Let’s Tune In To The EU’s Periphery: Bulgarian Pediatricians Concerned About Government Hiding Obesity

Nicholas Zalewski
Overweight child choosing to eat fruits and veggies or a cheeseburger and french fries. Source: Nutrigen

In official government documents, Bulgaria appears to be doing well with a very low percentage of children which are obese. The government claims that in 2021, children 0-6 years old had an obesity rate of 2.5 percent and children 7-19 had an obesity rate of 5.6 percent. The government hopes to decrease these obesity rates to 2 percent and 5.1 percent respectively. The problem is that these obesity rates are likely to be extremely inaccurate. Bulgarian pediatricians have spoken out anonymously on the matter and are concerned that the government is avoiding creating a plan to battle childhood obesity by denying it is a problem in the first place.

As can be seen by the WHO European Regional Obesity Report 2022, the real rates for childhood obesity and overweight kids are significantly much higher. In Bulgaria, childhood obesity for kids between 5-9 years old had an obesity rate of 14 percent and 17 percent of children in the same age range were overweight. 31 percent of children in this age range are currently at an unhealthy weight but these children vanish when looking at what the Bulgarian government reports. As these estimates are from 2016, it is possible obesity rates have decreased in Bulgaria, however, the global trend has been an increase in obesity rates rather than a decrease. This being said, it is also very unlikely that the obesity rate for children 5-9 years old fell from 14 percent to 5.1 percent or lower in only 7 years. 

Frequency at which Bulgarians try to consume a healthy diet. Source: LOGO Marketing Research and Consulting

Dangers Of Childhood Obesity

Not only is the Bulgarian government unable to accurately address childhood obesity if it bases its strategy on a false statistic but irreparable harm is done to Bulgarian children. In particular, children are now suffering from medical problems that were once considered to be exclusive to adults such as diabetes, high blood pressure, and high cholesterol. It is vital that children are taught healthy habits when they are young which they would ideally maintain when they become adults. If children are learning unhealthy eating habits, they are likely to continue these into adulthood. In a study about Bulgarian eating habits, 46 percent of respondents reported that they rarely or never try to maintain a healthy diet. These same adults may be passing on their unhealthy eating habits to children which can result in the health problems children are now suffering from. Schools can provide assistance with educating children on what a healthy diet should look like, but families have a role as well. Unless families are willing to implement it and ensure their children are able to spend time playing and exercising, children may suffer from being overweight or obese. 

Bulgaria’s Healthcare System

For Bulgaria, it is important to address problems sooner rather than later in order to avoid larger challenges. Bulgaria’s healthcare system is struggling as doctors continue to move to other EU member states where doctors receive a higher salary. Unfortunately for Bulgaria, workers earn more in any other member state as Bulgaria currently has the lowest wages of any EU member state. Bulgaria is trying to combat this by raising salaries. Last year, a new labor agreement gave doctors a pay raise of 400 euros a month. The labor agreement expires April 12, 2024, meaning another pay raise may occur. This is important because a third of doctors are old enough to retire. Bulgaria has lost at least 4,000 doctors to other EU member states since it joined the European Union in 2007. Bulgaria also has a shortage of nurses as well. There is hope that the nation will be able to convince Bulgarian healthcare professionals to return to work in Bulgaria. In 2021, Bulgaria had 59.67 general practitioners per 100,000 people, the second-lowest in the EU only ahead of Greece.

Unless healthcare workers do return, this leaves Bulgaria with fewer doctors to treat patients, meaning there would be fewer doctors to deal with an obesity epidemic as these children become adults. Rather than create more work for an already overburdened healthcare system, Bulgaria would benefit from aggressively addressing the problem when these children are still children and can learn what a healthy diet should look like and to include exercise in order to prevent more serious health problems later on in life. Besides considering the impact on the healthcare system, this would also allow Bulgaria to have a healthier population. 

Age breakdown of physicians in EU member states Source: Eurostat

EU Periphery

Besides Bulgaria, it is clear from the WHO’s report that other nations in the European Union’s periphery need to become serious about helping children lead healthier lives as well. Italy, Greece, and Malta are the three worst nations for childhood obesity in not only the EU, but the entire WHO European region. Spain, Portugal, Cyprus, Croatia, and Hungary all have childhood obesity rates above that of the EU as well, which has a childhood obesity rate of 13 percent. This is important to address in order to prevent further strain on their health care systems as well, as all of these nations have an aging population due to a low fertility rate. This means these nations will have to provide care for more elderly patients while there are less young workers to pay for the increased care that will be necessary. This may fuel a vicious cycle where higher healthcare costs continue to put financial strain on families through higher taxes causing them to have fewer children which in turn will leave these nations with less future workers to pay taxes, resulting in higher taxes for these workers and so on. Besides Bulgaria, other EU member states in the periphery have an issue with not having enough young doctors. Italy is the worse with only 10 percent of doctors which are younger than 35 years old. Another consequence of this is the goal of economic convergence of member states will be harder to obtain for these member states.


While this article focuses on Obesity in Bulgaria and other EU member states in the periphery, all EU member states have their work cut out to improve the health of children. Bulgaria’s problem appears to be a bit more serious given the fact that the national government appears to be publishing fake data to make child obesity appear to be less of a problem than it is in the nation. This does nothing to combat childhood obesity and instead can potentially overburden the nation’s healthcare system in the future which already has a shortage of doctors. Bulgaria is not alone as childhood obesity is growing worldwide but it gains nothing by allowing the problem to grow larger by denying its existence. 

Please Read the Following For More Information:  

Krassen, Nikolov. “Inaccurate data steering Bulgarian children’s health strategy, doctors warn”. Euractiv. 31 October 2023. 

“WHO European Regional Obesity Report 2022”. World Health Organization. 2 May 2022.

“Bulgaria eats: Insights into eating habits”. LOGO Market Research & Consulting Ltd. 23 June 2021.

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Let’s Tune In To The EU…

by Nicholas Zalewski time to read: 5 min