Childhood obesity in Europe has quietly become one of the most pressing public health challenges of our time. Recent data from the World Health Organisation (WHO) European Regional Obesity Report 2022 indicate that nearly one in three children in the WHO European Region is affected by overweight or obesity, with prevalence rates of 29% among boys and 27% among girls, figures that have been steadily increasing over recent decades.1 Figure 1 illustrates the aggregate prevalence of overweight and obesity among boys and girls between 11 and 15 years old in 2014 and 2022. The data shows that across all age groups, boys consistently had higher rates of overweight and obesity than girls in both years. Additionally, the overall prevalence increased by approximately two percentage points across all age groups from 2018 to 2021, with the most significant rise observed among 13-year-old boys.
Figure 1. Aggregate prevalence of childhood overweight (including obesity) in the EU by age and year
Note: Data for England, Ireland and Romania are missing. HBSC data utilises the WHO definition of overweight and obese children:2 Overweight is indicated by a BMI–for–age greater than 1 standard deviation above the WHO Growth Reference median, while obesity is indicated by a BMI–for–age greater than 2 standard deviations above the WHO Growth Reference median.
The issue of childhood overweight and obesity threatens the health of current and future generations. Childhood obesity can have short and long-term effects on an individual’s life. In the short term, it can lead to orthopaedic, neurological, pulmonary, and endocrine conditions, as well as social and psychological issues affecting self-esteem and body image.3 Long-term effects include increased risk of cardiovascular disease, type 2 diabetes, hypertension, certain types of cancer and premature mortality in adulthood.4 The costs aren’t just medical – they are economic and societal too. Beyond individual health, childhood obesity imposes a substantial economic burden on European societies, encompassing both direct costs on healthcare systems due to increased demand for medical care, as well as indirect costs stemming from lost productivity, social exclusion, and reduced educational outcomes. According to a 2019 report on the economic burden of obesity,5 between 2020 and 2050, OECD countries will spend, on average, 8.4% of their entire annual health budget on treating the consequences of overweight (including obesity).
The causes of childhood obesity are multifaceted, involving:
- Lifestyle choices (lack of physical activity due to sedentary jobs and screen time)
- Dietary habits (high consumption of high-fat, salt or sugar food and drinks)
- Economic and environmental influences (limited access to affordable, healthy food and safe spaces for physical activity)
- Psychological factors (overeating led by stress, anxiety and depression)
- Medications, diseases, trauma, and genetic variations
Understanding recent trends in these modifiable risk factors is therefore critical to designing effective prevention strategies.
The graphs below illustrate the changes in prevalence rates of key obesity risk factors from 2010 to 2021 across all EU Member States and the UK, focusing on children aged 11 to 15 years. The data reveal that boys consistently engaged in higher levels of vigorous physical activity (VPA) compared to girls; however, both groups experienced a decline over time, with the steepest drop occurring in 2021, likely due to the COVID-19 lockdowns that limited outdoor activities and organised sports. Regarding dietary factors, daily fruit intake remained stable for both genders, while vegetable consumption showed a gradual increase, particularly among girls. Notably, sugary drink consumption dropped significantly from around 30% in 2010 to roughly 15% in 2021, reflecting a positive shift toward healthier beverage choices. Additionally, breastfeeding rates, a recognised protective factor against childhood obesity, vary widely across Europe, with exclusive breastfeeding at six months ranging from 13% to 39%, complicating efforts to assess its impact on obesity trends.6
Figure 2. Average prevalence rates of major risk factors to childhood obesity
Note: Vigorous physical activity: “How many times a week do you usually eat or drink vegetables?” (Responses of once daily or more than once daily are coded as 1, otherwise 0); Daily Fruit Intake: “How many times a week do you usually eat or drink fruit?” (Responses of once daily or more than once daily are coded as 1, otherwise 0); Daily Vegetable consumption: “How many times a week do you usually eat or drink vegetables?” (Responses of once daily or more than once daily are coded as 1, otherwise 0). Daily sugary drinks: “How many times a week do you usually drink sugary beverages?” (Responses of once daily or more than once daily are coded as 1, otherwise 0). Aggregated data for children aged 11, 13 and 15 years old.
These findings underscore the complex interplay of behavioral and environmental factors influencing childhood obesity and highlight areas where targeted interventions may help reverse the rising trend in obesity prevalence across Europe. These trends suggest some progress, but they have not been enough to reverse rising obesity rates. Indeed, despite improvements in obesity risk factors, the prevalence of obesity is growing due to the cumulative and long-term nature of obesity development. While some individual behaviors may be improving, the obesogenic environment – settings that promote unhealthy eating and physical inactivity – remains largely unchanged or even worsening in subtle ways. For example:
- Food systems still promote cheap, calorie-dense, ultra-processed foods, which are widely accessible and heavily marketed.
- Portion sizes and sedentary lifestyles remain problematic despite awareness campaigns.
- Weight gain accumulates over time, so even small imbalances in energy intake vs. expenditure can result in rising obesity rates across the population.
- Intergenerational effects of obesity, intended as the transmission of obesity risk from parents to children, starting as early as during pregnancy and early childhood, and early-life exposures continue to predispose children to obesity.
No single intervention can halt the growth of obesity on its own; action is needed with a comprehensive approach to protect the future health and well-being of European populations.7 Since obesity develops and becomes more pronounced across the life course, prevention of obesity in critical life-course phases, such as preconception and pregnancy periods,8 infancy and adolescence, is likely to have the greatest health and cost benefits.9 Likewise, preventing obesity from a young age holds the most significant promise for breaking the intergenerational cycle of obesity, as well as dietary inequalities, often linked to differences in income, education, or geography between different population groups.10
Curbing overweight and obesity rates involves societal changes to obesogenic environments11 by reducing calorie intake from fats and sugars, increasing consumption of whole foods, plant-based foods and fruits, increasing regular physical activity and sleep and, to this end, reducing exposure to screens.
Recognising the scale of the issue, the European Union adopted the EU Action Plan on Childhood Obesity (2014–2020)—a non-binding policy framework developed in collaboration with the Member States through the High-Level Group on Nutrition and Physical Activity and coordinated by the European Commission. While defining national health policy remains the exclusive competence of Member States under Article 168 of the Treaty on the Functioning of the European Union (TFEU), the Action Plan provides structured guidance and coordination, outlining priority areas and mechanisms to collectively track progress. The multifactorial approach taken by the Action Plan is structured into eight strategic areas for action:
While the implementation of the Action Plan and related childhood obesity prevention and management strategies rests with national authorities, the coordinated framework offered by the EU provides a critical platform for shared progress and accountability across Europe.
In 2024, Open Evidence conducted the evaluation of the EU Action Plan on Childhood Obesity 2014-2020, assessing the current state of its implementation, identifying key obstacles and challenges, and highlighting best practices. The study is available here . Annex V on country profiles with colour code identifying the status of implementation of policies per Area of Action of the Action Plan can be accessed here.