What country has the worst obesity problem

1 in 6 Europeans are now obese. Which countries are the worst hit by the rising obesity crisis?

The data shows one in six Europeans with obese and over 50% of adults overweight. The rates vary from country to country but where is the problem the worst?

Obesity poses an increasing challenge in Europe with one in six EU citizens classed as obese, and over half of adults in the EU overweight.

Obesity is a serious public health problem as it increases the risk of chronic diseases such as hypertension, diabetes, coronary heart disease, and certain cancers.

On average in the EU, overweight and obesity reduce life expectancy by nearly three years according to the Organisation for Economic Co-operation and Developments (OECD) 'Health at a Glance: Europe 2020 : State of Health in the EU Cycle' report.

Recent estimates also suggest that overweight and obesity cause more than 1.2 million deaths every year across the World Health Organization (WHO) European Region, which comprises 53 countries.

The WHO's 'European Regional Obesity Report 2022' report shows that obesity is the fourth highest cause after high blood pressure, dietary risks, and tobacco, corresponding to more than 13 per cent of total deaths.

The body mass index (BMI) is largely accepted as the most useful measure of obesity for adults (those aged 18 years and over) when only weight and height data are available.

It is a measure of a persons weight relative to their height.

The table above shows the WHOs BMI result classification:

< 18.50: underweight;

18.50 < 25.00: normal range;

>=25.00: overweight;

>= 30.00: obese.

The rates of overweight and obese significantly differ in gender, age, and level of education.

So, how do obesity and overweight rates vary across Europe? Which countries have the most obese populations? And what are the reasons behind obesity?

More than half of adults in the EU are overweight

In 2019, 44.8 per cent of adults living in the EU had a normal weight while more than half (52.7 per cent) were overweight, and 2.5 per cent were underweight, as measured by their BMI, according to Eurostat, EUs official statistical office.

Overweight is categorised into two main groups, namely pre-obese and obese. We will look at them in more detail below.

The proportion of overweight people significantly varied across the EU.

Highest share of overweight adults in Croatia and Malta

Croatia and Malta (both 64.8 per cent) had the highest proportion of overweight people in the EU. Almost two out of every three were considered overweight in these countries.

When the European Free Trade Association (EFTA) and two EU candidate countries are included, they were followed by Iceland, Czechia, and Hungary where the overweight rate was 60 per cent or over.

Lowest overweight rates in Italy and France

The lowest proportion of overweight people was recorded in Italy (45.7 per cent), France (47.2 per cent), and Luxembourg (48.4 per cent). These were the only countries with an overweight rate below 50 per cent.

One in six adults in the EU are obese

Looking at the details of overweight adults, 16.5 per cent of adults were obese - around one in six - and 36.2 per cent were pre-obese in the EU.

In 2019, the proportion of obese varied from 10.9 per cent in Romania to 28.7 per cent in Malta.

At least one in five adults were obese in 12 of 33 countries across Europe.

Obesity in EUs 'Big Four' and the UK

The obesity rate was 21 per cent in the UK (2017 data). In the EUs so-called "Big Four" economies, Germany (19 per cent) had the highest obesity rate, followed by Spain (16 per cent), France (15 per cent) and Italy (11.7 per cent).

The prevalence of obesity is on the rise

Over the last two decades, the prevalence of obesity has increased in the EU according to OECDs 'Health at a Glance: Europe 2020' report.

Among the 18 EU countries with data available since around 2000, the average obesity rate increased from 11 per cent in 2000 to 15 per cent in 2008, and 17 per cent in 2018.

Between 2008 and 2017/18, the obesity rate rose in almost all countries except Cyprus and Hungary.

In this period, four Nordic countries saw the largest increase in the obesity rate. Iceland (6.5 percentage points, or pp) had the highest change, followed by Finland (4.3 pp), Norway (4.2 pp), and Sweden (3.8 pp).

Why do overweight and obesity rates significantly vary?

There is no one simple answer to explain the variance in rates. An article titled 'Prevalence of adult overweight and obesity in 20 European countries, 2014,' which appeared in European Journal of Public Health, found that the overall prevalence was higher in Eastern European countries when compared with central and northern countries.

The prevalence of overweight and obesity was related to socioeconomic characteristics. Low socioeconomic status is described as associated with obesity.

"The socioeconomic status may indirectly influence weight status through dietary habits, good access to exercise facilities, health literacy, and physical activity participation," the article suggested.

Overweight rate was higher in men than women in all countries

Gender is a significant variable in explaining the rates of being overweight. It was higher in men than women among all 33 European countries.

In the EU, 60.2 per cent of men were overweight while this rate was 45.7 per cent in women.

The gender gap significantly differed. The largest difference was recorded in Luxembourg (20.1 pp), followed by Czechia (19.2 pp) and Cyprus (18.6 pp).

However, the gender gap was not considerable in some countries such as Turkey (2 pp) and Latvia (3.2 pp).

Share of obese women was higher than men in several countries

When we look at obesity by gender, we have a different story than the overweight.

In 2019, there was no systematic difference between the sexes as regards the share of obese men and women.

In the EU, the obesity rate was 16.8 per cent in men while it was slightly lower in women (16.3 per cent).

The highest proportion of obese men (30.6 per cent and women (26.7 per cent) was recorded in Malta.

In 11 of 30 countries, the proportion of obese adults was higher in women than men.

These countries included Turkey, Latvia, Estonia, Lithuania, the Netherlands, Finland, France, Portugal, Denmark, Ireland and Sweden.

The states of obese women in Turkey and Latvia are striking, as their shares were substantially higher than men. Thus, the gender difference was significantly high in these countries, respectively 7.8 pp and 6.1 pp.

Proportion of overweight generally increased with age

Except for those aged 75 or over, the older the age group, the higher the share of overweight people in the EU.

The 18 to 24 age group recorded the lowest shares of overweight people (25 per cent), whereas the 65 to 74 group had the highest shares (65.7 per cent).

Similarly, this was also a pattern for the obesity rate (6 per cent vs. 22 per cent).

There were a few countries, such as Denmark, Ireland, and Sweden, where the percentage of overweight was highest in the 54 to 64 age group, indicating slight exceptions.

Education level matters in overweight and obese

There was a clear pattern for education level, too. The proportions of overweight and obese people fall as the educational level rises in the EU.

In 2019, the percentage of overweight adults among those with a low education level stood at 59 per cent, while it was 54 per cent for those with a medium education level and 44 per cent for adults with a high education level.

Likewise, 20 per cent of adults with low and 17 per cent with medium to 11 per cent of adults with high education level were obese in the EU.

The overweight rate was higher in those with a low education level than a high degree level in all the countries in the table.

The education gap between the low and high levels substantially varies in the overweight population. It ranged from 4.6 pp in Norway to 36.5 in Turkey. This figure was 20.8 pp in the EU.

The WHO warns that this gap also results in further inequality in health and employment outcomes.

Educational level is based upon the International Standard Classification of Education (ISCED) and refers to:

Low: pre-primary, primary and lower secondary education (ISCED levels 02);

Medium: upper secondary and post-secondary non-tertiary education (ISCED levels 3 and 4);

High: tertiary education (ISCED levels 58).

Causes of obesity and suggestions to halt the rise

The rising prevalence of obesity is driven by several behavioural and environmental factors, according to the OECD report. These include urbanisation, increased sedentary behaviour, and the widespread availability and marketing of energy-dense foods.

"Socially disadvantaged groups are particularly at risk of becoming obese, either because of less healthy nutrition habits or lack of physical activity," the report also found.

"Obesity is a complex multifactorial disease," Dr Hans Kluge, WHO Regional Director for Europe, wrote in the report. That means no single intervention alone can halt the rise of the growing obesity epidemic.

You can easily calculate your BMI at NHS's website and see whether you are overweight.

Obesity

Obesity is a major risk factor for a range of diseases, including heart disease, stroke, diabetes, and various types of cancer.

It is most commonly measured using the body mass index (BMI) scale.

On this page, you will find global data and research on obesity its prevalence, drivers, health consequences, and trends over time.

See all interactive charts on Obesity

Related topics:

Food Supply

How had the availability of food changed over time? How does food supply vary across the world today?

Hunger and Undernourishment

How does undernourishment vary across the world? How has it changed over time?

Micronutrient Deficiency

Food is not only a source of energy and protein, but also micronutrients vitamins and minerals which are essential to good health. Who is most affected by the "hidden hunger" of micronutrient deficiency?

Other research and writing on obesity on Our World in Data:

What is obesity?

Obesity is commonly measured using the Body Mass Index (BMI) scale

Obesity can be measured in different ways, but the most common is the Body Mass Index (BMI) scale, which is calculated based on a persons height and weight.

BMI is defined as their weight in kilograms divided by the square of their height in meters (kg/m²).¹

BMI values are used to define whether an individual is considered to be underweight, healthy, overweight, or obese.

In adults, the WHO defines these categories using the cut-off points: an individual with a BMI between 25 and 30 is considered "overweight", while a BMI greater than 30 is defined as "obese".² However, different cut-off points are used for other groups, such as children and pregnant women.

Read more in our article:

What is obesity and how is it measured?

Obesity is a leading risk factor for poor health outcomes. How is obesity defined and measured?

Obesity is one of the leading risk factors for early death

Obesity is responsible for millions of premature deaths each year

Obesity is one of the world's largest health problems one that has shifted from being a problem in rich countries to a health challenge around the world.

The Global Burden of Disease is a major global study on the causes and risk factors for death and disease.³ The authors of the study have estimated the annual number of deaths attributed to a wide range of risk factors, as you can see below.

Obesity defined as having a high body mass index is a risk factor for several of the world's leading causes of death, including heart disease, stroke, diabetes, and various types of cancer.⁴

As you can see, its estimated that around 5 million people died prematurely in 2019 as a result of obesity, which makes it one of the leading causes of death worldwide.

Read more in our article:

How do researchers estimate the death toll caused by each risk factor, whether its smoking, obesity, or air pollution?

Risk factors are important to understand because they can help us identify how to save lives. How do researchers estimate their impact?

The global distribution of health impacts from obesity

What share of global deaths are the result of obesity?

Globally, its estimated that almost 10% in 2019 resulted from the consequences of obesity this was almost double the share in 1990.

This share varies significantly across the world. In the map here we see the share of deaths attributed to obesity across countries.

Across many middle-income countries such as in Eastern Europe, Central Asia, North Africa, and Latin America more than 15% of deaths were attributed to obesity in 2019.

This results from both a high prevalence of obesity, as well as poorer overall health and healthcare systems compared to high-income countries with similarly high levels of obesity.

In 2019, in most high-income countries, the share of deaths attributed to obesity was in the range of 8 to 10%. In many middle-income countries, this share was almost twice as high.

In contrast, across several low-income countries especially across Sub-Saharan Africa its estimated that obesity accounts for under 5% of deaths.

There is a large difference in death rates from obesity across the world

Death rates from obesity can also help us understand differences in the impact of obesity between countries and over time.

In the map here you can see differences in death rates from obesity across the world, per 100,000 people in the population.

Death rates tend to be higher in Eastern Europe, Central Asia, North Africa, and Latin America.

In contrast, they tend to be much lower in Western Europe, Australia, and East Asia.

When we look at the relationship between death rates and the prevalence of obesity we find a positive one: death rates tend to be higher in countries where more people are obese.

But what we also notice is that for a given prevalence of obesity, death rates can vary by a factor of four. While around a quarter of people in Russia and Norway are obese, death rates in Russia are much higher.

It's not only the prevalence of obesity that plays a role but also other factors such as underlying health, other confounding risk factors (such as alcohol, drugs, smoking, and other lifestyle factors), and healthcare systems.

What share of adults are obese?

Obesity varies widely worldwide and has become more common

In the chart here, we see the share of adults (aged 18 years and older) who are obese across regions. These estimates are based on survey data and statistical modeling by the World Health Organization (WHO).

Overall we see a pattern roughly in line with prosperity: the prevalence of obesity tends to be higher in richer countries across Europe, North America, and Oceania. Obesity rates tend to be much lower across South Asia and Sub-Saharan Africa.

More than a third of adults in the United States were obese in 2016. In countries such as India and Nigeria, that share was far lower.

The chart also shows the share of adults who are obese has grown over time.

Obesity in men vs. women

See the data in our interactive visualization

What share of adults are overweight?

Globally, its estimated that around two-fifths of adults were overweight or obese in 2016.⁴

The classification of "overweight" is also defined based on the body-mass index it refers to BMI values between 25 and 30.

In the map here we see the share of adults who are overweight or obese across countries.

As you can see, the share of people who are overweight tends to be higher in richer countries and lower in poorer countries.

In many high-income countries such as the United States, its estimated that over 60% of adults are overweight or obese.

In contrast, across South Asia and Sub-Saharan Africa, its estimated that around one in five adults are overweight or obese.

Share of women who are overweight or obese

See the data in our interactive visualization

Body Mass Index (BMI)

Mean BMI in adult women

In the map, here we see the distribution of average (mean) BMI in adult women across the world.

In 2016, the global average (mean) BMI in women was around 25, which is the cut-off for overweight. The average BMI tends to be higher in North and South America and North Africa, and lower in sub-Saharan Africa and Asia.

Mean BMI in adult men

In the map here we see the distribution of mean BMI for adult men across the world.

In 2016, the global average (mean) BMI in men was estimated to be around 25, which is the cut-off for overweight. The average BMI tends to be higher in North and South America and North Africa, and lower in sub-Saharan Africa and Asia.

Childhood obesity

Share of children that are overweight

Obesity and overweight in children are also measured based on body mass index (BMI).

However, BMI scores are interpreted differently for children and adolescents.

Weight categories are defined by comparing weight to the WHO Growth Standards a child is defined as overweight if their weight-for-height is more than two standard deviations from the median of the WHO Child Growth Standards.⁴

What are the drivers of obesity?

At a basic level, weight gain eventually leading to being overweight or obesity is determined by a balance of energy.⁵

When we consume more energy typically measured in calories than the energy expended to maintain life and carry out daily activities, we gain weight. This is called an energy surplus. When we consume less energy than we expend, we lose weight this is an energy deficit.

This means there are two potential drivers of the increase in obesity rates in recent decades either we eat more (an increase in calorie intake) or we expend less energy in our daily life through lower activity levels. Both elements are likely to play a role in the rise in obesity.

To tackle obesity, interventions that address both energy intake and expenditureare important.⁶

Daily supply of calories

Over the past century but particularly over the past 50 years the supply of calories has increased across the world.

In the 1960s, the global average supply of calories (that is, the availability of calories for people to eat) was around 2,200 kcal per person per day. By 2013, this had increased to 2800kcal.

Across most countries, energy consumption has therefore increased. Without an increase in energy expenditure, weight gain and obesity tend to rise.

In the chart here, we see the relationship between the share of men who are overweight or obese versus the daily average supply of kilocalories per person.

Overall there is a strong positive relationship: countries with higher rates of overweight tend to have a higher supply of calories.

If you press "play" on the interactive timeline you can see how this has changed for each country over time. Countries tend to move upwards and to the right: the supply of calories has increased as obesity rates have increased.

Is BMI an appropriate measure of weight-related health?

The merits of using BMI as an indicator of body fat and obesity are contested.

A key contention to the use of BMI indicators is that it is a measure of body mass/weight rather than providing a direct measure of body fat.

Whilst physicians continue to use BMI as a general indicator of weight-related health risks, there are some cases where its use should be considered more carefully, which are listed below, and physicians are recommended to evaluate BMI results carefully on an individual basis.⁷

• Muscle mass can increase body weight; this means athletes or individuals with a high muscle mass percentage can be deemed overweight on the BMI scale, even if they have a low or healthy body fat percentage;
• Muscle and bone density tends to decline as we get older; this means that an older individual may have a higher percentage body fat than a younger individual with the same BMI;
• Women tend to have a higher body fat percentage than men for a given BMI.

Read more in our article:

What is obesity and how is it measured?

Obesity is a leading risk factor for poor health outcomes. How is obesity defined and measured?

Interactive charts on Obesity

Hannah Ritchie and Max Roser (2017) - Obesity Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/obesity' [Online Resource]

@article{owid-obesity,    author = {Hannah Ritchie and Max Roser},    title = {Obesity},    journal = {Our World in Data},    year = {2017},    note = {https://ourworldindata.org/obesity}}

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