• Overview
  • Obesity prevalence
  • Trends over time
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
  • Actions
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Obesity prevalence

Adults, 2017

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2014

Survey type:Self-reported
Age:18+
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2014-2015

Survey type:Measured
Age:25-64
Sample size:3966
Area covered:National
References:Aranceta-Bartrina, J. et al. (2016) 'Prevalence of General Obesity and Abdominal Obesity in the Spanish Adult Population (Aged 25-64 Years) 2014-2015: The ENPE Study', Rev Esp Cardiol (Engl Ed), 69(6), pp. 579-87. doi: 10.1016/j.rec.2016.02.009. Epub 2016 Apr 26
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2008-2010

Survey type:Measured
Age:18+
Sample size:12036
Area covered:National
References:Gutierrez-Fisac JL, Guallar-Castillion P, Leon-Munoz LM, Graciani A, Banegas JR & Rodriguez-Artalejo F. Prevalence of general and abdominal obesity in the adult population of Spain, 2008-2010. Obesity Reviews early online 12th Dec 2011.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2001

Survey type:Measured
Age:20+
Sample size:6569
References:http://www.fnri.dost.gov.ph/files/fnri%20files/nns/factsandfigures2003/anthropometric.pdf last accessed June 14th 2011
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1990-2001

Survey type:Measured
Age:20+
Sample size:20589
Area covered:Regional
References:Serra Majem L, Ribas Barba L, Aranceta-Bartrina J, Pérez Rodrigo C, Saavedra Santana P, Peña Quintana L. Obesidad infantil y juvenil en España. Resultados del estudio enKid (1998-2000). Med Clin (Barc). 2003, 121 (19): 725-732. Aranceta-Bartrina J, Serra-Majem L, Foz-sala M, Moreno-Esteban B; Grupo Colaborativo SEEDO. Prevalencia de obesidad en España. Med Clin (Barc). 2005, 125 (12): 460-6. Gutierrez-Fisac JL, López E, Banegas JR, Graciani A, Rodríguez-Artalejo F (2004). Prevalence of overweight and obesity in elderly people in Spain. Obes Res; 12 (4): 710-715.
Notes:Pooled analysis of random regional population samples: 1998 - 2000 1990 - 2000 2001
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
References:Aranceta J, Perex Rodrigo C, Serra Majem LI et al. Prevalence od Obesity in Spain: SEEDO'97 study. Spanish Collaborative Group for the Study of Obesity. Med Clin (Barc). 1998;117:441-5
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2015-2016

Survey type:Measured
Age:6-9
Sample size:10,899
Area covered:National
References:Available from: http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/observatorio/Estudio_ALADINO_2015.pdf (accesed 9th April 2019) [Article in Spanish].
Notes:IOTF cut-offs used.
Cutoffs:IOTF

Children, 2012

Survey type:Measured
Age:8-17
Sample size:978
Area covered:National
References:Sánchez-Cruz JJ, Jiménez-Moleón JJ, Fernández-Quesada F, Sánchez MJ. Prevalence of Child and Youth Obesity in Spain in 2012.Rev Esp Cardiol. 2013 Jan 31. pii: S0300-8932(12)00640-9. doi: 10.1016/j.recesp.2012.10.016. [Epub ahead of print] In English & Spanish
Notes:International IOTF cut off points
Cutoffs:IOTF

Children, 2010

Survey type:Measured
Age:10-12
Sample size:1008
Area covered:Regional
References:Brug J, van Stralen MM, te Velde SJ, Chinapaw MJM, De Bourdeaudhuij I, et al. (2012) Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project. PLoS ONE 7(4): e34742. doi:10.1371/journal.pone.0034742
Notes:IOTF International Cut Off
Cutoffs:IOTF

Children, 2009-2013

Survey type:Measured
Age:7-8
Sample size:7747
Area covered:National
References:Spinelli et al (2019). 'Childhood Severe Obesity in Europe', Obes Facts.12, pp. 244–258. (Data from COSI round 1-3)
Notes:NOTE - this data is from COSI round II and III (2009- 2013) IOTF cut-offs used.
Cutoffs:IOTF

Children, 2000-2002

Survey type:Measured
Age:13-14
Area covered:National
References:Personal communication from LA Moreno
Notes:Large National Survey but sample size not specified IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3
Cutoffs:IOTF

Children, 1998-2000

Survey type:Measured
Age:5-17
Sample size:2057
Area covered:National
References:Serra Majem L, Ribas Barba L, Aranceta Bartrina J, Pérez Rodrigo C, Saavedra Santana P, Peña Quintana L. (2003). Obesidad infantil y juvenil en España. Resultados del estudio enKid (1998-2000). Medicina Clinica (Barc). 121 (19): 725 - 732
Notes:IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3.
Cutoffs:IOTF

Children, 1995-1996

Survey type:Measured
Age:13-14
Area covered:National
References:Personal communication from LA Moreno
Notes:Large National Survey but sample size not specified Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3
Cutoffs:IOTF

Children, 1985-1986

Survey type:Measured
Age:13-14
Area covered:National
References:Personal communication from LA Moreno
Notes:Large National Survey but sample size not specified IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3
Cutoffs:IOTF

Overweight/obesity by age and education

Men, 2017

Survey type:Self-reported
Area covered:National
References:EUROSTAT Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2017

Survey type:Self-reported
Area covered:National
References:EUROSTAT Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by education

Men, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample size in EU = 35100 (Age 18+)
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 9 November 2016)
Notes:Less than primary, primary and lower secondary education (levels 0-2) Upper secondary and post-secondary non-tertiary education (levels 3 and 4) Tertiary education (levels 5-8) Translated graphics for obesity by educational level are also available for 2011-12 & 1990-94 (on request).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample size in EU = 35100 (Age 18+)
Area covered:National
References:Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 9 November 2016)
Notes:Less than primary, primary and lower secondary education (levels 0-2) Upper secondary and post-secondary non-tertiary education (levels 3 and 4) Tertiary education (levels 5-8) Translated graphics for obesity by educational level are also available for 2011-12 & 1990-94 (on request).
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2011-2012

Survey type:Self-reported
Age:25-64
Sample size:34784
Area covered:National
References:National Health Survey Spain. Ministry of Health. Social Services and Equality and INE. http://www.ine.es (last accessed 20.5.15)
Notes:Education definitions: 1. Cannot read or write, or incomplete primary education 2. Complete primary education 3. Secondary education, 1st stage 4. Secondary education, 2nd stage 5. Advanced professional training or the equivalent 6. University education
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2011-2012

Survey type:Self-reported
Age:25-64
Sample size:34784
Area covered:National
References:National Health Survey Spain. Ministry of Health. Social Services and Equality and INE. http://www.ine.es (last accessed 20.5.15)
Notes:Education definitions: 1. Cannot read or write, or incomplete primary education 2. Complete primary education 3. Secondary education, 1st stage 4. Secondary education, 2nd stage 5. Advanced professional training or the equivalent 6. University education
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:Definitions are: levels 0-2 = pre-primary, primary and lower secondary education levels 3-4 = upper secondary and post-secondary non-tertiary education levels 5-6 = first and second stage of tertiary education
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:Definitions are: levels 0-2 = pre-primary, primary and lower secondary education levels 3-4 = upper secondary and post-secondary non-tertiary education levels 5-6 = first and second stage of tertiary education
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435. http://www.nature.com/ejcn/journal/v55/n6/pdf/1601189a.pdf (last accessed 29.4.15)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435. http://www.nature.com/ejcn/journal/v55/n6/pdf/1601189a.pdf (last accessed 29.4.15)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2012

Survey type:Measured
Age:8-17
Sample size:978
Area covered:National
References:Sánchez-Cruz J-J, et al. Prevalencia de obesidad infantil y juvenil en España en 2012. Rev Esp Cardiol. 2013. http://dx.doi.org/10.1016/j.recesp.2012.10.016 (last accessed 20.5.15)
Notes:Prevalence of overweight and obesity of children based on educational level of person responsible for diet.
Cutoffs:Other

Children, 2010

Survey type:Measured
Age:10-12
Sample size:1008
Area covered:National
References:Brug J, van Stralen MM, te Velde SJ et al. Differences in Weight Status and Energy-Balance Related Behaviors among Schoolchildren across Europe: The ENERGY-Project. PLoS ONE 2012;7 (4) e34742
Cutoffs:IOTF

Overweight/obesity by age

Adults, 2017

Survey type:Self-reported
Area covered:National
References:EUROSTAT Database http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=ilc_hch10&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Adults, 2008-2010

Survey type:Measured
Sample size:12036
Area covered:National
References:Gutiérrez-Fisac, J. L., Guallar-Castillón, P., León-Muñoz, L. M., Graciani, A., Banegas, J. R. and Rodríguez-Artalejo, F. (2012). Prevalence of general and abdominal obesity in the adult population of Spain, 2008–2010: the ENRICA study. Obesity Reviews; 13: 388–392. doi: 10.1111/j.1467-789X.2011.00964.x
Notes:Data on waist circumference and prevalence of abdominal obesity also available.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2015-2016

Survey type:Measured
Sample size:10,899
Area covered:National
References:Available from: http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/observatorio/Estudio_ALADINO_2015.pdf (accesed 9th April 2019) [Article in Spanish].
Notes:IOTF cut-offs used. Translated graphics for data by age category are also available from 2011-12 and 2010-11 (on request).
Cutoffs:IOTF

Children, 2012

Survey type:Measured
Sample size:978
Area covered:National
References:Sánchez-Cruz J-J, et al. Prevalencia de obesidad infantil y juvenil en España en 2012. Rev Esp Cardiol. 2013. http://dx.doi.org/10.1016/j.recesp.2012.10.16 (last accessed 20.5.15)
Cutoffs:IOTF

Children, 2012-2013

Survey type:Measured
Sample size:7yrs 1820 8yrs 1606 Both genders
Area covered:National
References:WORLD HEALTH ORGANIZATION. (2018). WHO European Childhood Obesity Surveillance Initiative: overweight and obesity among 6–9-year-old children. Available: http://www.euro.who.int/__data/assets/pdf_file/0010/378865/COSI-3.pdf?ua=1. Last accessed [Accessed 28th Aug 2018].
Notes:WHO cut-offs used.
Cutoffs:WHO

Children, 2011-2012

Survey type:Self-reported
Sample size:6051
Area covered:National
References:National Health Survey: http://www.ine.es/jaxi/tabla.do (last accessed 20.5.15)
Notes:Self Report
Cutoffs:IOTF

Children, 2010-2011

Survey type:Measured
Sample size:7659
Area covered:National
References:Pérez-Farinós N, López-Sobaler AM, Dal Re MÁ, Villar C, Labrado E, Robledo T, Ortega RM. The ALADINO study: a national study of prevalence of overweight and obesity in Spanish children in 2011. Biomed Res Int. 2013;2013:163687. doi: 10.1155/2013/163687. Epub 2013 Sep 8
Cutoffs:IOTF

Overweight/obesity by region

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Obesity defined as BMI => 30 kg/m2
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Obesity defined as BMI => 30 kg/m2
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Data is age-adjusted prevalence. Obesity defined as BMI => 30 kg/m2 Note that odds ratio for obesity by socio-demographic factors also available.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions: Catalunya, Basque Country, Madrid and Valenci
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Notes:Data is age-adjusted prevalence. Obesity defined as BMI => 30 kg/m2 Note that odds ratio for obesity by socio-demographic factors also available.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by age and region

Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1u&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1u&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by age and socio-economic group

Adults, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2014

Survey type:Self-reported
Area covered:National
References:Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20)
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Overweight/obesity by socio-economic group

Men, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample number in EU: 35100 (Age 18+)
Area covered:National
References:EUROSTAT Database: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 9 November 2016)
Notes:1st Quintile (lowest income), 5th Quintile (highest income) Please note where data = zero, there were insufficient data.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2014

Survey type:Self-reported
Age:18+
Sample size:Total sample number in EU: 35100 (Age 18+)
Area covered:National
References:EUROSTAT Database: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 9 November 2016)
Notes:1st Quintile (lowest income), 5th Quintile (highest income) Please note where data = zero, there were insufficient data.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2011-2012

Survey type:Self-reported
Age:18+
Sample size:34784
Area covered:National
References:National Health Survey: http://www.ine.es/jaxi/tabla.do (last accessed 20.5.15)
Notes:Definitions: I. Directors and managers of establishments with 10 or more wage earners and professionals traditionally associated with university degrees II. Directors and managers of establishments with 10 or more wage earners, professionals traditionally associated with university degrees and other technical support professionals III. Intermediate occupations and self-employed workers IV. Supervisors and workers in skilled technical occupations V. Skilled primary sector workers and other semi-skilled workers VI. Non-skilled workers
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2011-2012

Survey type:Self-reported
Age:18+
Sample size:34784
Area covered:National
References:National Health Survey: http://www.ine.es/jaxi/tabla.do (last accessed 20.5.15)
Notes:Definitions: I. Directors and managers of establishments with 10 or more wage earners and professionals traditionally associated with university degrees II. Directors and managers of establishments with 10 or more wage earners, professionals traditionally associated with university degrees and other technical support professionals III. Intermediate occupations and self-employed workers IV. Supervisors and workers in skilled technical occupations V. Skilled primary sector workers and other semi-skilled workers VI. Non-skilled workers
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:SES assessed by annual income.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 2008

Survey type:Self-reported
Age:18+
Area covered:National
References:EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015)
Notes:SES assessed by annual income.
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Men, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Women, 1990-1994

Survey type:Measured
Age:25-60
Sample size:5388
Area covered:Four Spanish regions (Catalunya, Basque Country, Madrid and Valencia)
References:Aranceta J, Perez Rodrigo C, Serra Majem L et al. Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO '97 Study. European Journal of Clinical Nutrition (2001); 55: 430-435
Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m².

Children, 2012

Survey type:Measured
Age:8-17
Sample size:978
Area covered:National
References:Sánchez-Cruz J-J, et al. Prevalencia de obesidad infantil y juvenil en España en 2012. Rev Esp Cardiol. 2013. http://dx.doi.org/10.1016/j.recesp.2012.10.016 (last accessed 20.5.15)
Cutoffs:IOTF

Children, 2007-2008

Survey type:Measured
Age:2-9
Sample size:1824
Area covered:National
References:Ahrens W, Pigeot I, Pohlabeln H et al. Prevalence of overweight and obesity in European children below the age of 10. IJO 2014;38:S99-S107
Notes:Lowest income groups sample size too small so excluded
Cutoffs:IOTF

Insufficient physical activity

Adults, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Men, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Women, 2016

References:Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7

Children, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Boys, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Girls, 2010

Age:11-17
References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en
Notes:% of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily.
Definitions:% Adolescents insufficiently active (age standardised estimate)

Sugar consumption

Adults, 2016

References:Source: Euromonitor International
Definitions:Sugar consumption (Number of 500g sugar portions/person/month)

Estimated per-capita sugar sweetened beverages intake

Adults, 2016

References:Source: Euromonitor International

Prevalence of at least daily carbonated soft drink consumption

Children, 2014

Survey type:Measured
References:World Health Organization. (2017). Adolescent obesity and related behaviours: Trends and inequalities in the who european region, 2002-2014: observations from the Health Behavior in School-aged Children (HBSC) WHO collaborative cross-national study (J. Inchley, D. Currie, J. Jewel, J. Breda, & V. Barnekow, Eds.). World Health Organization. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org
Notes:15-year-old adolescents
Definitions:Prevalence of at least daily carbonated soft drink consumption (% of at least daily carbonated soft drink consumption)

Prevalence of confectionery consumption

Adults, 2016

References:Source: Euromonitor International
Definitions:Prevalence of confectionery consumption (Number of 50g confectionery portions/person/month)

Prevalence of sweet/savoury snack consumption

Adults, 2016

References:Source: Euromonitor International
Definitions:Prevalence of sweet/savoury snack consumption (Number of 35g sweet/savoury snack portions/person/month)

Estimated per-capita fruit intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita fruit intake (g/day)

Prevalence of less-than-daily fruit consumption

Children, 2014

Survey type:Measured
References:Global School-based Student Health Surveys. Beal et al (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily fruit consumption (% less-than-daily fruit consumption)

Prevalence of less-than-daily vegetable consumption

Children, 2014

Survey type:Measured
Age:12-17
References:Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287 sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system
Definitions:Prevalence of less-than-daily vegetable consumption (% less-than-daily vegetable consumption)

Estimated per-capita processed meat intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita processed meat intake (g per day)

Estimated per-capita whole grains intake

Adults, 2017

Survey type:Measured
Age:25+
References:Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/
Definitions:Estimated per-capita whole grains intake (g/day)

Mental health - depression disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with depression disorders

Mental health - anxiety disorders

Adults, 2015

References:Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.
Definitions:% of population with anxiety disorders

Oesophageal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000

Breast cancer

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000

Colorectal cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000

Pancreatic cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000

Gallbladder cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000

Kidney cancer

Men, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000

Cancer of the uterus

Women, 2018

Age:20+
References:Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020)
Definitions:Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000

Raised blood pressure

Adults, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Men, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Women, 2015

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en
Definitions:Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90).

Raised cholesterol

Adults, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Men, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Women, 2008

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885
Definitions:% Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate).

Raised fasting blood glucose

Men, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Women, 2014

References:Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en
Definitions:Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication).

Diabetes prevalence

Adults, 2017

References:Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org
Definitions:Diabetes age-adjusted comparative prevalence (%).

Health systems

Economic classification: High Income

Health systems summary

Spain has a universal healthcare system that is consistently ranked among the best in the world. The national system (Sistema Nacional de Salud) is primary funded by taxation and is mostly free at point of service. In addition to the national health service, there are other statutory provisions for civil servants, the armed forces and the judiciary. Public sector workers, for example, are eligible to opt out of the public system if they sign up to the government-subsidised health insurance called MUFACE. Despite the comprehensive health coverage in Spain, out of pocket (OOP) payments make up 23.9% of total health expenditure (greater than the European Union average). Most OOP payments are for pharmaceuticals and medical devices.

Spain has the highest life expectancy in the European Union and has relatively low mortality rates from preventable and treatable causes. Obesity, however, has been increasing in recent years.

Indicators

Where is the country’s government in the journey towards defining ‘Obesity as a disease’?Some progress
Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’?Some progress
In practice, how is obesity treatment largely funded?Not known
Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity?Yes
Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity?Yes
Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas?No
Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas?No
Are there any obesity-specific recommendations or guidelines published for adults?Yes
Are there any obesity-specific recommendations or guidelines published for children?Partial

Perceived barriers to treatment

  • Lack of political will, interest and action
  • Economic crisis
  • Stigma
  • Poor health literacy and behaviour
  • Cultural norms and traditions

Summary of stakeholder feedback

While seemingly not yet considered to be a disease by the government and healthcare providers, Spain has several prevention policies in place related to obesity. These include school-level interventions around physical activity and diet, and a sugar tax in the Catalonia region. Stakeholders and patients felt that obesity could be better prevented by the provision of cheaper fruit and vegetables, perhaps through subsidies.

Overall, the health system is generally not thought to be working in terms of obesity treatment. Having said that, one stakeholder felt that primary care centres were becoming better at addressing obesity, with several new and effective programmes being implemented. Generally, though, it appears that a high BMI is required before treatment if offered, and even then, there are long waiting lists. Long waiting lists are said to be one of the reasons individuals leave the health system without treatment.

There are insufficient numbers of obesity professionals in both urban and rural areas but in rural areas, there is said to be no possibility of receiving specialised treatment. There is no specialised obesity training available, except for training for bariatric surgeons.

Based on interviews/survey returns from 3 stakeholders

Last updated: June 2020

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