RKI Study: Around Every Tenth Preschool Child in Germany is Overweight

A BMI value of 30 or above is classified as obesity. Obesity refers to excessively high body weight caused by an excess of body fat; the condition is also called adiposity. The RKI clearly contextualizes the finding: approximately every tenth preschool child in Germany is overweight.

The evaluation was published in the "Journal of Health Monitoring" and produced in collaboration with the news agencies dpa and epd. However, in some years the RKI only had data from two or three federal states, meaning the figures are only comparable to a limited extent. Data availability fluctuated significantly between states and was greatest for the school entry years 2015 to 2019.

Increase During the Pandemic, Decline by 2024

During this period from 2015 to 2019, the prevalence of overweight and obesity remained largely stable. After the onset of the COVID-19 pandemic in 2020, the RKI recorded an increase in overweight and obesity in several federal states. Tendentially higher prevalences had been observed here. The highest proportion of overweight children was recorded in 2021, at just over 13 percent.

The figure declined again in the following years. By 2024, the figures were back at pre-pandemic levels or even below – the lowest proportion across the entire study period was recorded in 2024, at just under nine percent. Thus, while the evaluation shows a temporary pandemic effect, it does not point to a lasting worsening at the national level.

Social and Regional Inequalities

However, the study reveals significant regional and social differences. "Je höher die sozioökonomische Benachteiligung eines Landkreises war, desto häufiger waren Übergewicht und Adipositas bei den Kindern zu beobachten", the RKI writes. Children growing up in socially and economically deprived areas are therefore more frequently affected by obesity. This shows that poverty is already an important risk factor for the disease in childhood, according to the RKI.

Settlement structure also plays a role: in urban districts, the proportion of overweight children was lower than in major cities or rural districts. For the year 2019, the figures were linked with data on settlement structure and socioeconomic factors of the respective districts. In rural areas, it is primarily contextual factors that contribute to the development of overweight: for example, a lack of sidewalks and public transport, as well as long distances to recreational facilities, the researchers say.

Research, Data Situation, and Need for Action

The researchers call for taking health inequality in childhood into focus and reducing it for prevention purposes. This evaluation ties into a broader debate on the connection between poverty, living environment, and health in early life. The authors see a particular need for action in regions where multiple risk factors converge.

Up to 13 percent of preschool children are overweight, considerably more often in socioeconomically deprived regions. Even though the nationwide figure has recently declined again, the unequal distribution between urban and rural areas, and between better-off and worse-off regions, remains the central message of the study.

The school entrance examinations underlying the data record the height and weight of almost all children starting school in Germany in a standardized manner nationwide. They are considered one of the few comprehensive data sources on the health status of children in this age group – and thus an important basis for health reporting at the federal and state level.