OBESITY IN THE

WHO EUROPEAN REGION

Health consequences of living with obesity

Chronic Mental health

respiratory problems
diseases
Chronic obstructive
pulmonary disease
Cardiovascular
Obstructive diseases
sleep apnoea
Stroke
Asthma
Ischaemic heart disease
Heart failure
Hypertensive heart
disease
Nonalcoholic Dyslipidaemia
fatty liver Hypertension
disease

Diabetes
mellitus
Chronic
kidney
disease

Cancer
Breast, colorectal,
gallbladder, gastric
Musculoskeletal cardia, kidney, liver,
complications meningioma, multiple
melanoma, oesophagus,
Low back pain ovarian, pancreas,
Osteoarthritis thyroid, uterus

Note: These do not include all health consequences associated with obesity.
Sources: Malnick & Knobler, 2006 (1); GBD 2015 Obesity Collaborators et al., 2017 (2); Lauby-Secretan et al., 2016 (3); Brock et al., 2020 (4); Luppino et al. (2010) (5).

IN THE WHO
This is a summary of the WHO European Regional Obesity Report 2022 (6) EUROPEAN REGION
∙ Obesity is a complex multifactorial disease defined by excessive adiposity that  iving with overweight or obesity has
L
presents a risk to health (7). been identified as a serious public
∙ Overweight and obesity are among the leading causes of disability and death health challenge.
in the WHO European Region (8).
Obesity is a major determinant of
∙ In Europe, obesity is the highest risk factor for disability (9). death and disability (12).
∙ For some countries, obesity might overtake smoking as the the main risk
Almost 60% of adults live with
factor for cancer in the coming decades (10).
overweight or obesity (13).
∙ People living with overweight and obesity have been disproportionately affected
by the effects of COVID-19, with an increased risk of intensive care admissions One in three school-aged children
and death (11). live with overweight or obesity (14).

1
 OBESITY IN THE
WHO EUROPEAN REGION

Prevalence and trends of living with overweight or obesity

in the WHO European Region

 he WHO European Childhood Obesity

T < 5 YEARS
Surveillance Initiative (COSI) shows that
29% of boys and 27% of girls aged 7–9 years
are living with overweight or obesity (14).
8%
7–9 YEARS CHILDREN

 reliminary data suggests that obesity

P 29% 27% OVERWEIGHT (INCLUDING OBESITY)
levels for children and adolescents are BOYS GIRLS
In children below 5 years of age, 8% are
rising due to the COVID-19 pandemic (15). living with overweight (including obesity)
This is particularly concerning as levels (16). Prevalence is higher between 5 and
of overweight and obesity are already 9 years, with 30% of children living with
significant in children and adolescents. OVERWEIGHT (INCLUDING OBESITY) overweight (including obesity) (13).

25% 59%
ADOLESCENTS ADULTS

 atterns in children vary by parental

P
OVERWEIGHT (INCLUDING OBESITY) OVERWEIGHT (INCLUDING OBESITY)
educational level. In many high-income
countries, prevalence of overweight in
 revalence decreases temporarily in
P Almost two thirds of adults (59%) are living children was higher when the parents
adolescents, with one quarter living with with overweight or obesity. Levels are had lower educational status. This pattern
overweight (including obesity) (13,17). higher among men (63%) than among was reversed in several middle-income
women (54%) (13). countries (18).

Between 1975 and 2016, prevalence of overweight and

obesity amongst children aged 5 to 19 years increased
nearly three-fold in boys, and more than doubled in girls.

Obesity prevalence is
higher in adults with  o Member State in the WHO European
N
lower educational Prevalence of adults living with obesity rose 138% between Region is on track to reach the target of
attainment (19). 1975 and 2016, with a 21% rise between 2006 and 2016. halting the rise in obesity by 2025 (20).

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OBESITY IN THE
WHO EUROPEAN REGION

Prevalence of overweight and obesity among children aged 7–9 years

in 36 countries of the WHO European Region, by sex (2015–2017) a

Boys Girls

Albania
Austria
Bulgaria
Croatia
Cyprus
Czechia
Denmark
Estonia
Finland
France
Georgia
Greece
Hungary
Ireland
Italy
Kazakhstan
Kyrgyzstan
Latvia
Lithuania
Malta
Montenegro
Noth Macedonia
Norway
Poland
Portugal
Romania
Russian Federation b
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Tajikistan
Turkey
Turkmenistan
COSI average c
0 10 20 30 40 50 0 10 20 30 40 50
% %

Overweight (including obesity) Obesity Overweight (including obesity) Obesity

a Data from COSI report on the fourth round of data collection, 2015–2017 (14).
b Moscow only
c Represents the average value across the countries that provided relevant information.

3
OBESITY IN THE
WHO EUROPEAN REGION

Policy recommendations for all age groups

Diet Physical activity

∙ Tax unhealthy food products. ∙ Provide convenient and safe access to quality public
open space.
∙ Restrict the sales, marketing and portion sizes of
unhealthy foods. ∙ Encourage active travel by providing safe footpaths,
local cycle lanes and creating walking buses for children
∙ Provide subsidies to increase the consumption of fruits
attending local educational facilities.
and vegetables.
∙ Ensure that urban design incorporates residential density,
∙ Have mandatory front-of-pack nutrition labelling on all
connected street networks that include sidewalks, easy
foods.
access to a diversity of destinations and access to public
∙ Run mass-media campaigns on healthy diets. transport.
∙ Regulate where and how food outlets can operate. ∙ Run mass-media campaigns, community-based education
and motivational and environmental programmes.
∙ Implement healthy public food procurement and service
policies; require that all foods and beverages served or ∙ Provide physical activity counselling and referral as part
sold in public settings contribute to the promotion of of routine primary health care services through brief
healthy diets. interventions.
∙ Control the clustering of unhealthy food outlets around
secondary schools to support efforts within schools.

Surveillance Obesity management

∙ Monitor obesity across the life course to help support ∙ Provide equitable access to integrated health-care
policy efforts through systems such as COSI and the services for management of overweight and obesity as
STEPwise Approach to NCD Risk Factor Surveillance part of universal health coverage.
(STEPS).
∙ Provide equitable access to family-based, multicomponent,
∙ Include other important indicators, such as socioeconomic lifestyle weight management services for children and
status, to help inform and monitor policy action to address young people who are living with obesity.
the social determinants of health.
∙ 
Continue monitoring food and physical activity
environments (including digital environments) and
policy actions at country level.

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OBESITY IN THE
WHO EUROPEAN REGION

Prevalence of overweight (including obesity) among adults (age-standardized)

in countries/country groups of the WHO European Region (2016)

Turkey
Malta
Israel
United Kingdom
Andorra
Greece
Czechia
Bulgaria
Spain
Hungary
Ireland
Lithuania
Croatia
France
Belgium
Montenegro
Belarus
Iceland
Cyprus
EU13 a
Luxembourg
EU Member States
WHO European Region
EU14 b
Italy
Ukraine
Poland
Norway
North Macedonia
Finland
Netherlands
Latvia
Romania
Albania
Portugal
Northern Dimension c
Serbia
Russian Federation
Germany
Sweden
Slovakia
Slovenia
Estonia
Denmark
CIS d
Armenia
Switzerland
Austria
Georgia
Kazakhstan
Azerbaijan
Bosnia and Herzegovina
Turkmenistan
Republic of Moldova
Kyrgyzstan
Uzbekistan
Tajikistan
50 60 70
%

Both sexes Females Males

a EU13: countries that became EU members after 2004 – Bulgaria, Croatia, Cyprus, Czechia, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Romania, Slovakia, Slovenia.
b EU14: countries that were part of the EU prior to 2004 – Austria, Belgium, Denmark, Finland, France, Germany, Greece, Italy, Ireland, Luxembourg, Netherlands, Portugal, Spain, Sweden.
c Northern Dimension: EU, Russian Federation, Norway, Iceland.
d CIS: members and associate members of the Commonwealth of Independent States – Armenia, Azerbaijan, Belarus, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, Tajikistan, Turkmenistan, Uzbekistan.
Source: WHO estimates, 2016 (13).

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OBESITY IN THE
WHO EUROPEAN REGION

Policy recommendations for settings

Nurseries, kindergartens and schools Local environments

∙ Implement whole-of-school programmes that include ∙ Reach out-of-work adults through community health
quality physical education; ensure availability of adequate promotion programmes.
facilities and programmes to support physical activity for ∙ Develop age-friendly environments leading to cities and
all children. communities that enable people of all ages to realize their
∙ Have health-promoting frameworks in nurseries and full potential of health in a sustainable and equitable way.
kindergartens.
∙ Provide free meals and clean drinking-water; particularly
for early school years and children from low-income
households.
∙ Implement mandatory national food standards for child- Digital environments
care settings, recreation facilities and schools.
∙ Have statutory nutrition education in educational curricula.
∙ Implement nutrition education and counselling in schools ∙ Restrict online advertising for unhealthy foods, tobacco,
to increase the intake of fruits and vegetables. alcohol and baby formula milk.
∙ Make every school a health-promoting school through ∙ Recognize the digital environment as a determinant of
supporting implementation, maintenance and scaling-up health.
of initiatives.

Workplaces Health-care settings

∙ Implement multicomponent physical activity programmes ∙ Implement nutrition education and counselling in hospitals
in workplaces. to increase the intake of fruits and vegetables.
∙ Implement nutrition education and counselling in
workplaces to increase the intake of fruits and vegetables.
∙ Promote healthy, safe and resilient places of employment
through supporting workplace wellness programmes.

IMPLEMENTING POLICIES A national strategy must provide clear definitions for the role of local government, which has an
POLICY APPROACHES TO PREVENT important part to play in creating supportive environments and tackling inequalities.
OBESITY REQUIRE LEAD FROM T he support of lower socioeconomic population groups should be a priority in any obesity prevention
NATIONAL GOVERNMENTS strategy, as these groups face more constraints and limitations on making healthy choices.
THROUGH INVOLVEMENT AND  overnments need to “build back better” after the COVID-19 pandemic, recognizing that human,
G
INVESTMENT AT ALL LEVELS. animal and environmental health are all connected.

6
OBESITY IN THE
WHO EUROPEAN REGION

Policy recommendations for preconception and infancy

Why have policies for these life stages? Breastfeeding and early nutrition support

∙ A woman’s nutritional status during preconception and ∙ Implement the WHO and UNICEF Baby-friendly Hospital
in the prenatal period may influence her offspring’s Initiative to enable mothers to breastfeed infants, along
health and susceptibility to obesity and a range of with lactation support training for health professionals.
noncommunicable diseases.
∙ Once born, the promotion and support of exclusive ∙ Provide universal paid maternity leave, national labour
breastfeeding for the first 6 months of life is recommended. policies and workplace support for breastfeeding, along
with laws to protect breastfeeding in public.

∙ Restrict the inappropriate marketing of products that

compete with breast milk, as detailed in the International
Supporting the health of the parents
Code of Marketing of Breast Milk Substitutes.

∙ Encourage a healthy introduction to solid food through

∙ Monitor and provide counselling on nutrition and exercise reformulation of infant food to improve its nutritional
before and during pregnancy. profile, along with accurate labelling of these products.
∙ Provide food vouchers for new parents to subsidize the
purchase of healthy foods.

Prevalence of overweight and obesity among adults in the WHO European

Region, by sex (1975–2016)

Overweight (including obesity)

60

40

%
Obesity
20

0
1980 1990 2000 2010
Year

Overweight (including obesity) Both sexes Females Males Obesity Both sexes Females Males
Source: WHO estimates, 2016 (13).

7
OBESITY IN THE
WHO EUROPEAN REGION

Barriers to implementing Policy approaches

obesity policy must be:

WHO European Region conducted consultations with Member ∙ comprehensive

States to understand the barriers to implementing obesity
∙ multisectoral
policy, including WHO “best buys”. These barriers include:
∙ reach individuals across the life course
1. The continuing narrative that addressing obesity is the
responsibility of the individual, and not the responsibility ∙ target inequalities
of wider society including governments.
∙ move away from exclusively individualistic approaches
2. The upstream determinants of obesity (including
obesogenic digital environments) are not always prioritized
for action. ∙ A number of policy tools are available to Member States to
prevent and manage obesity.
3. Economic priorities often take precedence over health,
including obesity policies. ∙ No single intervention can halt the growth in the obesity
epidemic on its own.
4. Cross-sectoral engagement and impact delivery is
challenging.

5. Interventions that impact the food industry face significant To address the burden of overweight and obesity in the Region,
opposition and low political will. This is a key barrier for it is important for countries to prioritize their areas of action.
cross-sectoral engagement. Currently, some of the policy areas which have gained attention
6. Lack of guidance on how to implement effective and are sugar-sweetened beverage taxation, marketing restrictions
integrated obesity treatment and management as part to children and strengthening health systems to better prevent
of universal health coverage. and manage obesity and overweight.

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WHO European Office for the Prevention and Control of Noncommunicable Diseases
© World Health Organization 2022. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license.