Are school-based programs effective in tackling childhood obesity in Europe? A systematic review

Background

Childhood obesity is a major public health challenge worldwide, with increasing prevalence across Europe. Excess weight during childhood is strongly associated with obesity and non-communicable diseases in adulthood. Schools provide an important setting for promoting healthy behaviours through physical activity and nutrition programmes.

Methods

A systematic literature review was conducted using PubMed and Scopus databases. Studies published between 2010 and 2026 were included if they: (1) were conducted in school settings; (2) targeted children aged 6–18 years; (3) assessed outcomes related to body mass index (BMI), anthropometric measures, nutrition, or physical activity; (4) were conducted in Europe; and (5) had a minimum duration of one academic year.

Results

Sixteen studies met the inclusion criteria, covering nine European countries (England, Germany, Ireland, Italy, Netherlands, Norway, Spain, Switzerland, and Poland). Most interventions were implemented in primary schools (81.25%), with fewer in secondary schools (18.75%). The majority of studies were randomised controlled trials (75%). Intervention duration ranged from nine months to five years. Among studies assessing anthropometric outcomes, 78.6% reported positive effects, while 21.4% found no significant impact. Evidence on nutrition-related behaviours and physical activity was less consistent.

Conclusions

School-based interventions appear effective in improving anthropometric outcomes and may contribute to preventing childhood obesity. Long-term, multicomponent interventions that include parental involvement and address environmental factors are likely to be more effective. Socioeconomic and cultural contexts should be considered when designing future interventions.

Key messages

• School-based interventions are effective in improving children’s BMI and can play a key role in preventing childhood obesity across Europe.

• Long-term, multicomponent programmes involving families and environments are more effective than single interventions in promoting healthy behaviours.