Childhood obesity in Spain: cases double among girls and hit poorer families hardest

Childhood obesity in Spain has become one of the most worrying public health trends of the 21st century. New data show that, while overall figures have crept up, the situation has deteriorated sharply for girls and for children from low‑income families, with obesity and abdominal fat rising much faster in these groups than in the rest of the population.

Obesity in girls and adolescents has doubled since 2000

A new analysis led by the Gasol Foundation and published in the journal Obesity Facts compares two large national studies carried out at the turn of the century (enKid 1998‑2000) and almost twenty years later (PASOS 2019‑2020). In total, data from nearly 5,000 children and adolescents aged 8 to 16 have been examined to see how their weight and body fat have evolved over time.

For the child and adolescent population as a whole, obesity measured by body mass index (BMI) has increased from 10.4% to 12.4% in the first two decades of the century, a modest but worrying rise. The real shock comes when looking at girls specifically: in girls and female adolescents the prevalence of obesity has doubled, from 5.1% to 10%. Among boys, by contrast, the prevalence has remained broadly stable over the same period.

These figures echo broader estimates from the Ministry of Health, which indicate that around one in three minors aged 2 to 17 in Spain has excess weight and roughly one in ten is already living with obesity. Taken together, they confirm that childhood obesity is no longer a marginal issue but a structural problem affecting hundreds of thousands of children.

Abdominal obesity surges, especially in girls

The study does not stop at BMI. It also looks at abdominal obesity, measured using the ratio between waist circumference and height, an indicator closely linked to cardiometabolic risk. Here, the trend is even more alarming than for overall obesity.

Between 2000 and 2019, the prevalence of abdominal obesity in children and adolescents climbed from 16% to 22.6% in the general sample. Once again, girls are hit hardest: in girls and female adolescents, abdominal obesity has increased from 9.3% to 20%, more than doubling in less than two decades.

According to the researchers, in 2019 more than half a million Spanish children aged 8 to 16 were living with obesity and over one million had abdominal obesity. For the population as a whole, the probability of presenting abdominal obesity was several times higher in 2019 than in 2000, and the increase was even steeper among those from poorer households.

Poverty makes obesity much more likely

One of the clearest messages from the Gasol Foundation’s work is the link between obesity and socioeconomic status. For children and adolescents from low‑income families, the probability of living with obesity in 2019 was significantly higher than in 2000, while for those from more advantaged backgrounds the probability remained essentially unchanged.

The same pattern appears with abdominal obesity. Children from the least well‑off households are far more likely to have excess fat around the waist than their peers in better‑off families. The data suggest that, as the years have passed, inequalities have deepened: not only is childhood obesity more common than before, but it is increasingly concentrated among those who have fewer resources.

These findings align with other national and international studies that consistently show a higher prevalence of childhood obesity in areas with greater poverty, less access to healthy food, fewer safe spaces for physical activity and more exposure to ultra‑processed products and aggressive marketing.

Spain among the countries with the highest childhood obesity rates

The Spanish figures sit within a wider global context in which childhood obesity has exploded. The World Health Organization estimates that, since 1990, obesity has more than doubled among adults and quadrupled among children and adolescents worldwide. Projections suggest that by 2050 around one third of children and adolescents could have overweight or obesity if current trends continue.

Spain is near the top of the European table. Recent Ministry of Health reports indicate that roughly 30% of minors between 2 and 17 years old have excess weight, with about 10% living with obesity and a smaller but significant proportion suffering severe obesity. In some age brackets, Spanish childhood excess‑weight rates are higher than those recorded in countries such as the United Kingdom.

At the same time, adherence to the traditional Mediterranean diet among children and adolescents has weakened over the past two decades, while the consumption of ultra‑processed products has grown. Studies referenced in the press reports note that Spanish minors see multiple adverts for fast food and sugary products every day, and that ultra‑processed foods already represent a substantial share of their total calorie intake.

Why the waistline matters: health risks linked to early obesity

Childhood obesity is not just an aesthetic issue or a problem for later in life. Excess fat in childhood, especially around the abdomen, is strongly linked to early metabolic alterations. These include insulin resistance, impaired glucose metabolism that can lead to type 2 diabetes, abnormal lipid profiles and elevated blood pressure.

Over time, these changes greatly increase the risk of cardiovascular disease, liver problems and other chronic conditions appearing at younger ages than in previous generations. Carrying extra weight in childhood is also associated with musculoskeletal issues, sleep problems, lower quality of life and psychological difficulties such as low self‑esteem and stigma.

For all these reasons, the researchers behind the Spanish studies recommend using waist‑to‑height ratio as a routine indicator alongside BMI when assessing children. Measuring only weight and height can miss important changes in fat distribution that are more closely connected to health risks.

Calls for strong public policies: PENROI and beyond

Faced with this picture, experts are calling for robust public policies that go far beyond individual advice to “eat better and exercise more”. The Gasol Foundation team and other specialists argue that Spain needs to transform the environments in which children grow up, making healthy choices easier, cheaper and more attractive than unhealthy ones.

At national level, the Government has launched the Strategic Plan for the Reduction of Childhood Obesity (PENROI) for 2022‑2030. This plan sets out around 200 measures across different settings, from schools and healthcare to urban planning and marketing regulation, and counts the Gasol Foundation as a strategic partner. Other initiatives include specific programmes in schools and communities to promote physical activity and improve diet quality.

Researchers insist that these strategies will only work if they are properly implemented by regional and local authorities and backed with adequate resources. They also point to examples from other countries, such as restrictions on advertising ultra‑processed foods to children in the United Kingdom, as models Spain could emulate or adapt.

What families can do while policy catches up

While big‑picture policies are debated and rolled out, families still have an important role. Experts recommend prioritising home‑cooked meals based on unprocessed foods, limiting sugary drinks and ultra‑processed snacks, and creating daily routines that include physical activity and sufficient sleep. Reducing screen time, especially around meals and before bed, is another simple but powerful step.

At the same time, the data remind us that many families face economic and environmental barriers that make healthy living difficult. That is why the burden cannot be placed entirely on parents. Tackling childhood obesity in Spain will require a combination of personal choices, community support and sustained political will to ensure that growing up healthy is a realistic option for all children, not just those from better‑off households.