• Overview
  • Obesity prevalence
  • Trends over time
  • Population breakdowns
  • Drivers
  • Comorbidities
  • Health systems
  • Actions
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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

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

Perceived barriers to treatment

  • Lack of political will, interest and action
  • High cost of out of pocket payments
  • Influence of food industry
  • Fragmented or failing health system
  • Lack of training for healthcare professionals
  • Lack of multidisciplinary teams
  • Poor health literacy & behaviour
  • Obesogenic environment
  • Obesity not recognised as a disease

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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