Key facts
- Overweight and obesity are among the leading causes of disability and death in the WHO European Region; recent estimates suggest that they cause more than 1.2 million deaths across the Region every year.
- Overweight and obesity are the fourth most common risk factor for noncommunicable diseases (NCDs) in the Region, after high blood pressure, dietary risks and tobacco.
- Almost 60% of adults live with overweight or obesity. Levels are higher among men (63%) than among women (54%).
- Of school-aged children, 1 in 3 live with overweight or obesity.
- In children below 5 years of age, 8% are living with overweight (including obesity).
- A quarter of adolescents live with overweight (including obesity).
- Obesity prevalence is higher in adults with lower educational attainment.
- Patterns in children also vary by parental educational level. In many high-income countries, the prevalence of overweight in children is higher when the parents have lower educational status. This pattern is reversed in several middle-income countries.
- The prevalence of adults living with obesity rose by 138% between 1975 and 2016, with a 21% rise between 2006 and 2016.
- Between 1975 and 2016, the prevalence of overweight and obesity among children aged 5–19 years increased nearly 3-fold in boys and more than doubled in girls.
- No Member State in the European Region is on track to reach the target of halting the rise in obesity by 2025.
Overview
Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Obesity is linked to an increased risk for many NCDs, including cardiovascular diseases, 13 types of cancer, type 2 diabetes mellitus, and chronic respiratory diseases including obstructive sleep apnoea. Across the European Region, obesity is likely to be directly responsible for at least 200 000 new cancer cases annually, with this figure projected to rise in the coming decades. For some countries, obesity might overtake smoking as the main risk factor for cancer. Furthermore, people living with overweight and obesity have been disproportionately affected by the effects of COVID-19, with an increased risk of intensive care admissions and death.
Weight gain in individuals, understood in terms of an increase in adipose tissue, comes as a result of energy imbalance, in which the amount of energy taken in is greater than that used over a period of time. However, this simple idea can obscure the complex nature of the ways in which the behaviours that lead to energy intake and energy expenditure may be determined, not to mention the large number of interactive influences on these behaviours. Obesity is complex, with multifaceted determinants (including social determinants) and no single intervention alone can halt the rise of this public health problem.
In order to be successful, any policy must have high‑level political commitment, strong political leadership and supportive government administrations. Policies must also be comprehensive, reaching individuals across the life-course and targeting inequalities. Efforts to prevent obesity need to consider the wider determinants of the disease – including environmental and commercial determinants – and policy options should move away from solely individualistic approaches and address the structural drivers of obesity. Commercial determinants are “the strategies and approaches used by the private sector to promote products and choices that are detrimental to health”.
WHO’s response
Addressing obesity is key for achieving the Sustainable Development Goals (SDGs), particularly SDG 3: ensure healthy lives and promote well-being for all at all ages. This is a priority that is echoed in the European Programme of Work, 2020–2025 – “United Action for Better Health”. Several policy frameworks and action plans to halt the rise in obesity have been set out, including the 2016 “Report of the Commission on Ending Childhood Obesity”, the “European charter for counteracting obesity” and the “Global nutrition targets 2025: childhood overweight policy brief”. Despite these action plans, there have been consistent increases in the prevalence of overweight and obesity in the European Region and no Member State is on track to reach the target of halting the rise in obesity by 2025.
In 2022, WHO/Europe published the “WHO European regional obesity report 2022” and accompanying policy brief, which aims to accelerate the ongoing efforts to halt the rise in obesity in the European Region. It brings together all of the relevant up-to-date statistics on the burden of obesity in the Region and highlights the importance of including prevention and control of obesity within measures to build back better in the wake of the COVID-19 pandemic. This report on obesity shows us the need to build resilient health systems that enable multisectoral action to tackle obesity through a whole-of-government approach, with all stakeholders taking timely action.
The Special Initiative on NCDs and Innovation (SNI) is coordinating the largest surveillance initiative of its kind in the world, the WHO European Childhood Obesity Surveillance Initiative (COSI). This initiative includes almost all of the Member States in the WHO European Region and provides important, nationally representative data for drawing comparisons between countries and tracking trends over time for primary school aged children. The SNI is also committed to providing country-level technical support for the implementation of evidence-informed public health interventions to halt the rise in overweight and obesity across the Region, with a special focus on obesity and overweight surveillance, implementation of comprehensive obesity policies, and strengthening of management services for people living with overweight and obesity.