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 In the US, there’s plenty of obesity to go around, but the problem is significantly worse in rural areas compared to urban ones, a new study finds. Some 39% of rural Americans are obese, versus 33% of urbanites, a researcher tells ABC News. Rather than depending on self-reporting, researchers in the study used a database of measured heights and weights—and they learned that rural obesity rates were almost twice what self-reported studies suggested.

The obesity issue is “most pronounced for younger adults between the ages of 20 and 39,” says the lead researcher. One reason: Manual labor has decreased, but diets haven’t changed accordingly. Geographic isolation is also a problem; rural dwellers may lack access to healthier food selections, gyms are harder to find, and “there is very little awareness and concern about how preparation contributes to calories in the food,” the author says.

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