediately to begin moving the needle on obesity in our state."

Obesity is defined as an excessively high amount of body fat compared to lean body mass. These rates do not include the percentage of adults who are simply overweight, a lower threshold than obesity. The percentage of adults in South Carolina who are either overweight or obese is 66.5 percent, according to the report.

The Associated Press contributed to this report. Reach Lauren Sausser at 937-5598.