A Tightrope Act:
Europe Caught Between Health-Activism and Insecurities


In light of growing tensions, Europeans are taking caring for their health into their own hands. But the road to wellbeing is littered with stumbling blocks: strong self-reported levels of physical health coincide with high numbers of Europeans who consider themselves overweight. Substantial portions of the population are invested or interested in appearance-enhancing products and procedures, underscoring a complex relationship between body image and self-confidence. Physical as well as mental well-being and happiness are intricately linked and need to be kept on the right path – women are particularly at risk of falling by the wayside.

Majority of Europeans report “unhealthy” BMI

Just over half of Europeans (54) declare themselves to be in good physical health. People in Uzbekistan (71), Austria (68), Romania (67) and Switzerland (66) feel they are in particularly outstanding condition. Just over a third of Europeans (35) describe their physical health as “fair”, and 11 percent as “poor” – led most notably by people in Sweden and Hungary (22 each) and the Czech Republic (18). There seems to be a clear link between perceived physical and mental health and overall happiness, as those who report poor mental health and below-average levels of happiness rate their physical health dramatically lower than those with good mental health (70 vs 17) and higher levels of happiness (68 vs 17).

Albeit controversial, the Body Mass Index (BMI), which calculates a numerical score by relating a person's body weight to their height, is still widely used as a common tool to assess body fat percentage. In comparison to the slight majority of Europeans who consider themselves to be in good physical health, only 40 percent actually have a healthy BMI. People in Uzbekistan (52), Italy (48) and France (46) are particularly likely to fall into this range. Women (45) are more likely to report a healthy BMI than men (34). Just over a third (35) of Europeans would be considered overweight according to their BMI, and an additional 17 percent fall into the “obese” category with a BMI of 31 and above.

1 in 5 Europeans dissatisfied with their appearance

Taking into consideration physical health and BMI, about a third of Europeans (29) are neither satisfied nor dissatisfied with the way they look, while just about half of Europeans (49) are satisfied with their physical appearance. People in Uzbekistan (78) and the Netherlands (67) are the most confident about their appearance. The majority of those who feel good about their looks say they simply accept themselves as they are (63). Others either feel they have been blessed with good looks (23) or take pride in their physique (23). 16 percent say external validation in the form of compliments helps them feel good about themselves, and 15 percent say they have worked hard for their body. Over 1 in 4 Europeans (28) also point out that contentment with their physical appearance has increased with age.

Excess weight and self-comparison drive unhappiness

Around 1 in 5 Europeans (21) say they are dissatisfied with their body. In Romania (35), Kazakhstan and Ireland (31 each), people are least likely to be content with how they look. The same applies to women (46) compared to men (53). The most common reasons why people struggle with self-confidence in their appearance are excess weight (49) and simply finding other people more attractive than themselves (23). There seems to be an overall imbalance between men and women in terms of self-perception and satisfaction: despite reporting a healthier BMI than men on average, women (55) are significantly more likely than men (40) to cite feeling overweight as a reason for body dissatisfaction. Women between the ages of 18 to 34 are particularly hard on themselves, with 51 percent of them thinking they are overweight and 38 percent regularly comparing themselves to others, e.g. on social media. This compares to only 28 percent of men in this age group who worry about their weight, and 21 percent who feel pressured by how others present themselves online.

VMS key investment for many Europeans to support physical appearance

With nearly half of the European population feeling dissatisfied with their physical appearance and experiencing significant body image insecurities, what are their looks worth to Europeans in the truest sense of the word? Currently, the main appearance-related investments are vitamins and mineral supplements (VMS), on which 37 percent and 18 percent of Europeans, respectively, spend some or a considerable sum of money. General healthcare products are the second most commonly mentioned expenditure, with 54 percent purchasing them to improve their looks. Cosmetic products like make-up, moisturisers and the like are purchased by 52 percent of Europeans overall, including 71 percent of women. Gym or sports memberships, along with the required equipment, are almost equally likely to be part of European men’s (29) and women’s (26) healthcare spending balance sheets. 

Gender gap in openness to body modification

While only 2 percent of Europeans are currently spending money on plastic surgery, a significant share of them has at least entertained the idea of going to greater and more invasive lengths to improve their appearance. Comparing the 8 percent of Europeans who have had aesthetic dental work, which is the most sought-after cosmetic procedure across the continent, to the 58 percent who would consider getting it if it were free, it becomes clear that cost is a strong inhibiting factor. 38 percent of Europeans would also consider laser hair removal, an interest driven particularly by Slovenia (48). Just under 1 in 4 Europeans (23) could imagine undergoing weight reduction or general plastic surgery, the latter of which Austrians (37) are most open to. While more men would consider a hair transplant (23 vs 16), women are in the lead in terms of all other types of aesthetic procedures: 61 percent of women would get aesthetic dental work (55 men), 52 percent would consider laser hair removal (24 men), 30 percent are open to plastic surgery (15 men). Furthermore, 29 percent of women would consider weight reduction surgery (17 men) and 28 percent could see themselves getting Botox or fillers (10 men). It seems that, despite all efforts to overcome unrealistic beauty ideals, the pressure on women to adhere to certain standards of beauty and looks, whether self-imposed or external, remains significant.

Self-actualisation trumps social pressure as a corrective catalyst

However, motivations for cosmetic procedures are mainly driven by individual interests, not a desire to appease others: 45 percent of Europeans say they would undergo a procedure to feel better about their body, and 41 percent are convinced such interventions could help with their self-confidence. A further 28 percent would seek treatment to reverse the effects of ageing, while 25 percent are confident it would help them feel more like “themselves”. Only 10 percent would undergo body modifications to be more socially acceptable and 8 percent to make their partner happy.

The overall attitudes regarding the topic of physical appearance, self-confidence and social impact are conflicting. 77 percent of Europeans agree that society and the media place too much emphasis on physical appearance, while 71 percent believe that society still has a long way to go when it comes to accepting different types of beauty. 59 percent also agree that a person’s status is determined by their physical appearance, and 56 percent call for stricter regulations and more transparency about the filters being used on social media. 54 percent even say they believe plastic surgery should be reserved for extreme cases rather than the pursuit of a certain type of beauty. Even though Europeans see through the societal beauty bias, 36 percent are certain that their mental health would improve significantly if they were happier with their appearance.

 

Europeans take charge of their health

In light of dissatisfaction with healthcare systems, mental health issues and low body confidence, Europeans nevertheless feel motivated to step up and take their health into their own hands.

89 percent of Europeans currently engage in activities to support their overall well-being. Physical exercise is the most popular habit, with 1 in 2 Europeans moving their body regularly. The most active Europeans can be found in Finland (66), Spain (62) and Italy (60). While it seems obvious that the majority of those who work out do so to feel better physically (87), improved mental health is also a strong motivating factor for 60 percent – and more so for women (63) than men (57).

The STADA Health Report 2023 already brought to light a lack of preventive healthcare in Europe, and seeing as only 33 percent of Europeans consider such appointments part of their personal health routine, this still rings true today. People in the Czech Republic (56), Germany and Slovakia (48 each) are most likely to keep up with preventive check-ups.

Healthy eating valued for physical and mental benefits

The second most popular habit is following a healthy diet, which 49 percent of Europeans say they do. Along with Italy (67), the Netherlands and Spain (68 each) are the self-reported forerunners of balanced nutrition. And the benefits are clear: 83 percent say they eat a healthy diet to feel better physically, and 50 percent say that good food is even good for their mental health. Vitamins and nutritional supplements are taken by 32 percent of Europeans and most popular in the Czech Republic (51), Slovakia (50) and Poland (44).

Social connections build mental resilience

Regular time spent with friends is a major mood booster for 1 in 3 Europeans (31), 79 percent of whom say that joint activities improve their mental well-being significantly. Overall, women are more likely to engage in activities expressly targeted at mental well-being (42) than men (36), seek out stress-reducing activities like meditation (21 vs 15) more frequently, and place more importance on time spent with family and friends (34 vs 28 men).

Calls for targeted actions to support healthy choices

While it is commendable that Europeans are investing time, money and effort in taking care of themselves, additional support from external sources could help complete the puzzle towards better health in the future. To further improve their well-being, 68 percent of Europeans ranked “Receiving advice on how to improve their diet to reduce intake of sugars and fats etc.” among their top three suggestions for external measures, meaning that consumers should have an easier time making healthy choices from the get-go. A day off work or school every month for self-care would be much appreciated by 61 percent. Just over half of Europeans (51) would like to be offered discounts on their health insurance, and an equal number would appreciate the same for other well-being activities such as gym memberships. Bonus programmes or incentives from health insurance companies, which already exist in some instances, are among the top three most important measures in the eyes of 43 percent.