At present, estimation of the prevalence and secular trends in paediatric obesity in Europe is severely hampered by methodological problems in the definition of obesity and the paucity of data sets that mirror the demographic, cultural and socioeconomic composition of the European population. The available cross-sectional data, however imperfect, suggest that there are complex patterns in prevalence which vary with time, age, sex and geographical region. Overall, the prevalence of obesity in young children is relatively low compared to adolescents. Gender differences in prevalence are inconsistent. The highest rates of obesity are observed in eastern and southern European countries and even within countries there may be marked variability in the rates of obesity. It is not clear whether the trends in paediatric obesity are a simple consequence of an overall increase in fatness in Europe or whether there may be sub-groups of children who, at certain ages, are either particularly susceptible to environmental challenges or are selectively exposed to such challenges. The respective contributions of dietary energy intake and patterns of physical activity to the aetiology of childhood obesity present a confused and confusing picture. Changing demographic and social circumstances throughout Europe are linked to childhood obesity but it is highly unlikely that these interact in similar ways in the genesis of obesity in different individuals and population groups.
Conclusion: At present, our limited understanding of the variability in susceptibility to obesity in European children and adolescents provides powerful justification for the development of preventive strategies which are population based rather than selectively targeted at high-risk children.