Germany
- Overview
- Obesity prevalence
- Trends over time
- Population breakdowns
- Drivers
- Comorbidities
- Health systems
- Actions
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National obesity risk *7/10This is a composite ‘obesity risk’ score (out of 10, the highest risk) based on obesity prevalence, rate of increase, likelihood of meeting the 2025 target, treatment indicator and childhood stunting levels.Childhood obesity risk *6.5/11This is a ‘risk score’ for each country’s likelihood of having or acquiring a major childhood obesity problem during the 2020s, taking account of current prevalence levels and risk for future obesity (based on stunting among infants, maternal obesity, maternal smoking, and breastfeeding rates).
* Based on estimated data. For more information see Publications
Obesity prevalence
Trends over time
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Drivers
Insufficient activity
Sugar consumption
Soft drink consumption
Confectionery consumption
Sweet/savoury snack consumption
Fruit consumption
Vegetable consumption
Processed meat consumption
Grains consumption
Depression
Anxiety
Roots of obesity »
Like all chronic diseases, the root causes/drivers of obesity are complex. Select here to view 'other' root causes/drivers.Comorbidities
Health systems
Actions
Obesity prevalence
Adults, 2014
| Survey type: | Self-reported |
| Age: | 18+ |
| Area covered: | National |
| References: | Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2008-2011
| Survey type: | Measured |
| Age: | 18-79 |
| Sample size: | 7116 |
| Area covered: | National |
| References: | G.B.M. Mensink. A. Schienkiewitz. M. Haftenberger. T. Lampert. T. Ziese. C. Scheidt-Nave. Overweight and obesity in Germany. Results of the German Health Interview and Examination Survey for Adults (DEGS1)Bundesgesundheitsbl 2013. DOI 10.1007/s00103-012-1656-3 (English supplement available online http://link.springer.com/article/10.1007%2Fs00103-012-1656-3 last accessed 28th May 2013) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2005-2007
| Survey type: | Measured |
| Age: | 18-80 |
| Sample size: | 13207 |
| Area covered: | National |
| References: | Federal Ministry of Food, Agriculture and Consumer Protection and Federal Research Institute of Nutrition and Food, Germany, Report of Results 2008 (http://www.bmelv.de/cln_045/nn_1196770/sharedDocs/downloads/03-Ernaehrung/NVS2/NVS_Ergebnisbericht,templateId=raw,property=publicationFile.pdf/NVS_Ergebnisbericht.pdf) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2002
| Survey type: | Measured |
| Age: | 25+ |
| Sample size: | 3807 |
| References: | Helmert U, Strube H. Die Entwicklung der Adipositas in Desutschland im Zeitraum von 1985 bis 2002. Gesundheitswesesn 2004;66:409-415 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 1991
| Survey type: | Measured |
| Age: | 25+ |
| Sample size: | 7398 |
| References: | Helmert U, Strube H. Die Entwicklung der Adipositas in Desutschland im Zeitraum von 1985 bis 2002. Gesundheitswesesn 2004;66:409-415 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2014-2017
| Survey type: | Measured |
| Age: | 3-17 |
| Sample size: | 3,567 |
| Area covered: | Regional |
| References: | Schienkiewitz A, Damerow S and Rosario AS. 2018. Prävalenz von Untergewicht, Übergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland – Einordnung der Ergebnisse aus KiGGS Welle 2 nach internationalen Referenzsystemen. Journal of Health and Monitoring. 3(3). DOI 10.17886/RKI-GBE-2018-080 |
| Notes: | IOTF cut-offs used (WHO cut off data also available in paper) |
| Cutoffs: | IOTF |
Children, 2008
| Survey type: | Measured |
| Age: | 12-16 |
| Sample size: | 5623 |
| Area covered: | National |
| References: | Blüher S, Meigen C, Gausche R, et al. Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes. 2011;6(2-2):e199-e206. doi:10.3109/17477166.2010.526305 |
| Cutoffs: | IOTF |
Children, 2004
| Survey type: | Measured |
| Age: | 12-16 |
| Sample size: | 8690 |
| Area covered: | National |
| References: | Blüher S, Meigen C, Gausche R, et al. Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes. 2011;6(2-2):e199-e206. doi:10.3109/17477166.2010.526305 |
| Cutoffs: | IOTF |
Children, 2003-2006
| Survey type: | Measured |
| Age: | 5-17 |
| Sample size: | 15662 |
| Area covered: | National |
| References: | Kurth BM & Schaffrath RA. 2007. The prevalence of overweight and obese children and adolescent s living in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt, 50: 736 - 743. |
| Notes: | IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3. |
| Cutoffs: | IOTF |
Children, 2002-2003
| Survey type: | Measured |
| Age: | 5-17 |
| Sample size: | 12863 |
| Area covered: | National |
| References: | Kurth & Schaffrath Rosario, The prevalence of overweight and obese children and adolescents living in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), Bundesgesundheitsblatt 2007; |
| Notes: | IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3. |
| Cutoffs: | IOTF |
Children, 2000
| Survey type: | Measured |
| Age: | 12-16 |
| Sample size: | 6689 |
| Area covered: | National |
| References: | Blüher S, Meigen C, Gausche R, et al. Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes. 2011;6(2-2):e199-e206. doi:10.3109/17477166.2010.526305 |
| Cutoffs: | IOTF |
Children, 1992
| Survey type: | Measured |
| Age: | 5-6 |
| Sample size: | 16281 |
| References: | Kalies H, Lenz J, von Kries R. Prevalence of overweight and obesity and trends in body mass index in German pre-school children, 1982-1997. International Journal of Obesity 2002;26:1211-1217 |
| Notes: | Sample size number included for the duration of the study from 1982 - 1997 Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3. |
| Cutoffs: | IOTF |
Children, 1982
| Survey type: | Measured |
| Age: | 5-6 |
| Sample size: | 16281 |
| References: | Kalies H, Lenz J, von Kries R. Prevalence of overweight and obesity and trends in body mass index in German pre-school children, 1982-1997. International Journal of Obesity 2002;26:1211-1217 |
| Notes: | Sample size number included for the duration of the study from 1982 - 1997 IOTF Cut off. Reference: Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000 May 6;320(7244):1240-3. |
| Cutoffs: | IOTF |
Children living with overweight or obesity in Germany 2000-2008
| Survey type: | Measured |
| References: | Blüher S, Meigen C, Gausche R, et al. Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes. 2011;6(2-2):e199-e206. doi:10.3109/17477166.2010.526305Blüher S, Meigen C, Gausche R, et al. Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes. 2011;6(2-2):e199-e206. doi:10.3109/17477166.2010.526305Blüher S, Meigen C, Gausche R, et al. Age-specific stabilization in obesity prevalence in German children: a cross-sectional study from 1999 to 2008. Int J Pediatr Obes. 2011;6(2-2):e199-e206. doi:10.3109/17477166.2010.526305 |
| Different methodologies may have been used to collect this data and so data from different surveys may not be strictly comparable. Please check with original data sources for methodologies used. | |
Overweight/obesity by age and education
Men, 2014
| Survey type: | Self-reported |
| Area covered: | National |
| References: | Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2014
| Survey type: | Self-reported |
| Area covered: | National |
| References: | Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Overweight/obesity by education
Men, 2014
| Survey type: | Self-reported |
| Age: | 18+ |
| Area covered: | National |
| References: | Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 9 November 2016) |
| Notes: | Total sample size in EU = 35100 (Age 18+) Less than primary, primary and lower secondary education (levels 0-2) Upper secondary and post-secondary non-tertiary education (levels 3 and 4) Tertiary education (levels 5-8) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2014
| Survey type: | Self-reported |
| Age: | 18+ |
| Area covered: | National |
| References: | Eurostat Database:http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1e&lang=en (last accessed 9 November 2016) |
| Notes: | Total sample size in EU = 35100 (Age 18+) Less than primary, primary and lower secondary education (levels 0-2) Upper secondary and post-secondary non-tertiary education (levels 3 and 4) Tertiary education (levels 5-8) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Men, 2008
| Survey type: | Self-reported |
| Age: | 18+ |
| Area covered: | National |
| References: | EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015) |
| Notes: | Definitions are: levels 0-2 = pre-primary, primary and lower secondary education levels 3-4 = upper secondary and post-secondary non-tertiary education levels 5-6 = first and second stage of tertiary education |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2008
| Survey type: | Self-reported |
| Age: | 18+ |
| Area covered: | National |
| References: | EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015) |
| Notes: | Definitions are: levels 0-2 = pre-primary, primary and lower secondary education levels 3-4 = upper secondary and post-secondary non-tertiary education levels 5-6 = first and second stage of tertiary education |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2012
| Survey type: | Measured |
| Age: | 3-6 |
| Sample size: | 1217 |
| Area covered: | Subnational - Munich |
| References: | Manios, Y. et al. (2018). Prevalence and sociodemographic correlates of overweight and obesity in a large Pan-European cohort of preschool children and their families: The ToyBox-study. Nutrition. 55-56 (p), pp.1-7. |
| Notes: | IOTF International cut-offs used. Low Maternal education classed as <14 y of education. Medium/high Maternal education classed as >14 y of education. |
| Cutoffs: | IOTF |
Children, 2007-2008
| Survey type: | Measured |
| Age: | 2-9 |
| Sample size: | 2194 |
| Area covered: | National |
| References: | Ahrens W, Pigeot I, Pohlabeln H et al. Prevalence of overweight and obesity in European children below the age of 10. IJO 2014;38:S99-S107 |
| Cutoffs: | IOTF |
Overweight/obesity by age
Adults, 2008-2011
| Survey type: | Measured |
| Sample size: | 7116 |
| Area covered: | National |
| References: | G.B.M. Mensink. A. Schienkiewitz. M. Haftenberger. T. Lampert. T. Ziese. C. Scheidt-Nave. Overweight and obesity in Germany. Results of the German Health Interview and Examination Survey for Adults (DEGS1)Bundesgesundheitsbl 2013. DOI 10.1007/s00103-012-1656-3 (English supplement available online http://link.springer.com/article/10.1007%2Fs00103-012-1656-3 last accessed 28th May 2013) |
| Notes: | Last reviewed 2nd November 2017 |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 2005-2007
| Survey type: | Measured |
| Sample size: | 13207 |
| Area covered: | National |
| References: | Federal Ministry of Food, Agriculture and Consumer Protection and Federal Research Institute of Nutrition and Food, Germany, Report of Results 2008 (http://www.bmelv.de/cln_045/nn_1196770/SharedDocs/downloads/03-Ernaehrung/NVS2/NVS__Ergebnisbericht, templateId=raw,property=publicationFile.pdf/NVS_Ergebnisbericht.pdf) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Adults, 1998
| Survey type: | Measured |
| Sample size: | 7015 |
| Area covered: | National |
| References: | Bergmann KE, Mensink GBM (1999) Korpermasse und Ubergewicht.Gesundheitswesen:62:S115-S120, kindly provided by Prof G Mensk |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2008
| Survey type: | Measured |
| Sample size: | 40625 |
| Area covered: | National |
| References: | Bluher S, Meigen C, Fausche R, Keller E, Pfaffle R, Sabin M, Werther G, Odeh R, Kiess W. Age specific stabilization in obesity prevalence in German children: A cross sectional study from 1999 to 2008. IJPO 2010;Early online |
| Cutoffs: | IOTF |
Children, 2004
| Survey type: | Measured |
| Sample size: | 34649 |
| Area covered: | National |
| References: | Bluher S, Meigen C, Fausche R, Keller E, Pfaffle R, Sabin M, Werther G, Odeh R, Kiess W. Age specific stabilization in obesity prevalence in German children: A cross sectional study from 1999 to 2008. IJPO 2010;Early online |
| Cutoffs: | IOTF |
Children, 2000
| Survey type: | Measured |
| Sample size: | 17757 |
| Area covered: | National |
| References: | Bluher S, Meigen C, Fausche R, Keller E, Pfaffle R, Sabin M, Werther G, Odeh R, Kiess W. Age specific stabilization in obesity prevalence in German children: A cross sectional study from 1999 to 2008. IJPO 2010;Early online |
| Cutoffs: | IOTF |
Overweight/obesity by region
Children, 2003-2006
| Survey type: | Measured |
| Age: | 3-17 |
| Sample size: | 14747 |
| Area covered: | National |
| References: | Reinehr T, Holl RW, Wabitsch M. The German Working Group of Obesity in Childhood and Adolescence (AGA): Improving the Quality of Care for Overweight and Obese Children in Germany. Obesity Facts 2008 DOI:10.1159/000113405 |
| Notes: | See paper for cut off |
| Cutoffs: | Other |
Overweight/obesity by age and region
Men, 2014
| Survey type: | Self-reported |
| Area covered: | National |
| References: | Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1u&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2014
| Survey type: | Self-reported |
| Area covered: | National |
| References: | Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1u&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Overweight/obesity by age and socio-economic group
Adults, 2014
| Survey type: | Self-reported |
| Area covered: | National |
| References: | Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Men, 2014
| Survey type: | Self-reported |
| Area covered: | National |
| References: | Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2014
| Survey type: | Self-reported |
| Area covered: | National |
| References: | Eurostat http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 25.08.20) |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Overweight/obesity by socio-economic group
Men, 2014
| Survey type: | Self-reported |
| Age: | 18+ |
| Sample size: | Total sample number in EU: 35100 (Age 18+) |
| Area covered: | National |
| References: | EUROSTAT Database: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 9 November 2016) |
| Notes: | 1st Quintile (lowest income), 5th Quintile (highest income) Please note where data = zero, there were insufficient data. |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2014
| Survey type: | Self-reported |
| Age: | 18+ |
| Sample size: | Total sample number in EU: 35100 (Age 18+) |
| Area covered: | National |
| References: | EUROSTAT Database: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ehis_bm1i&lang=en (last accessed 9 November 2016) |
| Notes: | 1st Quintile (lowest income), 5th Quintile (highest income) Please note where data = zero, there were insufficient data. |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Men, 2008
| Survey type: | Self-reported |
| Age: | 18+ |
| Area covered: | National |
| References: | EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015) |
| Notes: | SES assessed by annual income. |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Women, 2008
| Survey type: | Self-reported |
| Age: | 18+ |
| Area covered: | National |
| References: | EUROSTAT Database http://ec.europa.eu/eurostat/web/health/health-status-determinants/data/database# (last accessed 17th July 2015) |
| Notes: | SES assessed by annual income. |
| Unless otherwise noted, overweight refers to a BMI between 25kg and 29.9kg/m², obesity refers to a BMI greater than 30kg/m². | |
Children, 2007-2008
| Survey type: | Measured |
| Age: | 2-9 |
| Sample size: | 2194 |
| Area covered: | National |
| References: | Ahrens W, Pigeot I, Pohlabeln H et al. Prevalence of overweight and obesity in European children below the age of 10. IJO 2014;38:S99-S107 |
| Notes: | SES assessed by annual income. |
| Cutoffs: | IOTF |
Children, 2003-2006
| Survey type: | Measured |
| Sample size: | 14747 |
| Area covered: | National |
| References: | Kurth BM, Rosario AS. Die Berbreitung von Ubergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland. Bundesgesundheitsblt-Gesundheitsforsch-Gesundheitsschutz 2007;50:736-743 |
| Notes: | Low, medium & high socio-economic group based on Mother. Kromeyer-Hauschild Cut off 90th Percentile |
| Cutoffs: | Other |
Insufficient physical activity
Adults, 2016
| References: | Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7 |
Men, 2016
| References: | Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7 |
Women, 2016
| References: | Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1.9 million participants. Lancet 2018 http://dx.doi.org/10.1016/S2214-109X(18)30357-7 |
Children, 2010
| Age: | 11-17 |
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en |
| Notes: | % of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily. |
| Definitions: | % Adolescents insufficiently active (age standardised estimate) |
Boys, 2010
| Age: | 11-17 |
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en |
| Notes: | % of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily. |
| Definitions: | % Adolescents insufficiently active (age standardised estimate) |
Girls, 2010
| Age: | 11-17 |
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A893?lang=en |
| Notes: | % of school going adolescents not meeting WHO recommendations on Physical Activity for Health, i.e. doing less than 60 minutes of moderate- to vigorous-intensity physical activity daily. |
| Definitions: | % Adolescents insufficiently active (age standardised estimate) |
Sugar consumption
Adults, 2016
| References: | Source: Euromonitor International |
| Definitions: | Sugar consumption (Number of 500g sugar portions/person/month) |
Estimated per-capita sugar sweetened beverages intake
Adults, 2016
| References: | Source: Euromonitor International |
Prevalence of at least daily carbonated soft drink consumption
Children, 2014
| Survey type: | Measured |
| References: | World Health Organization. (2017). Adolescent obesity and related behaviours: Trends and inequalities in the who european region, 2002-2014: observations from the Health Behavior in School-aged Children (HBSC) WHO collaborative cross-national study (J. Inchley, D. Currie, J. Jewel, J. Breda, & V. Barnekow, Eds.). World Health Organization. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org |
| Notes: | 15-year-old adolescents |
| Definitions: | Prevalence of at least daily carbonated soft drink consumption (% of at least daily carbonated soft drink consumption) |
Prevalence of confectionery consumption
Adults, 2016
| References: | Source: Euromonitor International |
| Definitions: | Prevalence of confectionery consumption (Number of 50g confectionery portions/person/month) |
Prevalence of sweet/savoury snack consumption
Adults, 2016
| References: | Source: Euromonitor International |
| Definitions: | Prevalence of sweet/savoury snack consumption (Number of 35g sweet/savoury snack portions/person/month) |
Estimated per-capita fruit intake
Adults, 2017
| Survey type: | Measured |
| Age: | 25+ |
| References: | Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/ |
| Definitions: | Estimated per-capita fruit intake (g/day) |
Prevalence of less-than-daily fruit consumption
Children, 2014
| Survey type: | Measured |
| References: | Global School-based Student Health Surveys. Beal et al (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287. Sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system |
| Definitions: | Prevalence of less-than-daily fruit consumption (% less-than-daily fruit consumption) |
Prevalence of less-than-daily vegetable consumption
Children, 2014
| Survey type: | Measured |
| Age: | 12-17 |
| References: | Beal et al. (2019). Global Patterns of Adolescent Fruit, Vegetable, Carbonated Soft Drink, and Fast-food consumption: A meta-analysis of global school-based student health surveys. Food and Nutrition Bulletin. https://doi.org/10.1177/0379572119848287 sourced from Food Systems Dashboard http://www.foodsystemsdashboard.org/food-system |
| Definitions: | Prevalence of less-than-daily vegetable consumption (% less-than-daily vegetable consumption) |
Estimated per-capita processed meat intake
Adults, 2017
| Survey type: | Measured |
| Age: | 25+ |
| References: | Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/ |
| Definitions: | Estimated per-capita processed meat intake (g per day) |
Estimated per-capita whole grains intake
Adults, 2017
| Survey type: | Measured |
| Age: | 25+ |
| References: | Global Burden of Disease, the Institute for Health Metrics and Evaluation http://ghdx.healthdata.org/ |
| Definitions: | Estimated per-capita whole grains intake (g/day) |
Mental health - depression disorders
Adults, 2015
| References: | Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO. |
| Definitions: | % of population with depression disorders |
Mental health - anxiety disorders
Adults, 2015
| References: | Prevalence data from Global Burden of Disease study 2015 (http://ghdx.healthdata.org) published in: Depression and Other Common Mental Disorders: Global Health Estimates. Geneva:World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO. |
| Definitions: | % of population with anxiety disorders |
Oesophageal cancer
Men, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000 |
Women, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, oesophagus, adults ages 20+. ASR (World) per 100,000 |
Breast cancer
Women, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, breast, females, ages 20+. ASR (World) per 100,000 |
Colorectal cancer
Men, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000 |
Women, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, colorectum, adults, ages 20+. ASR (World) per 100,000 |
Pancreatic cancer
Men, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000 |
Women, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, pancreas, adults, ages 20+. ASR (World) per 100,000 |
Gallbladder cancer
Men, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000 |
Women, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, gallbladder, adults, ages 20+. ASR (World) per 100,000 |
Kidney cancer
Men, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000 |
Women, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, kidney, adults, ages 20+. ASR (World) per 100,000 |
Cancer of the uterus
Women, 2018
| Age: | 20+ |
| References: | Global Cancer Observatory, Cancer incidence rates http://gco.iarc.fr/ (last accessed 30th June 2020) |
| Definitions: | Estimated age-standardized incidence rates (World) in 2018, cervix uteri, females, ages 20+. ASR (World) per 100,000 |
Raised blood pressure
Adults, 2015
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en |
| Definitions: | Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90). |
Men, 2015
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en |
| Definitions: | Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90). |
Women, 2015
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A875?lang=en |
| Definitions: | Age Standardised estimated % Raised blood pressure 2015 (SBP>=140 OR DBP>=90). |
Raised cholesterol
Adults, 2008
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885 |
| Definitions: | % Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate). |
Men, 2008
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885 |
| Definitions: | % Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate). |
Women, 2008
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A885 |
| Definitions: | % Raised total cholesterol (>= 5.0 mmol/L) (age-standardized estimate). |
Raised fasting blood glucose
Men, 2014
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en |
| Definitions: | Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication). |
Women, 2014
| References: | Global Health Observatory data repository, World Health Organisation, http://apps.who.int/gho/data/node.main.A869?lang=en |
| Definitions: | Age Standardised % raised fasting blood glucose (>= 7.0 mmol/L or on medication). |
Diabetes prevalence
Adults, 2017
| References: | Reproduced with kind permission of IDF, International Diabetes Federation. IDF Diabetes Atlas, 8th edition. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org |
| Definitions: | Diabetes age-adjusted comparative prevalence (%). |
Health systems
Economic classification: High Income
Health systems summary
Germany has a health insurance system that is mandatory for all its citizens and permanent residents. The system is made up of two types of insurances: “sickness funds” through the statutory health insurance system and private health insurance. The latter is typically held by those with higher incomes who opt out of the statutory insurance and the self-employed, covering approximately 11% of the population. “Sickness funds”, on the other hand, are used by the majority (87%) and is financed by compulsory contributions by employees and employers. There are said be approximately 109 different “sickness funds” available, all of which cover non-earning dependents free of charge. As a result of this described system, Germany is considered to have universal health coverage for all legal residents. Out of pocket expenditure is considerably low compared to European neighbours at 12.5% of total health spending in 2017.
Indicators
| Where is the country’s government in the journey towards defining ‘Obesity as a disease’? | Defined as disease |
| Where is the country’s healthcare provider in the journey towards defining ‘Obesity as a disease’? | Some progress |
| In practice, how is obesity treatment largely funded? | Not known |
| Is there specialist training available dedicated to the training of health professionals to prevent, diagnose, treat and manage obesity? | Partial |
| Have any taxes or subsidies been put in place to protect/assist/inform the population around obesity? | No |
| Are there adequate numbers of trained health professionals in specialties relevant to obesity in urban areas? | Partial |
| Are there adequate numbers of trained health professionals in specialties relevant to obesity in rural areas? | No |
| Are there any obesity-specific recommendations or guidelines published for adults? | Partial |
| Are there any obesity-specific recommendations or guidelines published for children? | Partial |
Summary of stakeholder feedback
The German government is said to largely inactive in addressing obesity and do not yet act as if obesity is a disease. Obesity prevention is considered to be neglected and underfunded, with the few initiatives available provided by health insurance companies. However, the way in which health insurance companies address obesity differs between companies. While some do consider obesity to be a disease and act on this by covering some services, it was noted to be extremely variable because insurers were reluctant to provide care for financial reasons.
Stakeholder noted that most people living with obesity entered the system through primary care. Once in the system, it was felt that compliance to disease management was not sufficiently supported and there was inconsistency in referrals to local services. This, compounded by the poor financial coverage for obesity treatment and management, means that the majority receive insufficient care. It was agreed that there is too much variation in what insurers will cover, with coverage often extended to bariatric surgery only and few other treatment options. As a result, it appears that much treatment is paid for out of pocket.
Stakeholders felt that there are inadequate numbers of suitably qualified obesity treatment professionals in both urban and rural areas. Specifically, there is reportedly a lack of psychologists, specialist doctors and dieticians. It was recognised that while there are obesity guidelines, they are only partly followed due to lack of financing and training. It was reported that most obesity training is not mandatory for health professionals.
Based on interviews/survey returns from 3 stakeholders
Last updated: June 2020
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We are currently finalising our data for this section. It will be available from late 2020.
