1. Obesity in Germany

2. Introduction

3.  Obesity is a widespread phenomenon.
 It has doubled since 1980.
 In 2008 more than 1.4 billion adults
(>20y) were overweight
 Definition: abnormal or excessive fat
accumulation that may impair health.

4.  Obesity is based on the BMI or Body Mass
Index
 Overweight is a Body Mass Index greater
than or equal to 25, a Body Mass Index
greater than or equal to 30 is obesity.

5.  The 2009 results of the German Federal
Statistics Office:
 Every second German is overweight
 Every sixth is actually obese.

6.  Health implications are enormous
◦ Higher risk to develop a multitude of
comorbidities
 Type2 diabetes mellitus
 Coronary heart disease
 Some cancer types

7. Evolution

8. 1980
Mean BMI
25.4

9. 1985
25.7

10. 1990
25.9

11. 1995
26.3

12. 2000
26.7

13. 2005
27.0

14. 2008
27.2

18. Causes

19.  Most people consume more calories than
they burn.
Eating too much and exercising too little.
Many other factors

20.  Age:
◦ As you get older, your body’s ability to
metabolize food slows down.
 Gender:
◦ Men have a higher resting metabolic rate.
 Genetics:
◦ Obesity related genes could affect how we
metabolise food or store fat.
◦ Not destined to be obese, you have a higher
risk.

21.  Environmental factors:
◦ Closely related to nutrition an physical activity.
 Physical activity:
◦ Active individuals require more calories than
less active ones to maintain their weight.
 Illness:
◦ Hormone problems may slow down metabolism

22.  Medication
 Psychological factors:
◦ Many people eat in response to negative
emotions.

23. Initiatives
To lower the obesity rate in Germany

24.  The government:
◦ 2007: shocking study showed the severity of
the obesity problem in Germany
◦ 2008: German Government developed 21
initiatives to improve living in Germany
=> Initiative 14 concerns obesity

25.  14a
 Health and nutrition
 Living more healthily for longer
 Premature mortality
 (cases of death per 100,000 residents under 65) men
 Reduction to 190 cases per 100,000 by 2015
 14b
 Premature mortality (cases of death per 100,000 residents under
65) women
 Reduction to 115 cases per 100,000 by 2015
 14c
 Proportion of adolescents who smoke (12- to 17-year-olds)
 Decrease to under 12% by 2015
 14d
 Proportion of adults who smoke (15 years and older)
 Decrease to under 22% by 2015
 14e
 Proportion of obese people (adults, 18 and older)
 Reduction by 2020

27.  2008 -> 2020 = 12 years to reduce the
obesity rate in Germany
 30 000 000 Euros

28. List of initiatives
 Education on healthy eating and physical
activity;
 Tougher standards on school food
programs;
 Better product labeling by the food
industry;
 Reduced advertising by the makers of
sweets and junk food that target children;

29. Typical German Food

31. FIT instead of FAT campaign
 Improving the quality of food offered in
schools and hospitals;
 Encouraging children to participate in
physical activity.

32. German Politics seem to be aware of the
problem.
But if we are honest; they don’t seem to
take that much action to really adress
obesity, which is a big risk to public health…

33. Consequenses

34.  METABOLIC SYNDROME
◦ Central obesity
◦ Reduced HDL-cholesterol
◦ Raised blood pressure
◦ High fasting blood sugar 
DIABETES MELLITUS TYPE II
 LEADS TO CARDIOVASCULAR DISEASE !!!

36.  CARDIOVASCULAR DISEASE
◦ Heart attack
◦ Coronary artery disease (angina pectoris)
◦ Stroke – TIA
◦ Peripheral artery disease (claudicatio
intermittens)

37.  CANCER
◦ Hormone related cancers such as
breast, endometrium, ovary, cervix and
testicles
◦ Also : pancreas, colon, rectum, kidney

38.  GALLSTONES
◦ 3 to 5 times more often than in non-obese
people (especially women)
◦ Often painless
◦ Can cause gallstone attacks, acute
inflammation of the gall and of the pancreas

39.  HIATUS HERNIA AND INFLAMMATION OF THE
OESOPHAGUS
 LUNG FUNCTION – RESPIRATORY DISEASE
◦ Asthma : obesity increases risk by 50 %
◦ Obstructive sleep apnea : 50 % – 75 % are obese
 MUSCULOSKELETAL DISORDERS
◦ Arthritis : knee and hip
◦ Obese patients account for one-third of all joint
replacement operations
◦ Lower back pain, lower limb pain

40.  REPRODUCTION
◦ Women
 PCOS
 Increased risk of early and late miscarriage
 Gestational diabetes
 Preeclampsia
 Complications during labor and delivery
 Slightly increased chance of bearing a child with
congenital anomalies
 Correlation between increasing BMI and problems
with arousal, lubrication, orgasm, and satisfaction

41. ◦ Men
 BMI > 35 -> low sperm count and poor sperm
motility
 Erectile dysfunction increases with increasing BMI

42.  OTHER CONDITIONS
◦ Gout

43. ◦ Chronic kidney disease
◦ Non-alcoholic fatty liver disease
◦ Alzheimer’s disease (risk is increased by 42
%)

45.  http://www.minurses.org/files/files/Nursing%20Practice/CE_Obesity.pdf
 http://www.who.int/mediacentre/factsheets/fs311/en/
 http://www.berlin-institut.org/online-handbookdemography/overweight.html
 Zelissen, Pierre. Obesitas en overgewicht : oorzaken, gevolgen en behandeling.
Davidsfonds Leuven, 2003.

 Daansen, Peter. Leven met obesitas. Bohn Stafleu van Loghum, 2005.

 http://www.hsph.harvard.edu/obesity-prevention-source/obesity-
consequences/health-effects/index.html

 http://en.wikipedia.org/wiki/Metabolic_syndrome

 http://www.medscape.org/viewarticle/484768_2

 http://trialx.com/curetalk/2011/03/gout-clinical-trials-treatments-research-
sites/
 http://www.who.int/mediacentre/factsheets/fs311/en/
References