“It doesn’t come up,” said David Felinton, 5-foot-9 and 233 pounds, as he walked toward City Hall one recent morning. “We’ve got a lot of economic challenges here in Huntington. That’s usually the focus.”

Huntington’s economy has withered, its poverty rate is worse than the national average, and vagrants haunt a downtown riverfront park. But this city’s financial woes are not nearly as bad as its health.

Nearly half the adults in Huntington’s five-county metropolitan area are obese — an astounding percentage, far bigger than the national average in a country with a well-known weight problem.

Huntington leads in a half-dozen other illness measures, too, including heart disease and diabetes. It’s even tops in the percentage of elderly people who have lost all their teeth (half of them have).

It’s a sad situation, and a potential harbinger of what will happen to other U.S. communities, said Ken Thorpe, an Emory University health policy professor who is working with West Virginia officials on health reform legislation.

“They may be at the very top, but obesity and diabetes trends are very similar” in many other communities, particularly in the South, Thorpe said.

The Huntington area’s health problems, cited in a U.S. health report, are a terrible distinction for the city, but the locals barely talk about it. Many don’t even know how poorly the city ranks.