Washington ? Mississippi’s still king of cellulite, but an ominous tide is rolling toward the Medicare doctors in neighboring Alabama: obese baby boomers.

It’s time for the nation’s annual obesity rankings and, outside of fairly lean Colorado, there’s little good news. In 31 states, more than one in four adults are obese, says a new report from the Trust for America’s Health and the Robert Wood Johnson Foundation.

And obesity rates among adults rose in 23 states over the past year, and no state experienced a significant decline.

“The obesity epidemic clearly goes beyond being an individual problem,” said Jeff Levi, executive director of the Trust, a nonprofit public health group.

It’s a national crisis that “calls for a national strategy to combat obesity,” added Robert Wood Johnson vice president Dr. James Marks. “The crest of the wave of obesity is still to crash.”

While the nation has long been bracing for a surge in Medicare as the boomers start turning 65, the new report makes clear that fat, not just age, will fuel much of those bills. In every state, the rate of obesity is higher among 55- to 64-year-olds — the oldest boomers — than among today’s 65-and-beyond.

The report provides one of the first in-depth looks at obese boomers, and its implications are sobering. This first wave of aging boomers will mean a jump of obese Medicare patients that ranges from 5.2 percent in New York to a high of 16.3 percent in Alabama, the report concluded. In Alabama, nearly 39 percent of the oldest boomers are obese.

Medicare spends anywhere from $1,400 to $6,000 more annually on health care for an obese senior than for the non-obese, Levi said.

Some other findings:

• Mississippi had the highest rate of adult obesity, 32.5 percent, for the fifth year in a row.

• Three additional states now have adult obesity rates above 30 percent, including Alabama, 31.2 percent; West Virginia, 31.1 percent; and Tennessee, 30.2 percent.

• In 1991, no state had more than a 20 percent obesity rate. Today, the only state that doesn’t is Colorado, at 18.9 percent.