The document discusses obesity among Germans. It notes that Germans have high rates of obesity, especially among middle-aged and elderly individuals. Several factors contribute to this, including a diet high in fats and meats, a sedentary lifestyle, genetic factors, and changes in metabolism with age. Obesity is linked to numerous health issues. Efforts are being made in Germany to address obesity through improved nutrition, fitness programs, and more accurate food labeling.

1. Jessie Simmons
Black Health Care
Dr. Wallace
April 8, 2016
The Epidemic of Heavy Germans
Why Choose Obesity in Germans?
The epidemic of obesity is something that has been a struggle in the United States
for various minorities. As a server in a German bakery, Servatii, I noticed that a lot of our
German clientele, who happen to be the majority of our regulars were morbidly obese. In
addition, 3 out of 4 of the owner’s children struggled with their weight and of that three
two of them were morbidly obese and struggled to accomplish simple tasks such as
walking and picking up objects. I began to wonder if this was a trend among all German
people, especially since Cincinnati has a large population of German people compared to
other parts of the country. German culture is woven throughout Cincinnati for example:
Germans had a hand in the expansion and foundation of as a city Cincinnati. One
example is that they established the neighborhood Over the Rhine. In addition,
Oktoberfest is also a widely celebrated German event, particularly amongst German
individuals. It is important to know about the health issues plaguing the various
minorities where we live because it makes it more likely to come up with comprehensive
treatment programs.
Age and Gender Statistics
One could say that Germans have a big problem with their weight, pun intended.
The weight epidemic has cost the German government $90 million a year (BBC 1).

2. Overweight individuals have a Body Mass Index (BMI) of between 25 and 29%. Obese
individuals have a BMI over 30% In a study conducted by a German agency the
Independent Strategic Agency Opinium (EASO) in Conjunction with the European
Association for the Study of Obesity results concluded that obesity was equally prevalent
in young German men and women lying at 19 percent for both genders (EASO, 2).
Another study of German health conducted by epidemiologists: Hafenberger, Lampert,
Mensink, Scheidt, Schienkiewitz and Zise conducted was conducted on a population of
Germans who were between the ages of 30 and 79 and showed that obesity was
correlated with both height and age (851). By the age of bracket of 30-39 years old 62.4%
of German men and 53.4% of German women classify as being either overweight or
obese (Haftenberger et al. 851). The percentage of German women who are overweight
by the age of 79 increases by 22.4 percent and the percentage for German men increases
by 18.4 percent (Haftenberger et al. 852).
There are many reasons as to why obesity is more likely to occur in middle aged
and elderly Germans. One reason for the increase in obesity in older Germans is that the
older people get, the more their spine compresses in making them shorter, decreasing
their opportunity for mobility and making it easier for people to gain weight
(Hafternberger et al. 852). In addition, the older a person gets the more likely they are for
their socioeconomic status changes meaning that they cannot afford as healthy of foods
or luxuries like gym memberships (Haftenberger et. al. 853). According to the National
Gallup Poll “low-income [German] adults and those aged 45 and older are among the
most […] to be overweight or obese, while high-income and younger Germans are the
least likely (English and Scharioth 1). The reason for the increase in obesity with lack of

3. employment is because people have a lower self-esteem and are less likely to care about
their appearance and make an effort to change their appearance because they care less
about themselves (English and Scharioth 1). In addition, many retired German
individuals tend to spend their time relaxing and maintaining the high fat diet that they
did before they retired. Essentially, they are maintaining the unhealthy diet of a young
person but their metabolism has slowed down and they are moving even less than they
did when they are working. (English and Scharioth 1).
Biological Factors that Contribute to Being Overweight and Obese
“Obesity occurs when a person consumes more calories than they need for the
energy they use” (HealthCentral 1). One factor that contributes to obesity is appetite;
appetite is different than hunger in that appetite is the particular craving for a specific
type of food, if a person is exposed to fattening foods they are more likely to crave those
foods (HealthCentral 2). Many Germans consume fattening meat and dairy heavy foods
for every meal and drink a great deal of beer in the evening (Calorie Count Strength in
Numbers 2). On average a German breakfast contains 270 calories, German lunch
contains around 410 calories and a dinner 650 (Calorie Count Strength in Numbers 4-6).
According to page 1 of the organization HealthCentral’s article Obesity
“Appetite is determined by processes that occur both in the brain and gastrointestinal
tract. Eating patterns are controlled by areas in the hypothalamus and pituitary glands (in
the brain). The body produces a number of molecules that increases or decreases appetite,
including leptin. Leptin is a hormone that fat cells release. Some scientists think this
hormone may also be released by cells in the stomach. Leptin appears to play an
important role in insulin resistance and fat storage in the body, but its role in obesity is
unclear. The most likely scenario is that leptin levels rise as the cells store more fat. This
increase in leptin levels decreases appetite. Falling levels of leptin make you feel hungry.
In people who have genetically lower levels of leptin, however, the brain may be tricked
into thinking that it is always starving because there is no leptin to decrease appetite. This
can lead to weight gain”

4. Other biological factors that lead to obesity and overweight individuals are
medical conditions. A common medical disorder is Hypothyroidism where the patient
has an underactive thyroid gland and can lead to a person gaining as much as 10 pounds
(HealthCentral 1). Another biological condition in women that can cause obesity is
Polycystic Ovarian syndrome, this condition occurs when there are a cyst or multiple
cysts on the women’s ovaries. Women who have Polycystic Ovarian Syndrome gain
weight because of high hormone levels in women cause them to gain weight in their bust,
hips, and thighs. (HealthCentral 1). Cushing’s disease a condition where the afflicted has
high steroid levels in one’s bloodstream, also causes a person to become grossly
overweight (HealthCentral 1). Individuals with Cushing’s disease usually gain weight in
their face and waistline, people with Cushing’s disease are said to have a moon-shaped
face.
Genetics does not directly cause obesity, however, genetics can impact the
functioning of an individual’s body and make them more susceptible to being overweight
or obese. Germans are more likely to have these genetic mutations (Headbrand, 2). The
Harvard University School of Public Health says that to date they have found 30 possible
genes associated with body mass index (Sifferlin 1). One common genetic mutation is
Germans is the MCHR 1 gene that helps stimulate melatonin throughout the body
(Headbrand 2). Melatonin is a hormone that is released by the pineal gland in the back of
the brain. Melatonin helps to control an individual’s sleep and wake cycles (Headbrand
2). Mutation in the MCHR 1 gene causes one of two things to happen first: too much
Melatonin to be released making the individual more sleepy and less inclined to do
physical activity (Headbrand 2). Melatonin can be found in vegetables, since Germans do

5. not eat a lot of vegetables they do not get as much melatonin to make up for the
melatonin they do not have (Headbrand 3). Secondly, if one does not have enough
melatonin they will be more likely to stay awake. Individuals who stay awake are more
likely to gain weight due to increased appetite from irregular sleeping patterns
(Headbrand 2). Gherlin is another gene that is linked to obesity (Sifferlin 1). In a related
matter, Gherlin is one of the genes that influences the brain’s reward system, this gene
makes certain foods look more desirable than others (Sifferlin 1). People who are sleep
deprived increased Gherlin levels that make them hungrier (Sifferlin 1). Finally,
“Genetics may directly contribute to severe obesity in people with family histories of the
problem. Genetic factors such as slow metabolisms may also make people more likely to
be overweight, and there have been some genetic mutations identified in rare causes of
severe obesity” (HealthCentral 1).
Certain medications can also cause severe weight gain or increased appetite.
Corticosteroid, a type of steroid that activates the adrenal system, the medicine creates
synthetic hormones lead to increased appetite. Examples of Corticosteroids include
hydrocortisone, which is used to treat rashes (Healthcentral 1). Hormone treatments for
females including oral birth control medications and cancer hormonal treatments lead to
increased progestins, which is a synthetic hormone that works in conjunction with
estrogen and progesterone. An extra dose of this hormone makes it more likely for an
individual gain more weight and increases their appetite. Anti-depressants and anti-
psychotic drugs including lithium and valproate lead to severe individuals to gain weight
as well, which is why some people stop taking these medications (HealthCentral 1).

6. “Insulin and insulin-stimulating drugs used to treat diabetes, a particularly unfortunate
conflict of interest for obese individuals with type 2 diabetes” (HealthCentral 1).
German Cultural and Lifestyle Factors Contributing to the Bulge
There are many cultural reasons that inadvertently increase the likelihood of
Germans becoming and remaining obese. The German clothing industry is one that
perpetuates a heavier lifestyle. “The body proportions of the German population have
changed significantly in the last decades – today we are on average taller and heftier than
our parents and grandparents,” (The Local 1). The initiative to loosen of the waste of
clothes SizeGermany Project (The Local 1). The SizeGermany conducted by a group of
German textile companies project used a 3-D body scanner and took waste and bust
measurements, used ergonomic sizing as well as demographic information to generate a
new line of clothing for their heftier population (The Local 1). Roughly 100 other textile
industries and “other firms with an interest in ergonomics such as German carmaker
BMW have paid to access the new [weight] numbers [that were surveyed by] the
SizeGermany” project (The Local 1). All in all, to appeal to the majority of the
population, heavier people, industries are forced to make everything looser and wider so
that people will be more inclined to purchase them.
The International Association for the Study of Obesity discovered that the reason
why German men and women are the heaviest in Europe is because of the amount of
fattening foods they eat (DW 1). As stated before Germans consume high calories meats,
creams, and sugars for almost every meal. That compiled with a sedentary lifestyle is the

7. main culprit for obesity in Germans (DW 1). “People are not only eating more food than
they did 20 years ago but also replacing home cooking with packaged foods, fast food,
and dining out” (HealthCentral 1). Fast foods are even more toxic than restaurant cooking
because these foods contain portions and have more calories and unhealthy fats
(HealthCentral 1). “Wolfgang Zöller, deputy head of the conservative Union bloc in the
German parliament, blamed the weight gain, especially among children, on recent
decisions often associated with cost cutting” (DW 1). Schools are cutting physical
education classes and the government is eliminating nutritionist jobs to save money (DW
1). The German parliamentary group also blames the food industry for clearly stating the
ingredients and calorie content of their foods (DW 1).
Health Statistics and Impacts of Obesity
“There is a clear link between obesity and poor health in Germany. Obese
Germans are more than twice as likely as normal weight and underweight Germans to
have high blood pressure, high cholesterol, and to have suffered a heart attack. Those
who are obese are more than six times as likely as those who are normal weight and
underweight to have diabetes” (English and Scharioth 1).
Obese Germans are 50.8% more likely to have high blood pressure and
overweight individuals are 33.7% more likely. (English and Scharioth 1). High blood
pressure is a medical condition where the impact of the blood upon a person’s artery
walls can cause lead to more complex issues such as heart disease (English and Scharioth
2). In addition, Germans who are obese are 27.7% more likely to have high cholesterol
and overweight Germans 18.7% chance (English and Scharioth 2). Cholesterol is a wax-
textured substance found in the lipids in a person’s blood (English and Scharioth 2)

8. Having high cholesterol may result in the generation of fatty deposits in one’s blood
vessels. High cholesterol can also lead to heart disease (English and Scharioth 2).
Germans who are obese are 20% more likely to have diabetes and overweight Germans
have a 10.8% increased chance of developing diabetes (English and Scharioth 2).
Diabetes is a disease where the body either cannot produce insulin (Type 2) or the
insulin being produced is defective (Type 1) this leads to increased glucose levels in the
blood (English and Scharioth 2). Obese Germans have an 11% increased chance of
suffering from a heart attack and overweight Germans are 6.5% more likely to suffer
from a heart attack (English and Scharioth 2). A heart attack when a loss of blood supply
leads to the sudden and occasionally fatal collapse of the heart muscle (English and
Scharioth 2).
Obesity is also linked to a lower sperm count in men (Norton 1). “A number of
recent studies have found that compared with leaner men, obese men tend to have lower
sperm counts, fewer rapidly mobile sperm and fewer progressively motile sperm, which
refers to sperm that swim forward in a straight line rather than moving about aimlessly”
(Norton 1). On average obese men have a lower sperm count range than than men of a
normal weight; obese men heaving a 20 million per a millimeter of semen versus 150
million per a millimeter of semen (Norton 1). Obese men tend to have “altered levels of
testosterone and other reproductive hormones compared with thinner men” (Norton 1).
A Small Ray of Hope for A Big Problem
One of the best ways to combat obesity is by eating small portions of healthy food
during the day (HealthCentral 1). The majority of people eat 3 large portioned meals a
day which expands their stomach and leaves them feeling hungry (HealthCentral 1).

9. “Germany's minister for food, agriculture and consumer protection, Horst Seehofer, is
calling for concrete steps to be taken to fight a nationwide battle of the bulge” (DW 1).
Seehofer plans to require food companies to prevent more accurate nutritional
information. Seehofer also initiated “an obesity prevention strategy formulated that calls
on the participation of politicians, scientists, sports clubs, health-care providers, unions
and the food industry” (DW 1). Seehofer also developed a plan called the “Fit Instead of
Fat” initiative (BBC 1). Fit Instead of Fat focuses on improving the quality of food in
hospitals and schools as well as initiating fitness programs for children. They are hoping
to have drastically decreased obesity rates by the year 2020 (BBC 1). Anti-obesity clinics
have also been in testing phases, eight participants entered for 27 months (English and
Scharioth 3). Participants who entered the anti-obesity clinic were given nutrition
counseling, behavioral therapy and a physical exercise program (English and Scharioth
3). The anti-obesity clinic proved to have motivated and educated the 8 individuals who
participated (English and Scharioth 3). Project Kugelbitz was a project started in the
hospital that was generated to help obese adolescents by improving their outlook, self-
esteem and come up with new outlets for dealing with frustrations other than compulsive
eating (English and Scharioth 3).
Germany has also developed a number of fitness programs to help individuals
lose weight. Bundeswehr’s fitness camp is an anti-obesity fitness camp for German
soldiers (English and Scharioth 4). Initially, soldiers had a limited amount of time that
they could devote to health and fitness and expected individuals to already be physically
fit. This fat camp has helped improve German military numbers because overweight
individuals are now offered a government sponsored option to work on their weight.

10. (English and Scharioth 4). Finally, many German schools have developed a fitness test
for students that they must complete in 2nd grade. The students will have weigh-ins and
will be taught eight different exercises” (English and Scharioth 4). To conclude,
overweight and obese individuals dominate the majority of the German racial group
because of their protein and fat heavy diet and sedentary lifestyles. Some genetic
mutations may cause a predisposition for increased appetite and fatigue but they do not
directly cause the weight epidemic. The best way to prevent weight issues is to replace
rich calorie heavy foods with lighter healthier ones. Replacing beer with water, tea and
other more natural drink options will decrease one’s appetite. Exercise can help burn out
the fat within the fat cells. Temporary diets are not an answer what will help is a
permanent lifestyle change. Without this lifestyle change Germans will continue to suffer
from chronic and life-threatening cardio conditions as well as the possibility of male
infertility.

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