It is an undeniable fact that the obesity epidemic sweeping Europe heeds immediate action to rectify this dire situation. While action in the field of public health is a shared competence between the European Union (EU) and Member States, this may soon change. The effects of the Covid-19 pandemic have amplified calls for increased EU competence in the field to better cross-border cooperation in tackling major epidemics, such as the obesity epidemic. It is also unknown how lockdowns and the closing of schools will impact , essentially cutting off access to the physical activity and healthy meals provided to European children in schools through programs such as the in the Netherlands. The effects of obesity on children are far-ranging. Many psychologically damaging effects can be found in children suffering from obesity, such as bullying based on weight or the development of eating disorders, coupled with increased risks of many serious physical conditions, such as cardiovascular disease, stroke and adulthood obesity. Obesity also increases the risk of serious health implications in Covid-19 patients: a major cause for alarm.
The EU has made many attempts in the past to curb these alarming childhood obesity trends witnessed across Europe. The most recent efforts include the EU Action Plan on Childhood Obesity, which aimed to tackle childhood obesity in 4 main areas: supporting a healthy start in life, promoting healthier school environments, restricting marketing to children and informing and empowering families to make healthier choices. Although this Action Plan resulted in a decrease in childhood obesity rates across Europe, the term of the 6-year plan has come to an end in 2020. Action must now be taken to decide a new direction for the EU in tackling childhood obesity, building upon the success of the policy of the past and ensuring that Europe does not meet the World Health Organisation’s dire prediction of 30% obesity in Europe by the end of 2020.
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In a world where obesity alone kills 4.72 million people a year, the alarming trends of childhood obesity witnessed across European countries is one in which action must immediately be taken to save these children from the perilous fate that lies ahead of them. Where 1 in 5 children globally is overweight, many European countries alarmingly exceed this worldwide average. In Cyprus and Italy, 21% of boys aged 6-9 are obese, while 19% of Cypriot girls in the same age bracket suffer from obesity. In comparison, the Netherlands reports only a 2.9% obesity rate across children aged 4-12. While many factors affect such rates of childhood obesity, gender and play a pivotal role in the availability of healthier foods and resources to combat this obesity epidemic.
The effects of childhood obesity are far-ranging; with many obese children suffering from mental traumas, such as bullying based on weight, alongside the many damaging effects obesity has on physical health at such a pivotal developmental stage of a child’s life. Obese children are more likely to go on to suffer adolescent and adult obesity, with increased risk of cardiovascular disease. Obesity is the 5th greatest cause of premature death globally, action must be taken to end this preventable premature death sentence given to the millions of overweight European children.
The Member States adopt health policies proposed by the EU into law. As public health is a shared competence with the EU, Member States may also draft their own legislation in areas that the EU legislation does not cover. It is the individual responsibility of Member States governments to enforce , “To ensure healthy lives and promote well-being for all at all ages “, as set out by the United Nations.
The World Health Organisation is a specialised agency of the and states its main objective as “the attainment by all peoples of the highest level of health”. It is composed of representatives of 194 states, who meet to direct and coordinate international health within the United Nations system. In response to growing levels of childhood obesity worldwide, the WHO has convened the WHO Commission on Ending Childhood Obesity and condemned the increasing trends in the Decade of Action on Nutrition.
The European Public Health Association is a non-governmental organisation, composed of over 14,000 medical professionals from across Europe, for the purpose of professional exchange of best practices and collaborative research in the field of public health.
In 2007, the European Commission’s Strategy on Nutrition, Overweight and Obesity-related health issues was adopted and was the first to tackle the obesity epidemic across Europe. While the strategy aimed to tackle obesity across all age brackets, many of its policies addressed the growing issues of childhood obesity, such as the School Fruit, Vegetable & Milk Schemes, which currently allocates €250 million a year to the scheme across Member States.
The EU 2020 Action Plan on Childhood Obesity was proposed in February 2014 by the European Commission, outlining a 6-year plan to tackle childhood obesity across Europe. Building on the work of its predecessor, The EU Nutrition, Overweight and Obesity Strategy, the Action Plan highlighted the need for swift action to stop the alarming trend of childhood obesity across Europe.
The plan addresses the need for greater assistance in providing healthy school meals for children from disadvantaged socio-economic backgrounds, restriction of marketing and advertising of unhealthy foods to young people and the need for further promotion of physical activity to European children.
At a national level, due to the nature of the shared competence between the EU and its Member States, there are many unique solutions to the issue implemented by each Member States. In the Netherlands, the Jong Leren Eten Program of the Dutch Ministry of Agriculture, Nature and Food Quality aims to support schools in the implementation of student education on healthy lifestyles. In the United Kingdom, a ‘Sugar Tax’ has been introduced in an attempt to curb childhood addiction to artificially sweetened beverages and other foods.
The Covid-19 pandemic has been declared a “wake-up call” for European policymakers in the field of public health. The EU Commissioner for Health has called for greater power to be appointed to EU health agencies in order to better their responses to cross-border health emergencies. This proposed shift from the EU and Member States past shared competence in the field of public health will not only affect the EU’s approach to the Covid-19 pandemic but to the obesity epidemic sweeping Europe. While the EU’s obesity rates increased from 11% in 2000 to 16% in 2016, the WHO currently estimates for up to 30% obesity rates across the continent in 2020.
While the effects of adult and adolescent obesity on physical health range in severity, with increased risks of developing Type 2 diabetes, cardiovascular disease, high blood pressure and stroke, many psychological effects are found in children suffering from obesity. Not only do children experiencing obesity at a young age have increased risks of developing adulthood obesity, but obese children are also more likely to experience bullying based on weight, depression and eating disorders. For these reasons, it is vital that the EU takes action to prevent these alarming trends from worsening.
In November 1989, the United Nations voted to ratify the Convention on the Rights of the Child (CRC): an international human rights treaty focussing on the 20 rights of a child. According to Article 24 of the United Nations Convention on the Rights of the Child, all children have the right to the best health care possible, along with healthy food. Article 27 of the CRC also states that children should have the right to food in order to develop in the best possible way, and if this is not attainable, the government should assist in its provision. When parents and guardians do not meet the needs of their children, in particular failing to provide adequate nutritious foods that combat childhood obesity, they are in breach of these Articles.
The stark disparities between obesity levels among children from a lower-income background versus a higher show a huge inequality in access to a healthy lifestyle in the EU, and that this is not always a choice. With the cost of food prices rising at a rapid rate, it is evident that the availability of healthier choices for children relies on their socioeconomic backgrounds. While Italy and Cyprus both show the highest average of 21% obesity in children aged 6-9, these countries also rank 17th and 18th respectively based on equitable response in the EU. To ensure childhood obesity is successfully combated, factors like gender, socioeconomic background and location should be taken into consideration to ensure an to this epidemic.
The success of previous EU legislation to tackle the childhood obesity epidemic is debatable. While the final evaluation of the EU Action Plan on Childhood Obesity 2014-2020 is scheduled to take place after the close of its period of action in 2021, its mid-term evaluation was performed in 2018. The Health Programme of the EU found that Area 2 (Promotion of Healthier Lifestyles in Pre-schools and Schools) was the most successful element of the Action Plan, while Area 4 (Restrict Marketing and Advertising to Children) was most unsuccessful. The success or failure of each policy element was measured using changes in obesity rates over the period of the Plan and the changes in legislation it had caused in the respective Member States. During the 4 year period of the Action Plan’s implementation, rates of childhood obesity decreased across the EU. Where 1 in 3 children aged between 6-9 years suffered from obesity in 2015, currently 1 in 10 7-8-year-olds suffer from obesity in 2020 in the EU.
The EU Action Plan on Childhood Obesity 2014-2020 has now reached the end of its time of action and so new measures must be put in place as Europe enters 2021, into a year where the effects of Covid-19 and extended lockdowns on children’s health is unknown. The Covid-19 pandemic has had detrimental effects on the availability of many health educational services and the availability of healthy school lunches to children in schools forced to close during the pandemic. Furthermore, according to the World Health Organisation, Covid-19 patients with obesity have significantly increased chances of severe outcomes, and long-term symptoms. Action is needed on a pan-European level to ensure that the effects of this pandemic will not further escalate Europe’s alarming childhood obesity trends.
World Health Organisation European Childhood Obesity Surveillance Initiative (7 minutes)