Overweight and obesity among children and adolescents
Overweight and obesity among children and adolescents is a major public health issue. Children and adolescents who are overweight or obese are at a greater risk of poor health, and this effect persists into adulthood. Moreover, obesity among children and adolescents is often related to psychosocial problems such as poor self-esteem, bullying and underachievement at school, which can further worsen health and economic outcomes in adulthood (OECD, 2019).
In 2018, almost one in five (19%) 15-year-olds was either overweight or obese on average across EU countries, up from one in six (16%) in 2010 (Figure 4.15). There is a three-fold variation in overweight and obesity rates among adolescents across EU countries, ranging from 12% in the Netherlands to 36% in Malta.
In all EU countries except Portugal, overweight and obesity is more prevalent in boys than girls. On average across EU countries, the prevalence in 2018 was 23% in 15-year-old boys compared to 15% in girls. This gender difference is driven by a combination of biological, social and environmental factors. In Poland, Italy and Greece, overweight and obesity among boys are more than twice as prevalent as among girls.
In all countries except Albania, children and adolescents from more affluent families are less likely to be overweight or obese than those from less affluent families (Figure 4.16). On average across EU countries, overweight and obesity among young people from less affluent families is over 50% higher than among those from more affluent families.
Many countries have implemented policies to reduce obesity specifically targeting children. These include restrictions on advertising of food and drinks to children, school-based wellness and educational programmes, reducing the availability of unhealthy food options in schools, encouraging or enabling active transport to school, and family physical activity programmes (OECD, 2019). Other policies, such as warning labels, marketing restrictions of unhealthy foods to children, pricing policies and mass media campaigns, can also help tackle childhood obesity.
The EU Action Plan on Childhood Obesity 2014-20 aims to halt the rise in obesity in children and young people in the EU by 2020. It identifies several key areas for action, such as supporting a healthy start in life, making healthier choices the easy option (e.g. food reformulation), reducing marketing to children, encouraging physical activity, and promoting healthier environments in schools (European Commission, 2014 and 2019). A mid-term evaluation from 2018 found that although many European countries were active in creating healthier school environments and improving the quality of food products through reformulation, making the healthier option the ‘easy option’ for children and restricting marketing/advertising of unhealthy foods still required further actions (Boer, 2018).
The EU Joint Action on Nutrition and Physical Activity (JANPA), which ran from 2015 to 2017, produced a web-based toolbox to help decision-makers and programme planners design and implement effective interventions on childhood obesity. Starting in 2018, the Science and Technology in childhood Obesity Policy (STOP) project, funded by Horizon 2020, brings together academic and other stakeholders from across Europe to generate evidence on the factors that contribute to childhood obesity, and the effectiveness of different actions to address this problem. In 2020, a new Joint Action was launched focusing on the promotion of food reformulation, the reduction of aggressive marketing to children of foods high in fat, salt and sugar, and the improvement of public procurement of food.
Childhood and adolescent data on overweight and obesity come from the Health Behaviour in School-aged Children (HBSC) study. This survey asked young people aged 11-, 13- and 15 years old to report their height and weight. Body mass index (BMI) was calculated from this information and cut-offs for overweight and obesity allocated based on the WHO growth reference for age.
The indicator of socio-economic status is based on the Family Affluence Scale, which asks young people about material assets in the household.
References
Boer, J. (2018), Supporting the mid-term Evaluation EU Action Plan on Childhood Obesity: Results of the Childhood Obesity Study, https://ec.europa.eu/health/sites/health/files/nutrition_physical_activity/docs/ev_20180601_co03_en.pdf.
European Commission (2014), EU Action Plan on Childhood Obesity 2014-20, Brussels, https://ec.europa.eu/health/sites/health/files/nutrition_physical_activity/docs/childhoodobesity_actionplan_2014_2020_en.pdf.
European Commission (2019), Initiatives on Nutrition and Physical Activity, https://ec.europa.eu/health/sites/health/files/nutrition_ physical_activity/docs/2019_initiatives_npa_en.pdf.
Inchley, J. et al. (2020), Spotlight on adolescent health and well-being: Findings from the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey in Europe and Canada, International report, Vol. 2, Key data, WHO Regional Office for Europe, Copenhagen.
OECD (2019), The Heavy Burden of Obesity: The Economics of Prevention, OECD Health Policy Studies, OECD Publishing, Paris, https://doi.org/10.1787/67450d67-en.
Note: The least and most affluent are defined as those living in the lowest and highest quintiles (20%) in each country. 1.The value for Belgium is the unweighted average of the Flemish and French Communities.
Source: HBSC data from Inchley et al. (2020).