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And it is African-American women who have the highest rates of being overweight and obese compared to other groups in the U.S. Reporter Taunya English looks at why.

TAUNYA ENGLISH, BYLINE: So when does it begin, this excess and unhealthy weight? Temple University researcher Clare Lenhart says: It starts early.

CLARE LENHART: By the age of 17, nearly 60 percent of black girls and about a third of white girls were reporting no physical activity participation at all.

ENGLISH: A National Institutes of Health study followed girls for 10 years, beginning at age eight or nine. Exercise declined dramatically over that time, and the drop-off for African-Americans girls was steepest. Researchers are trying to figure out what keeps some girls from getting the recommended 60 minutes of exercise.

LENHART: Sometimes it's very simple things. It's not wanting to run very hard or get sweaty during gym class, because they don't want their hair to be messed up for the rest of the day. It can be more larger things, where their friends maybe aren't participating anymore, and so it's not considered cool for them.

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UNIDENTIFIED MAN: Players, come in, coaches too.

INDIA BARNES: My name is India Barnes. And I'm nine years old. And I go to school at Holy Spirit Catholic School.

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ENGLISH: India plays soccer for her club team, the Anderson Monarchs.

BARNES: I play striker. Her job is to score, give good passes and try to help the defense too.

ENGLISH: At age nine, India still thinks sports are pretty cool.

BARNES: Yeah, I'm an athletic kind of girl. It makes me feel confident.

ENGLISH: The Monarchs are mostly African-American girls from urban Philadelphia. Coach Walter Stewart says the club gives city girls a chance to play a sport. For girls, team sports and structured activities may be the most consistent way to get exercise.

WALTER STEWART: In a soccer game at their age, as they get to be, say, 13, 14, they're probably running in a game three, to four or five miles.

ENGLISH: The Monarchs practice two or three times a week and travel to games on the weekend. Stewart says by the end of middle school many players lose interest and commitment.

STEWART: That's where it gets to be difficult, they are making a transition from young kids to more teenagers and they're more interested in boys and what boys think.

ENGLISH: And less interested in sports and fitness.

Concerns about black women and weight surfaced a full decade before the obesity epidemic hit the general population.

University of Pennsylvania Professor Shiriki Kumanyika says black women's weight started out high, then in the 1990s went higher.

SHIRIKI KUMANYIKA: So we used to be 30 percent, maybe white women were 15 percent. And now it's like 50 percent versus 30 percent. So everybody's gone up.

ENGLISH: Kumanyika is an epidemiologist, a detective of sorts, looking for clues to the weight gap. Research shows that opportunities for recess, sports, physical education or to just go out and play, aren't spread evenly among children.

KUMANYIKA: Add those situations up in urban, inner-city neighborhoods where most African-Americans live, they're not as available, and that's been documented.

ENGLISH: And that can be costly, both in terms of health and money. Obese people cost nearly $1,500 more a year in medical expenses compared to healthy-weight people.

UNIDENTIFIED GIRL #1: Who has India?

UNIDENTIFIED GIRL #2: I do.

UNIDENTIFIED GIRL #1: Who has Carissa?

UNIDENTIFIED GIRL #3: I do.

ENGLISH: Mom Jennifer Johnson discovered the Anderson Monarchs when she was looking for a way to keep her daughter active. Alexandria's 15 and a committed assistant coach these days, but her interest dipped around age 12, and that worried her mom.

JENNIFER JOHNSON: In comes the friends, and in comes the extracurricular activities at school, and as a parent you really have to press on. Because I said to her: If it's not this, you will be involved in something.

ENGLISH: Johnson says ultimately, good friendships kept Alexandria on the team.

JOHNSON: It's about the running around. It's about the fitness. And twice a week they have a common playing ground, you know, they have this team.

ENGLISH: Johnson also makes sure she's on the sidelines. Obesity researchers say that kind of family support may be another way to motivate girls to keep playing. For NPR News, I'm Taunya English.

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MONTAGNE: That story is part of a project on health care in the states, a partnership of WHYY, Kaiser Health News and NPR.

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