Roughly 1 in 3 adult Americans is now obese. And ground zero for the nation’s obesity battle is Mississippi — where 44 percent of kids are either overweight or obese. And 7 of 10 adults in the state are either overweight or obese.

“For the sixth year in a row we remain the most obese state in the most obese country in the world, I guess making Mississippi the most obese place in the world,” says Sandra Shelson, executive director of the Partnership for a Healthy Mississippi.

The problem is most pronounced in the Mississippi Delta — the flat, fertile flood plain fed by the Mississippi River. It’s a region with a history as rich as the soil, but with deeply rooted social problems.

In Holmes County, for instance, nearly half the residents live in poverty. And not only is it the state’s poorest county; it’s also the heaviest. Four out of 10 people in Holmes County are obese. And you see it all around — large kids lumbering to get on the school bus, patients spilling over their seats in the doctor’s waiting room.

Dr. David Gilder in Tchula, Miss., frequently sees patients with problems related to obesity — diabetes, heart disease, high blood pressure.

“It’s like a war,” Gilder says.

And half the battle, he says, is just getting people to own up to the fact that their weight is the problem.

“Calling someone obese, they don’t like that very much,” he says. “It’s a touchy subject. If you talk about the obese population, well, they’re thinking of someone who weighs more than me, no matter what they weigh.”

That’s the way local fry-cook Gracie Williams sees it. She’s a diabetic and considers that she is doing pretty well because she hasn’t gained any weight in five years. She’s stayed a steady 265 pounds on a 5-foot-5 frame.

“To me overweight is when you’re going past 300-something and you’re having a hard time walking and breathing, that’s when you’re overweight,” she says.

Obesity is not just a problem for the poor, mostly African-American communities in the Delta. Just look to the Mississippi state capital. The chairman of the Mississippi House Public Health Committee used to weigh a whopping 359 pounds. Rep. Steve Holland (D) has lost 140 pounds after bariatric surgery and grueling morning workouts with fellow lawmakers. He says Mississippi needs to change.

“We have a culture of easy living, good eating with fatback and lard and things like that. We like to sit on our porch, and we like our adult beverages, we like our fellowship and that kind of thing,” Holland says. “And when you put all that together over generations, you’ve got a bad health problem.” Copyright 2011 National Public Radio. To see more, visit http://www.npr.org/.