Uninsured Americans who are hoping the new health insurance law will give them access to weight loss treatments are likely to be disappointed.

That’s especially the case in the Deep South, where obesity rates are among the highest in the nation, and states will not require health plans sold on the new online insurance marketplaces to cover medical weight loss treatments like prescription drugs and bariatric surgery.

Dr. Erin Cummins directs the bariatric surgery department at in the state capital of Jackson. She grew up in the Delta, her husband is a cotton farmer, and although she’s petite and fit, she understands well enough how Mississippians end up on her operating table.

“You have to realize in the South, everything revolves around food. Reunions, funerals, parties — everything revolves around food,” Cummins says.

That long-standing food culture, as well as other factors like inactivity and poverty, have saddled Mississippi with the highest obesity rate in the nation.