BOSTON -- Bay State residents are in good shape, according to a recent report that states Massachusetts has the second-lowest percentage of obese people in the country.

The annual report, "F as in Fat: How Obesity Policies are Failing in America, 2009," found that 21.2 percent of Massachusetts are obese.

Obesity rates climbed in 23 states in 2009, and Mississippi had the highest rate this year with 32.5 percent, according to the report. Colorado had the lowest obesity rate with 18.9 percent.

Despite the Bay State's healthy standing relative to other states, Health Commissioner John Auerbach said the percentage of adult and childhood cases of obesity is still "very disturbing," especially because it leads to problems such as heart disease, asthma and heart disease.

"In spite of the fact that we look relatively good, we believe that we should be taking a number of steps in a comprehensive campaign," he said.

The campaign, Mass in Motion, started in 2008 and includes a Web site, a kit for workplaces and the first-ever Massachusetts-specific health report.

"In order to affect weight, we have to move beyond simply telling them what would be a better weight," Auerbach said.

Instead, Auerbach said Mass in Motion aims to redesign communities to make the healthy option the easiest option.

Within the next two years, Massachusetts will phase in two new state laws, he said. The first will require chain restaurants to display caloric information where food is ordered, and the second will require schools to use the health and weight data they already collect to calculate students' BMIs and confidentially send that data home with a package of health information.

"What people have said to us as we've rolled out different parts of the campaign is that they're glad it isn't just a campaign that lectures people," Auerbach said. "This is instead something that gives people information and tries to change conditions of their lives."

The National Institutes of Health define obesity as having a body mass index, which is a weight to height ratio, of 30 or more in adults. The state-by-state report is compiled annually by Trust for America's Health and the Robert Wood Johnson Foundation.