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J Occup Environ Med. 2014 Jan;56(1):20-7. doi: 10.1097/JOM.0000000000000065.

Sick leave days and costs associated with overweight and obesity in Germany.

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From the Department of Health Economics and Health Services Research (Mr Lehnert, Ms Stuhldreher, Ms Streltchenia, and Dr König), Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; IFB Adiposity Diseases (Mr Lehnert and Dr Riedel-Heller), University Medicine Leipzig, and Department for Social Medicine, Occupational Medicine, and Public Health (Mr Riedel-Heller), University of Leipzig, Leipzig, Germany.



To analyze the impact of body mass index on sick leave days and related costs in Germany.


Cross-sectional analysis of German Socio-Economic Panel data (n = 7990). The relationship between body mass index class and sick leave days was analyzed via analyses of variance (ANOVA) (bivariate) and zero-inflated negative binomial regression models (multivariate).


Body mass index was positively associated with annual sick leave days in the bivariate analysis (P < 0.001). In the fully adjusted zero-inflated negative binomial, overweight women had 3.64, obese women 5.19, and obese men 3.48 excess sick leave days in 2009 (vs normal weight), while excess sick leave days of overweight men were not statistically significant. The extrapolated excess costs in the German working population amount to &OV0556;2.18 billion (base case).


The absenteeism-related lost productivity costs associated with excess weight are formidable and emphasize the persistent need for health promotion efforts in Germany.

[Indexed for MEDLINE]

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