In 2020, the prevalence of overweight children under 5 in the ECA region was 7.1 percent, roughly 25 percent higher than the world average of 5.7 percent. There was a sharp increase in ECA region from 2000 to 2005, a steadying from 2005 and 2010, and a significant decrease during the last decade (Figure 11), from 10.4 percent in 2010 to 7.1 percent in 2020. Despite the decrease, the prevalence remains higher than the 2030 target of reducing childhood overweight to less than 3 percent and maintaining it at that level.
In 2020, only Central Asia and the EU27 and the United Kingdom were slightly below the world average. In the Western Balkans, the prevalence (11.8 percent) was more than double the world average. The Caucasus, at 9.3 percent, also had a high prevalence of overweight among children under 5 in 2020.
Accessing weight status during infancy and childhood is important due to the effects that thinness, overweight and obesity can have on child development, health and well-being (Kumar and Kelly, 2017). In 2007, the WHO Regional Office for Europe established the WHO European Childhood Obesity Surveillance Initiative (COSI) to measure the prevalence of childhood overweight and obesity throughout the region. COSI data collection is conducted every three years, and the fourth round (2015–2017) included 36 countries in Europe and Central Asia.
The results of overweight for children among boys and girls aged 6–9, by subregion and country, are presented in Figure 12.
Overweight is more common and severe among children aged 6–9 in the ECA region than among children under 5. On average, in 2015–2017, the prevalence of overweight for children aged 6–9 was 28.7 percent among boys and 26.5 percent among girls based on the pooled estimates (compared with 7.1 percent for children under 5).
The higher percentages were observed in Southern Europe, followed by Eastern Europe, Western Europe, and Northern Europe, whereas the observed prevalences in Central Asian countries were much lower. By country, the highest levels of overweight were observed in Cyprus (43.0 percent for boys and 43.1 percent for girls) and other European Union countries in Southern Europe, such as Spain (42.2 percent for boys and 40.2 percent for girls), Italy (41.9 percent for boys and 38.5 percent for girls) and Greece (42.0 percent for boys and 37.8 percent for girls) and countries in the Western Balkans (including Montenegro, North Macedonia and Serbia). The lower prevalence of overweight was observed in Central Asia (in particular Kyrgyzstan and Tajikistan).
In the ECA region, the prevalence of overweight differed between boys and girls, and boys were more likely to be overweight than girls (boys at 28.7 percent vs girls at 26.5 percent). This gender difference in overweight was widespread across all subregions. In Eastern Europe, 29.7 percent of boys were overweight, 3.2 percentage points higher than girls (26.5 percent). By country, boys had a higher prevalence of overweight than girls in 30 of the 36 countries with data available. The countries with boys having much higher prevalence of overweight included Croatia (8.6 percentage points), Montenegro (8.6 percentage points) and Austria (8.0 percentage points). The countries in which girls had a higher prevalence of overweight than did boys included Portugal (3.4 percentage points higher), Denmark (2.5 percentage points higher) and Kazakhstan (2.3 percentage points higher).