Here’s How Greece Is Tackling Its Childhood Obesity Epidemic

The Mediterranean diet is rich in whole foods and healthy fats, including vegetables, fruits, whole grains, nuts, fish, and olive oil. It has numerous health benefits largely centered around heart health, weight management, and cognitive function and is associated with a lower incidence of childhood obesity.

Despite this, Greece now has one of Europe’s highest rates of childhood obesity.

In 2019, the Hellenic Statistical Authority found that 37.5% of children aged 2-14 years were overweight or obese. In 2022, the World Health Organization’s (WHO’s) European Regional Obesity Report ranked Greece among the top positions in Europe for childhood overweight and obesity: third among children younger than 5 years (1 in 8), second among those aged 5-9 years (38.5%), and first among those aged 10-19 years (32%).

So what has gone wrong?

Shifting Diet and Lifestyle

Clinical dietician and nutritionist Eleni Pavlidou, PhD, who specializes in obesity and eating disorders, said that lifestyle and cultural shifts have ultimately led to the “gradual loss of connection with the Mediterranean way of eating.”

Her recent research found that more than 40% of 5188 preschool children had low compliance to the Mediterranean diet, with traditional diets increasingly replaced by ultraprocessed foods. Another recent study found that ultraprocessed foods accounted for 39.8% of the total daily calorie intake of 443 Greek children with an average age of 9 years.

“Children are increasingly consuming snacks high in sugar, saturated fat, and salt….Many families don’t have the time or energy for traditional cooking, and convenience foods are everywhere, and they’re heavily marketed to children,” she told Medscape Medical News. “At the same time, economic pressures have made some families rely on cheaper processed foods that are energy-dense but nutrient-poor.”

This, she said, was coupled with a major cultural shift: fewer shared family meals, less cooking at home, and less emphasis on seasonal, local ingredients.

Greece’s Alternative (Deputy) Minister of Health, Eirini Agapidaki, MSc, agreed.

“The community-centered everyday life that was the main societal model for decades in Greece has altered to a more parallel living model,” she told Medscape Medical News.

“Citizens live in the same building but have never met. Children coexist in the schoolroom but do not share a feeling of belonging to the school community. Healthy nutrition is not just about individual dietary choices but building social relationships.”

Action Against Childhood Obesity

In 2023, the Greek Ministry of Health, in collaboration with the United Nations Children’s Fund (UNICEF), launched a national action plan to reduce the childhood obesity rate to 24.5% by the end of 2025. It aimed to do this by implementing targeted interventions in schools, at health services, and in the wider community, while simultaneously trying to change the environment that leads to obesity.

The initiative has included, among other interventions, integrating nutritional education programs into school curricula, healthy cooking lessons, and physical activity opportunities in the community. It has also involved free, early screening for obesity and online dietician sessions supported by psychologists, pediatricians, endocrinologists, and physical activity educators.

“A family can attend 12 online sessions over a period of 6 months, making this service fully accessible to people living in remote areas,” Agapidaki said. “Families receive personalized guidance to improve their daily habits, as well as a tailored plan considering the needs of each child and family.”

As part of this, UNICEF child protection specialist responsible for coordinating the initiative, Antigoni Angelaki, MA, explained that pediatricians have been guided on how best to support a family’s nutrition. Resources have been developed in collaboration with experts on behaviors that help prevent childhood obesity. These are being disseminated through a network of universities set up across the country, she told Medscape Medical News.

But equally important to addressing what children eat is providing them ample opportunity to partake in physical activity, she added.

“It’s not just the diet that children follow, but it’s also about how much opportunity they have for physical activity,” she said.

Angelaki explained that this is the first program at the European level that has looked at all the different drivers of obesity.

“This program is looking at how we can reform the reality on the ground. Perhaps we can increase the number of physical activity hours done at school or make schools accessible in the afternoons because many municipalities don’t have spaces available for physical activity.”

Pavlidou said this was crucial, as increased screen time, safety concerns, and a lack of public spaces have all contributed to the obesity epidemic.

Changes to Legislation

In 2010, the World Health Assembly adopted the WHO set of recommendations on the marketing of foods and nonalcoholic beverages to children, urging countries to reduce the impact of marketing of highly processed foods and beverages that are high in fat, sugar, and salt on kids.

In 2022, the “Greek Pledge,” a voluntary initiative where food and beverage companies commit to improving how they advertise to children younger than 13 years, was launched. It’s unclear what impact this has had.

Angelaki said UNICEF was reviewing current advertising legislation to identify gaps.

One important step, Agapidaki said, is that Greece’s National Nutrition Committee revised the legal framework on canteen guidelines to ensure they only provide nutritious snacks and meals.

“According to the latest national data available, we see that our approach is already having meaningful changes in children’s behaviors, especially when parents are engaged,” she said. She did not offer additional data on obesity rates.

Applying Lessons Learned More Broadly

There are now hopes that the program will be expanded to other parts of Europe.

“Greece is no longer just trying to address the main factors contributing to childhood obesity — we are generating public health solutions that are also meaningful and efficient for other countries,” Angelaki said.

“Several countries have reached out to request guidance on replicating our program. We’ve been invited to share our tools and frameworks, especially around digital early detection, school and community integration, and whole-system governance.”

Pavlidou welcomed new approaches to tackle the epidemic but warned “We need more.”

“We need stronger policies on marketing to children, better food labeling, nutrition education schools, and greater support for families to access healthy options,” she said.

“Despite the challenges, I remain optimistic. The Mediterranean diet is not just a way of eating — it’s a cultural heritage rooted in balance, seasonality, and community. If we invest in educating families, empowering children, and building healthier environments, we can absolutely reverse these trends.”

Pavlidou, Agapidaki, and Angelaki reported having no relevant financial relationships.