Minnesota was The Biggest Gainer in 2014 — or rather, one of only five states with an increase in adult obesity at a time when the nation's obesity epidemic finally seems to be leveling off.

Minnesota's increase, to an obesity rate of 27.6 percent, came as a disappointment to state health officials, who have targeted the problem for several years with millions of dollars of investments in walking paths, farmers markets and other strategies to "make the healthy choice the easy choice."

They said, however, they suspect that the increase might be a one-year blip because obesity rates plateaued for most states in the report, which was released Monday by the Trust for America's Health.

And Minnesota's rate still was 15th lowest in the U.S.

"We're looking at the long-term trends," said state Health Commissioner Dr. Ed Ehlinger. "Our rate plateaued starting in 2008 and we've been … at a pretty stable rate since that time."

Minnesota joined Utah, Kansas, New Mexico and Ohio as the only states where rates increased by a statistically significant amount last year. The 2.1 percentage point increase in Minnesota was second largest; Ohio's rose 2.2 percent.

Most other states saw their rates level off, which is noteworthy considering that the national adult obesity rate has more than doubled since 1990. The trend has alarmed health officials because obesity is linked to diabetes, stroke and other crippling ailments.

"We see this as a sign of progress," the Trust's Jeff Levi said during a news conference. "We do know a lot about what works," he added later. "We just need to invest in these approaches."

On the negative side, the average American today is 24 pounds heavier than his or her counterpart in 1960.

Millions in savings

Diana Dickmeyer understands the state's up and down struggle with obesity, because she has lived it. The 47-year-old executive from Eagan experienced weight gain then loss amid diets, and took her son to sports but rarely found time for her own exercise. Then she found early morning exercise and strength training groups and nutritional advice at her local Life Time Fitness.

"Nothing else happens at 6 a.m. in the morning," she said.

She lost 80 pounds but gained 30 back when a foot injury curtailed her exercise routine and a change at work added new stress. "It was surprising how quickly it came back," she said, "and how quickly you can lose the motivation."

Minnesota's increase in 2014 comes despite investments in the very areas advocated by the Trust organization and the Robert Wood Johnson Foundation, which co-released Monday's report.

Minnesota's Statewide Health Improvement Program, or SHIP, has spent nearly $100 million since 2009 on projects to get people to eat better, exercise more and smoke less.

Many of the state grants focused on youth prevention efforts, and Minnesota has seen progress in that area, including a leveling off in student obesity rates since 2010.

The easiest path to reducing adult obesity is instilling healthy habits in today's youth, said Abbey Cofsky, of Robert Wood Johnson, which in February committed $500 million over the next 10 years to preventing childhood obesity.

That includes a campaign against sugary beverages for preschoolers, she said. "There's no reason for toddlers to be drinking sugary drinks."

Whether targeting youth or adults, Ehlinger said evidence shows Minnesota's strategies are working. A state report this spring estimated $265 million in reduced medical costs from 2010 to 2013 in Minnesota due to obesity prevention efforts.

"If we had not implemented SHIP, if we had followed the course we were on in 2008, we would be near the top of the list in terms of being bad on obesity," Ehlinger said.

The Trust report was based on survey data released earlier this month by the U.S. Centers for Disease Control and Prevention, which determined obesity by respondents' self-reported weight and height. An adult with a Body Mass Index of 30 or more is considered obese; that would be a weight of at least 210 pounds for someone who is 5-foot-10.

Dickmeyer has found her exercise rhythm again — and enjoys bicycle rides with her husband — but knows that her success will take continued work. "That's why I don't like to call it a diet," she said, "because it's not a one-time thing. It's a lifestyle."

Jeremy Olson • 612-673-7744