Obesity: An Overview

Obesity (severe overweight) is a chronic disease. It is based on an excessive increase in body fat due to a long-term positive energy balance. This means that more energy (kilocalories) is taken in through food than is consumed through metabolism and physical activity. The excess energy is stored in the body in the form of fat deposits. Numerous genetic, biological, psychological and socio-economic factors – such as income and education – as well as lifestyle and environmental factors contribute to the development of obesity.

Obesity can have a negative impact on well-being and quality of life and is associated with an increased risk of developing concomitant and secondary diseases. It requires comprehensive and lifelong treatment. The treatment is based on nutrition, exercise and behavioral therapy. In addition, formula diets and drugs can be used as support. Surgical intervention can also be useful in some cases. Digital tools such as apps and pedometers and what are called digital health applications (DiGAs; apps on prescription) support weight reduction.

A healthy lifestyle with a balanced diet, regular exercise, little stress and sufficient sleep can prevent the development of overweight and obesity.

Like diabetes and cardiovascular diseases, obesity is a non-communicable disease.

On this page you will find the most important information about obesity at a glance.

1. Clinical picture of obesity
2. What concomitant and secondary diseases can be associated with obesity?
3. What can I do to prevent obesity?
4. How high is my risk and how is obesity diagnosed?
5. How is obesity treated?
6. How widespread is obesity in Germany?

Obesity is a chronic disease recognized by the World Health Organization (WHO) and the German Bundestag. Obesity is also a risk factor for numerous concomitant and secondary diseases such as restricted mobility, type 2 diabetes, cardiovascular diseases and breathing disorders during sleep (sleep apnea syndrome).

There are many causes of obesity: Genetic predisposition, a high-calorie diet, lack of exercise, stress and lack of sleep all play a role, as do socio-economic (education, income and occupation), psychological and environmental factors. Once stored, fat reserves are difficult to break down again and require comprehensive and lifelong therapy – individually adapted and under specialist care.

The earlier obesity is recognized and treated, the better the chances of reducing body weight, preventing concomitant and secondary diseases and thus improving health, quality of life and well-being.

Find further information on the development and clinical picture of obesity here.
 

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The risk of developing overweight and obesity can be reduced by several measures. To achieve this, lifestyle plays a decisive role. A balanced diet, plenty of exercise, little stress and sufficient sleep are the most important factors in keeping body weight within the normal range and avoiding secondary diseases.

The diet should be as varied as possible and adapted to individual needs. There are various suitable forms of nutrition. It is also important to avoid highly processed foods and sugar-sweetened drinks.

The World Health Organization (WHO) recommends a combination of endurance and strength training as physical activity, as well as balance and coordination exercises for people aged 65 and over. In addition, as much exercise as possible should be integrated into everyday life and sitting times should be reduced.

It is important to avoid stress and get enough sleep with a regular sleep pattern.

Find more information about what you can do to prevent overweight and obesity here.
 

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The distribution of body fat also has an impact on health risk. Visceral fat in particular, which accumulates around the organs in the abdomen, is associated with a high health risk. This can be determined using the waist circumference.

Find detailed information on the risk factors and diagnosis of obesity here.
 

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As a chronic disease, obesity requires lifelong, individually tailored treatment. The therapy aims at reducing body weight in the long term, preventing the development of concomitant and secondary diseases and improving quality of life.

The multimodal basic therapy for obesity is based on a combination of dietary changes, more exercise and behavioral therapy. If this does not achieve sufficient weight reduction, formula diets or medication can be used as support. In Germany, there are three approved active substance groups: lipase inhibitors (orlistat), GLP-1 receptor agonists (liraglutide and semaglutide) and dual receptor agonists (tirzepatide).

In some cases, surgery may be another treatment option. Various methods are available for weight-loss surgery, often also referred to as bariatric or metabolic surgery, such as sleeve gastrectomy and gastric bypass.

Since 2020, digital health applications (digitale Gesundheitsanwendungen, DiGAs; apps on prescription) have also been approved as a supplement to obesity treatment.

Find more information about the different approaches to treating obesity and how these can help to reduce body weight and stabilize it in the long term here.
 

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The incidence of overweight and obesity has risen in recent decades. In Germany, more than half of adults are overweight. Of these, around a quarter have a BMI of 30 kg/m² or higher and are considered obese.

While the overall incidence of overweight and obesity increases with age, more and more children and adolescents also have an increased body weight.

Find more information on the prevalence of obesity in Germany here.
 

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