title: Sick leave days and costs associated with overweight and obesity in Germany.
abstract: OBJECTIVE
  To analyze the impact of body mass index on sick leave days and related costs in Germany.
  
  
  METHODS
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  The absenteeism-related lost productivity costs associated with excess weight are formidable and emphasize the persistent need for health promotion efforts in Germany.
authors.affiliation: 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.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehnert
authors.forename: Nina
authors.initials: N
authors.lastname: Stuhldreher
authors.forename: Pawel
authors.initials: P
authors.lastname: Streltchenia
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004526:Efficiency; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics*; D050177:Overweight / Q000191:economics; D018582:Sick Leave / Q000191:economics* / Q000706:statistics & numerical data*; D055815:Young Adult