What's Behind the 'Obesity Epidemic'? Explaining the Weight Gap between Italy and Spain

Posted: 5 Jul 2008

See all articles by Joan Gil

Joan Gil

University of Barcelona


The expansion of obesity is currently a black box for health policy analysts and demands additional empirical insights to better understand the potential socio-economic processes behind. These effects are likely to be gender and environmental specific as well as country specific. Interestingly enough, there is hardly any comparative analysis though there are wide cross-country differences. For instance, while the obesity prevalence rate is about 9% in Italy, reaches 13% in Spain. Comparing these two countries can be quite insightful as far as they are subject to similar dietary patterns and overall economic conditions, but differ according to environmental and socio-economic health production determinants. This paper contributes to the literature in the following way. First, we analyse and compare the factors that explain the BMI in Italy and Spain, by using country specific survey data (Encuesta Nacional de Salud-2003 and the Indagine sugli Aspetti della Vita Quotidiana-2003, for Spain and Italy respectively). Second, after appending the two datasets gender and cross-country differentials on BMI are analysed so as to disentangle the underlying explanatory factors, by undertaking quantile regression techniques and recently developed bootstrapped counterfactual decomposition methods (Machado and Mata, 2000). Thirdly, we proceed by analysing and comparing the determinants of the prevalence and the degree of obesity in each country and the cross-country differentials by using the Fairlie (2006) decomposition method. Our preliminary results suggest that different patterns affect the prevalence of obesity in both countries. Moreover, whilst gender differences are large in Spain they are not in Italy. However, both in Italy and Spain, evidence about regional patterns in obesity suggests that large heterogeneity in the prevalence and intensity of obesity calls upon the role of environmental and cultural factors behind its generation. Finally, we estimate that approximately 16% of total BMI country differential is due to a higher proportion of low educated people in Spain.

Keywords: BMI, Country and gender weigh gap, Counterfactual decomposition, Non-linear decomposition.

JEL Classification: I18, J15, J16

Suggested Citation

Gil, Joan, What's Behind the 'Obesity Epidemic'? Explaining the Weight Gap between Italy and Spain. iHEA 2007 6th World Congress: Explorations in Health Economics Paper. Available at SSRN: https://ssrn.com/abstract=994488

Joan Gil (Contact Author)

University of Barcelona ( email )

Department of Economic Theory
Faculty of Economics
Barcelona, Barcelona 08034

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