Why does Iceland have Europe's highest obesity rates?

Iceland is a land of volcanoes, geysers, hot springs, and... obesity? What drives excess weight in the country, and how are patient groups changing the narrative?

Iceland is one of the most beautiful countries in the world, but it’s notable in another way: 62% of residents have overweight or obesity — the highest rate in Western Europe and the third highest on the whole continent. But why?

Waterfall in Iceland’s Thingvellir national park

Why Iceland Struggles with Obesity

For one, the country’s far too stressed, says Dr. Guðrún Höskulsdóttir, an obesity medicine doctor in Iceland. Many of her patients get less than 6 hours of sleep and don’t get a real lunch break at work. “Maybe the biggest substance abuse in Iceland is work; we are workaholics,” echoes Grétar Björnsson, an Icelander who’s long struggled with alcohol addiction.

Stress and poor sleep are strongly associated with obesity due to reduced physical activity, increased food intake, and elevated levels of the survival hormone cortisol. It probably doesn’t help that, in Iceland’s summers, the sun sets at 11:30 PM and rises at 3 AM, although there’s really light outside all 24 hours.

But these factors aren’t unique to Iceland, so maybe the real answer is genetics. “If you look 200-300 years back, we didn’t have a lot here — a lot more poverty and even harsh conditions,” says Dr. Tryggvi Helgason, another Icelandic obesity medicine doctor. “People who have a good way of storing energy would have had a Darwinian head start and a much better chance to survive in those conditions.”

Dr. Helgason also chalks it up to Iceland’s early McDonaldization, with the country shifting toward the U.S. during World War II when war-torn Europe couldn’t provide supplies. “Both geographically and social-structurally, we are rather close to the Americans than the Europeans.”

12 AM at the University of Iceland

Iceland’s Biggest Obesity Advocate

Sólveig Sigurðardóttir has been living with obesity since she was 10 years old. “It started when I was sexually abused,” she says, her step-grandfather taking advantage and then threatening her to stay silent. “This is really, really hard on your system,” Sólveig says. “Living through that — it’s like going through a war.”

At her elementary school, the teachers would gather all the students to check their weights. “You had to stay in line, and they would put you on the scale in front of all your schoolmates, who would laugh at you,” she says. “Nobody asked how I felt or why I was putting on weight.”

The shame and silencing continued throughout her life and experiences with Iceland’s healthcare system. Sólveig has multiple sclerosis, but her diagnosis was delayed several years because her doctors would dismiss her symptoms, telling her she just needed to eat less and move more. “It’s like telling a depressed person to just smile,” says Sigurdur Ingi Kjartansson, Sólveig’s husband and an IT project manager living with obesity. “When I smile, I’m happy, so why can’t you?”