Childhood obesity and overweight remain a major concern across the Region, new WHO report finds

The prevalence of overweight and obesity in countries in the WHO European Region is consistently high, fuelling diabetes, cancer, cardiovascular diseases and other life-threatening noncommunicable diseases (NCDs). At the same time, parents of children living with overweight or obesity tend to underestimate their children's weight status. These are the findings from the new WHO/Europe report based on Round 6 of the WHO European Childhood Obesity Surveillance Initiative (COSI) study, revealing that the obesity epidemic in the WHO European Region shows a tendency towards stability.

COSI provides the most comprehensive picture yet of children's growth, lifestyle and health-related behaviours in the WHO European Region. The Round 6 COSI report is the first one to be fully based on data gathered since the height of COVID-19 pandemic, with measurements from about 470 000 children aged 6-9 years across 37 countries, with additional information on family and health behaviours for over 150 000 children.

A multilevel health threat

Across participating countries, 1 in 4 children (25%) aged 7-9 was living with overweight (including obesity) and 1 in 10 (11%) - with obesity. Boys (13%) were more likely to have obesity than girls (9%), and prevalence varied widely.

In most of the participating countries, more than 1 in 10 children - and in several southern European countries, nearly 1 in 5 - were living with obesity.

The overall trend was largely stable, yet where change occurred, increases were more frequent than decreases.

For the first time, COSI also reported on thinness - a reminder that undernutrition coexists with excess weight in several countries. This double burden of malnutrition highlights persistent inequality between and within countries.

Underestimation in every country

New to COSI Round 6, data on parental perception revealed a major gap in awareness. Overall, nearly two thirds (66%) of children living with overweight were perceived by their parents to be underweight or normal weight. In all countries with data available, more than half of the parents of children living with overweight underestimated their children's weight status.

Fruit, vegetables and online food ordering

According to the COSI report, only 46% of children ate fresh fruit daily and 32% ate vegetables at least once a day. Less than 5% met the WHO recommendation of 5 portions of fruit and vegetables per day.

Unhealthy foods remain widespread: 41% of children eat sweets, 29% drink sugary soft drinks and 16% consume savoury snacks more than 3 times per week.

Dietary behaviours are associated with socioeconomic background: healthier diets are more common among children of parents with higher education, while frequent consumption of sugary or salty snacks is more common in families with lower parental educational levels.

For the first time, COSI explored food ordered online - an increasingly important dietary factor. Across 18 countries surveyed, over half of families rarely or never ordered food online, but up to 39% reported doing so at least once per month, suggesting a trend towards greater reliance on prepared or delivered meals.

Physical activity, screen time and sleep

Fifty-three per cent of children travelled to school actively - walking, cycling, or skating - while 40% used motorized transport. Children from families with lower parental education were more likely to walk or cycle, showing that active travel is partly shaped by socioeconomic circumstances.

Nearly all parents reported that their child played actively or vigorously for at least 1 hour per day, meeting WHO recommendations. Eighty-nine per cent of children slept at least 9 hours per night, but less than half (47%) achieved 10 hours.

The COSI findings confirm that some behaviours have only partly recovered since the peak of the COVID-19 pandemic, with sedentary patterns still elevated in many countries. Overall, 42% of children spent at least 2 hours per day on screens during weekdays and 78% on weekends. Boys tended to spend slightly more time than girls, and screen time was higher among children of parents with lower education.

There is no silver bullet: a call for action

"The COSI Round 6 data suggest that while prevalence may be stabilizing in some countries, childhood overweight and obesity remain alarmingly high and continue to threaten the health of current and future generations," said Dr Kremlin Wickramasinghe, Regional Adviser for Nutrition, Physical Activity and Obesity at WHO/Europe.

"Addressing NCDs remains a priority under the Second WHO European Programme of Work 2026-2030. Strengthening and scaling evidence-based obesity prevention policies is an essential part of this effort and crucial to protecting the health and well-being of children across our Region," said Dr Gundo Weiler, Director for Prevention and Health Promotion at WHO/Europe.

Policy recommendations

WHO-recommended policies to tackle the challenge of obesity include:

• fiscal policies such as taxes on sugary drinks and foods high in sugar, salt and trans fats
• restrictions on marketing of unhealthy foods and beverages, especially those targeting children
• clear food labelling and improved nutritional standards for school meals
• policies promoting physical activity and active transportation.

With continued surveillance, evidence-based policies and sustained implementation of WHO-recommended measures, European countries can halt and reverse the obesity epidemic, ensuring that every child grows up healthy and able to reach their full potential.