Rockford Register Star, Amy J. Correnti) MANDATORY CREDIT, Associated Press
A photo taken March 15, 2012, shows Molly Kinkade, a clinical dietician at SwedishAmerican Hospital in Rockford, Ill., talking about food portion sizes. In a recent Gallup study Rockford again, near the top of an unflattering list, named the No. 4 most obese metro area in the nation. Kinkade said Rockford’s high unemployment could have contributed to increased obesity rates. The McAllen-Edinburg-Mission metro area in Texas took the top spot, and Boulder, Colo., is the least obese metro area on the list.

ROCKFORD, Ill. — We didn't need a Gallup study to tell us we have a weight problem.

But there was Rockford again, near the top of an unflattering list a week ago, named the No. 4 most obese metro area in the nation. The McAllen-Edinburg-Mission metro area in Texas took the top spot, and Boulder, Colo., is the least obese metro area on the list.

So what makes us so much worse than everywhere else? That's not entirely clear.

The region's high unemployment — meaning people can be less focused on scheduled meals and have less money to spend on food — could be a recent contributing factor. It's clearly not an overnight problem or just a Rockford problem, as more than one-third of U.S. adults and nearly 17 percent of children and adolescents ages 2 to 19 today are obese, according to the Centers for Disease Control and Prevention.

"It doesn't matter if we're fourth, 10th or 15th on that list — we are in a national crisis with obesity," said Lois Lutz, vice president of youth community development for the YMCA of Rock River Valley. "We all need to really work together to make significant changes."

Body mass index, a formula that's associated with body fat, is at the center of Gallup's results. The group tracks obesity levels as part of its Well-Being Index using people's self-reported height and weight to calculate BMI.

An adult with a BMI between 25 and 29 is considered overweight, while a BMI of 30 or higher means a person is considered obese, according to the CDC.

Obesity is linked to a host of health problems such as diabetes, high cholesterol and high blood pressure, and sleep apnea.

The CDC says weight gain can be caused by a variety of societal, cultural, economic and environmental factors. That's not news to Rockford-area officials, who've analyzed results of the 2010 Healthy Community Study spearheaded by the Rockford Health Council and released last year.

In Winnebago County, the leading causes of death in 2007 were heart disease, cancer, stroke, chronic lower respiratory diseases and accidents. In Boone County, they were the same, but in a different order.

Many aspects of those diseases are preventable by adjusting lifestyle choices, so local leaders are charged with creating programs and outreach efforts — and funding such initiatives — that help and encourage residents to improve their health. Committees formed based on the study's results are meeting now to prioritize ways to address a wide spectrum of health issues, including obesity.

As for someone who's new to town, Jason Walters said even he was surprised by Rockford's high place on the list. Walters is the ID Pennock Branch director of youth achievement at the YMCA and moved to the area about six months ago from Gainesville, Ga.

"I can honestly say I was surprised — there's a lot more fried food in the South," Walters said. "The Park District up here is so good, and there's a lot more green space up here than I expected. The Park District is so spread out, and the nonprofits, they're in it to help people out."

The Y teaches about 1,100 children in after-school programs about nutrition, exercise and goal-setting to encourage healthy living. Walters said children tend to respond to one-on-one and group conversations about their everyday habits and setting realistic goals.

"It's not to be perfect — that's not the goal," Walters said. "We as a staff help them set attainable goals. It's motivation. A goal of running three miles before walking may not be realistic for everybody. But maybe not drinking soda for a whole week is.

"It's easier to sneak in the wellness component, to make it fun by playing a game where they're running and not realizing they're working. It's not about muscle development at this age. The best exercise is to let them roll, rumble and run around so they stay healthy."

Nathan Hamman works with overweight people every day as the bariatric coordinator at OSF Saint Anthony Medical Center. OSF offers weight-loss surgery using Lap-Band technology, where an adjustable band is used to reduce the stomach's capacity, helping patients feel fuller faster and lose weight.

Most patients have BMIs of 35 to 45 and are in their 30s and 40s. Hamman said he typically sees more women than men, and the hospital performs about 50 to 60 of the surgeries a year.

Patients typically are overweight and also suffer from at least one other obesity-related condition. Their average weight loss after the surgery is about 60 to 70 pounds in the first year.

Hamman, a registered dietitian, said most patients seeking bariatric surgery have tried other weight-loss programs without much success. He cites easy access to high-calorie foods that are small in volume and people exercising less as two of the biggest issues contributing to the obesity crisis nationwide.

"You can eat a huge fast-food burger that's 700 calories or eat three to four times worth of fruits and vegetables," Hamman said. "Nobody wants to feel hungry. And people just don't exercise. Our concept of what's active has changed. People will tell me they're active at their jobs, and that means walking up and down the stairs a few times. Fifty years ago, people walked to work or did heavy labor."

Hamman and Molly Kinkade, a clinical dietitian at SwedishAmerican Hospital, both agreed that the average person doesn't understand how small, everyday habits can harm health and that adjusting them — cutting out regular soda in favor of water or switching from regular to diet soda — can help kick-start weight loss.

"Some things surprise people, but I always ask them, 'Did you think it was helping you?' and they usually say, 'No, I knew,'" Kinkade said. "People also feel bombarded by information in the media about health studies and food. ... They label foods as just good or bad, but anything in excess is still going to add up in calories."

Kinkade said Rockford's high unemployment could also have contributed to increased obesity rates.

"When people are laid off, their schedules are off, too," Kinkade said. "That may mean they eat 10 times one day and then once the next day. Depression can set in — it's a vicious cycle. If I see people who are laid off, I tell them to at least get on a schedule of when they wake up and go to bed each day and try to eat at the same times throughout the day."

Paying attention to what you're drinking during the day can be a good first step to losing weight. Calories from soda, fruit juice or energy drinks add up quickly and "we can consume those faster and don't remember those calories as well," Kinkade said.

Kinkade also recommends that people spread out their eating throughout the day and try to make their meals about the same size rather than having no or a small breakfast, a light lunch and then a heavy dinner.

Avoid or at least limit high-fat dairy products like butter, cheese and sour cream. And when you eat meat, the portion should be about 3 to 4 ounces, or similar in size to the palm of your hand.

Research your family medical history and make a doctor's appointment for a blood test so you know your cholesterol and blood-sugar levels and how you can start to improve them.

"Ignorance in this case is not bliss," Kinkade said. "Some people are fearful because they don't want to know. If you go to the doctor and you are diagnosed with diabetes or high cholesterol, you're going to need that time to just adjust to the news. Know your risk. Even if you think you're healthy, still go in. ... You can get your blood pressure tested at a health fair — at least do that if you're not ready to go to a doctor."

Information from: Rockford Register Star,