A health study released last week by the Trust for America’s Health found that three out of ten Texans are obese, meaning that their body mass index is over thirty.

In the Washington-based health policy organization’s annual obesity report, F as in Fat, the study’s authors caution that almost sixty percent of Texans could be obese by 2030 if current trends continue. Texas tied with Kentucky for tenth in the annual ranking, behind such perennial heavyweights as Mississippi and Louisiana. This is up from a ranking of twelve the year before.

The report warns that there are steep costs associated with such astronomical rates of obesity.

“The number of new cases of type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase ten times between 2010 and 2020, if current trends continue—and then double again by 2030” say Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation, and Jeff Levi, executive director of the Trust for America’s Health, wrote in a letter introducing the report. “The forecasting report in this year’s study demonstrates what’s at stake.”

Texas currently is on track to be a thundering 57 percent overweight by 2030, which would raise obesity-related health care costs by seventeen percent.

In response to years of troubling studies about Texas weight, several cities have announced initiatives to address the problem. Fort Worth Mayor Betsy Price announced a series of programs dubbed “FitWorth” this week, and Houston Mayor Annise Parker introduced Healthy Houston.

“We know a lot more about how to prevent obesity than we did ten years ago” Levi said in a press release. “Small changes can add up to a big difference. Policy changes can help make healthy choices easier for Americans in their everyday lives.”