Obesity is rising steadily around the world, and Italy is no exception. A 2021 study found that the number of obese adults in the country had grown by almost 30 percent over the previous three decades. Children are especially at risk: a new report predicts that more than 220 million children worldwide could have obesity by 2040 unless urgent action is taken.
The trend is hitting Italy's young hardest in the south. In parts of Campania, more than 40 percent of eight and nine-year-olds are overweight, and the Naples suburb of Ponticelli has gained the unfortunate title of one of the world's child obesity capitals. In fact, the World Health Organisation (WHO) has recently announced that Italian children are now among the most overweight on the continent, a shocking fact when considering that for decades, the Mediterranean diet has been heralded as the apex of healthy diets.
Rich in vegetables, legumes, olive oil, whole grains and fish, it became famous after the US physiologist Ancel Keys and his wife, the biochemist Margaret Keys, studied communities in southern Italy in the 1950s and linked their habits to remarkably low rates of heart disease.
But, sadly, that picture has changed. Cardiovascular diseases are now the leading cause of death in Italy, with notable disparities between north and south. Researchers put the rise in some of the major risk factors down to unfavourable changes in lifestyle, notably eating habits.
The WHO calls obesity an "escalating global epidemic". More than one billion people worldwide are now obese, and childhood obesity has quadrupled since 1990.
A chance to grow
Experts put this down to several factors. The cost of living crisis has hit traditionally less well-off regions in southern Italy particularly hard. Some have also suggested that the rise of both parents working full time has resulted in less time to cook homemade meals and a growing reliance on convenience foods.
Given these changes, it's certainly no coincidence that some of the world's biggest fast food chains are expanding in Italy faster than ever before. This is particularly so in the south. In March, McDonald's Italia CEO Giorgia Favaro expressly revealed that the chain's biggest opportunities lay in the provinces, small towns and the south. They're planning around 60 openings this year, boosting the number of franchises in the country by 200. Likewise, KFC recently announced that it would open 10 more restaurants in the south and on the islands by the end of 2026.
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Southern Italy has traditionally been a tougher market for the chains, given its strong local food traditions and generally lower disposable income than its northern cousins. But according to the Bank of Italy, the southern economy has grown faster than that of the centre-north since the pandemic.
In 2025, Italy became the first country to pass a national law recognising obesity as a chronic, progressive and relapsing disease. The law moves away from treating obesity as simply the result of poor choices, and instead sees it as a chronic disease shaped by biology, environment and social circumstances.
What our readers say
Readers of The Local Italy agree that the change is visible. Rosemarie in Foiano della Chiana hopes the south will be spared: "Let's hope the South doesn't become a large market for fast food chains. The younger generation, who would be the main target group, are already beginning to have problems with obesity due to fast food."
In Catania, Trisha is already noticing the shift. "We have a couple of McDonald's in Catania. A few Chinese/ Japanese popping up. Have to say the delivery firms are certainly kept busy with quick available food. But the options are nothing like what we have back in the UK (yet)."
For Laura, the latest arrival is hard to ignore: "Popeyes is the newest incursion, x the street from McD and down the street from KFC. A few BKs too. Impossible to not notice."
Laurie sees the effects over the counter at her cafe: "Every morning at my cafe in the Modena area, parents come in, buy plastic-wrapped pastries and potato chips for their children."
And it isn't only restaurants. Philipp finds the same trend in the supermarket, and it has surprised him: "I see more ready-to-eat options in the supermarket. The same junk-food quick meal options are filling the freezer case. I never would have guessed that Italians would tolerate this kind of fast food, but it's cheap and prices keep going up."
The communities of southern Italy once helped make the Mediterranean diet famous. Now, as predominantly American fast food chains are turning south, the relationship between their proliferation, increasing obesity and decreasing cardiovascular health is becoming clearer.
Hopefully, new regulations can take a bite out of the more severe impacts of Italy’s changing culinary landscape.
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