Americans are getting richer, older, and fatter.

Obesity is at an all-time high in at least nine states, according to a new report by Trust for America’s Health using data from the Centers for Disease Control. For the first time, obesity rates in Alabama, Arkansas, Iowa, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, and West Virginia rose above 35% in 2018. Just six years ago, not a single state had an obesity rate above 35%.