The number of states with high adult obesity rates declined in 2024 for the first time in more than a decade — but obesity rates are still increasing in Nevada, according to a new report on federal data. 

From 2023 to 2024, the state saw the greatest increase nationwide in the share of its adults who live with obesity. Nevada’s obesity rate ticked up more than 3 percentage points, to 34.2 percent in 2024, although the change was not deemed statistically significant.

That’s according to Trust for America’s Health, which analyzed the latest data collected by the U.S. Centers for Disease Control and Prevention (CDC) in a report released Oct. 16.

Obesity is associated with long-term health risks including diabetes, cancer and heart disease. Efforts to curb obesity rates have been complicated, experts told The Indy, by increasing health care costs, a doctor shortage and federal funding cuts to food assistance programs that enable more low-income Nevadans to access nutritious foods. Multiple bills to expand insurance coverage of anti-obesity surgery and medication stalled in the Legislature this year. 

“Obesity is such a complex medical condition,” said Nicole Bungum, a health education supervisor at the Southern Nevada Health District. “There’s multiple factors that contribute to it, so there’s no single intervention that can address it alone.”

Nationwide, 19 states had obesity rates of 35 percent or more in 2024, down from 23 states the year before, a sign that America’s epidemic of excess weight might be improving. 

But for the first time since the CDC began releasing standardized obesity data in 2011, no state had an adult obesity rate below 25 percent last year.

Nevada’s obesity rate reached 25 percent in 2012 and has been above 30 percent every year since 2019 save for 2020, when the rate dipped to 28.7 percent.

In adults, obesity is defined as having a body mass index of 30 or higher. Body mass index is a calculation based on height and weight. 

A spokesman for the U.S. Department of Health and Human Services wrote to The Associated Press that the administration is “encouraged by the new data showing progress in the fight against obesity.”

While the decreased number of states with high obesity rates is positive, “it’s too soon to call it a trend,” Dr. J. Nadine Gracia, president and chief executive for Trust for America’s Health, told The Associated Press. Federal actions on health mean that “this potential progress is also at risk.” 

Treatments exist, but can be out of reach

The slight declines in obesity rates nationwide could be in part because of the wider use of drugs such as Wegovy and Zepbound, science policy expert Aviva Musicus told The Associated Press. These drugs, commonly known as GLP-1s due to their chemical composition, limit appetite and slow digestion. 

However, many insurance programs do not cover GLP-1s, according to Dr. Pam Greenspon, a Las Vegas pediatrician who has worked on early childhood health policy. Paying out of pocket can cost hundreds of dollars every month.

Sen. Roberta Lange (D-Las Vegas) this year introduced SB244, which would have required Nevada Medicaid to cover intensive behavioral treatment programs for obesity and at least one anti-obesity medication approved by the Food and Drug Administration, but the bill died in a money committee. 

Nevada Medicaid has provided coverage of Wegovy since April 2024, but only for adults with documented cardiovascular disease.

Bariatric surgery, a common obesity treatment that shrinks the size of the stomach, is covered by Nevada Medicaid for adults older than 21 who have morbid obesity, defined as when BMI is 35 or greater. 

In this legislative session, Assm. Rebecca Edgeworth (R-Las Vegas) introduced AB399, which would have expanded access to bariatric surgery by requiring all health insurers to cover the surgery for Nevadans with morbid obesity and lowered the minimum age for the surgery to 18 years old. That bill also died in committee.

Dr. Randy Feikes, a cardiovascular doctor and board member for Nevada’s chapter of the American Heart Association, told The Indy he believed GLP-1s could create a facade of progress on obesity efforts, enabling patients to lose weight without developing significantly healthier habits. 

Nevada’s obesity response is plagued by “a systemic weakness in health care delivery and a lower number of primary care providers,” Feikes said. Overworked doctors might be less capable of providing the time and attention required for treating obesity, he explained.

Focus on kids’ nutrition, tribal communities 

Nevada’s obesity strategy is handled by the Division of Public and Behavioral Health, which launched its signature weight loss initiative, Healthy Eating Active Living Nevada, in 2023.

The program, also known as HealNV, oversees Nevada’s “5-2-1-0 Program,” which provides the public with educational programming on a daily diet consisting of at least five servings of fruits and vegetables, at most two hours of recreational screen time, at least one hour of physical activity, and zero sugary drinks.

At the time of publication, the state’s public health agency did not respond to The Indy’s request for comment on the increase in Nevada’s obesity rate in 2024. 

In 2022, the agency released a strategic plan for combating chronic diseases from 2023 to 2027. One of its proposed solutions to the state’s obesity crisis was providing targeted services to tribal communities, whose members are more likely to be obese in Nevada and nationwide.

The 14 counties Nevada classifies as “rural and frontier,” which include many tribal communities, had an adult obesity rate of 38.6 percent in 2023 — nearly 10 points higher than Clark County’s 28.9 percent rate that year. Geographic isolation, chronic poverty and weak public health infrastructure make health care more difficult to access and nutritious foods more scarce in these counties.

The state’s strategic plan also called for greater “consistency” across health districts, including standardizing rules around the foods available in child care facilities. 

That underscores the consensus that obesity is a lifelong condition most effectively addressed early, according to Greenspon. She said policies promoting healthy eating and physical activity should begin during pregnancy and breastfeeding.

The Trust for America’s Health study found that children are more likely to become obese as they age, making early action particularly important. In 2022, 1 in 5 Nevada children entered kindergarten overweight or obese. 

Nevada ranks 50th for physical activity in children, according to America’s Health Rankings, a policy group that is connected to the charitable arm of the health care company UnitedHealth. A bill that would have required Nevada’s public and charter schools to provide daily recess — which only 13 states explicitly require — failed to pass this year. 

Securing nutritious food in schools and child care facilities is especially important because a healthy diet is key to preventing obesity, said Dr. Amanda Haboush-Deloye, executive director of the Nevada Institute for Children’s Research and Policy. Students who do not grow up eating foods considered nutritious “will look at school lunch and not want to eat it,” Haboush-Deloye said, “because they don’t even know what it is.”

Bungum said a lack of access to and information on healthy foods both contribute to obesity in Nevada, which the Trust for America’s Health study concluded has the 8th-highest diabetes rate in the country. Roughly half of the state’s new cases of Type 2 diabetes annually are linked to obesity. 

“Where are people getting education on nutrition? There’s a gap there,” Bungum said. SNHD, where Bungum works, sponsors tours of grocery stores by licensed dieticians and hosts presentations at food pantries on reading food labels.

But federal cuts to food assistance have endangered some of the only routes available for Nevadans to reliably access healthy foods. 

President Donald Trump has championed a Make America Healthy Again plan that he argues will reduce processed foods and fight child obesity. But advocates have criticized Trump’s One Big Beautiful Bill, passed by Congress in July, for cutting billions in dollars from the Supplemental Nutrition Assistance Program (SNAP) and Medicaid.

The $186 billion cuts to SNAP included an initiative focused on preventing obesity via nutrition education, which sent roughly $4.4 million to Nevada annually before funding cuts took effect Sept. 30.

Bungum, from the Southern Nevada Health District, told The Indy her office was concerned about federal funding cuts and paused programs. The district supplements federal programs with its own initiatives, including educating families about healthier eating and providing food pantries with guidance on nutrition standards. 

“There’s still a lot of unknowns. … Those programs play a really important role,” Bungum said. 

The Associated Press contributed to this report.