Britney Robinson, 20 waits to see a nurse practitioner for a checkup in Clay County, one of the unhealthiest counties in the state, in Manchester, Ky. The national obesity rate for adults is 24 percent; in Manchester and surrounding Clay County it's been estimated as high as 52 percent. In a study of the healthiness of Kentucky's 120 counties, Clay County ranked dead last, with 41 percent of the population classified as in poor or fair health.
Linda Davidson-The Washington Post
Nurse practitioner Suzie Smith checks Britney's heartbeat. Local pharmacist Regina Stevens says, "A lot of our medications are for 'disease states,' such as type 2 diabetes, hypertension, things that can be adversely affected by increased weight... If many of my patients lost weight, they could be totally taken off some of these medications. They would have increased longevity in life."
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Britney, who attends the Manchester branch of Eastern Kentucky University, wants to be an elementary schoolteacher. When it comes to activity, she likes sitting in the woods. "Basically, I work, sleep, hang out with my friends."
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Scott Robinson talks to his daughters Britney, 20, left, and Carlin, 12, at their home in Clay County, Kentucky. Carlin is at least 20 pounds overweight. "I won't weigh myself," she says. "No way. I ain't gonna embarrass myself. Why in the world would I want to do that?"
Britney Robinson is at least 30 pounds overweight. She doesn?t weigh herself, either.
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Carlin Robinson, left, and her sister Britney, eat fast food, while their grandmother, Sylvia Robinson, 71 makes pecan pies in their kitchen. Britney admits she'd like to talk to her sister about the weight Carlin's been gaining, but she won't. "Talking about her weight just might push her buttons," she says. "You don't really want to bring it up because you just don't know how the other person will feel. In a way it's uncomfortable. I know I should talk about it."
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Carlin shows her grandmother Sylviia her new bridesmaid dress.
Linda Davidson-The Washington Post
Rather than walking, Carlin Robinson is driven to the bus stop by her grandmother.
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Hair stylist Pat Root, center, applies a spray tan to Carlin Robinson in Manchester, Ky.
Linda Davidson-The Washington Post
Hair stylist Pat Root puts the finishing touches on Carlin's new hairdo.
Linda Davidson-The Washington Post
Carlin Robinson is a beautiful bridesmaid at a relative's wedding.
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Carlin Robinson, shows off her new nails to her grandmother Sylvia, as friend Alexia Cotton, looks on. Carlin won't say what she weighs. Carlin says she has started to notice how much bigger she is than other kids. "Sometimes you get picked on for your size."
Linda Davidson-The Washington Post
Cancer survivors receive hugs and applause during a cancer fundraiser in Manchester, Ky. Sylvia Robinson, who is not obese, survived breast cancer.
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Scott Robinson maintains the city golf course in Clay County, Manchester, Ky. He takes a blood pressure pill daily but has no idea how much he weighs. "Lord, I couldn't tell you," he says. "Two-seventy, two ninety. I don't remember the last time I weighed myself."
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Scott Robinson has a fairly active job working to maintain the city golf course in Clay County, yet he is a very large man.
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Scott takes a break on the golf course.
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An intersection in Manchester, Ky., sports a fast food restaurant on nearly every corner with few options for anything else.
Linda Davidson-The Washington Post
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