OBJECTIVES: Available evidence on the association of obesity and workplace productivity loss is scarce and fails to estimate the impact across individual obesity classes. Therefore, this observational study aims to explore sick leave in patients living with obesity stratified by obesity class.

METHODS: This is a cross-sectional, observational study of routinely collected claims data of the statutory health insurance (SHI) system in Germany. Individuals generally eligible for sick payments between 2016 and 2021 were included. Individuals living with obesity, identified by the presence of diagnoses for obesity, were selected and stratified into four subgroups, namely BMI classes I, II, III and not specified obesity class based on the observed diagnosis for obesity (ICD-10-GM E66). Results were compared to patients without obesity.

RESULTS: Of the available 3,227,677 individuals in the database (2021), 124,617 met the inclusion criteria (e.g. obesity, minimum age of 5 years and eligibility for sick leave). In 2021, higher rates of patients with sick leave (68.3% vs 51.7%) and elevated average number of days on sick leave were found for those living with obesity (40.5 days, 95% CI [40.1, 40.9]) compared to patients without obesity (18.9 days, 95% CI [18.8, 19.0]). Average number of days on sick leave was highest for obesity class III (47.9), followed by classes II (44.2), class I (42.3), and not specified obesity (33.3). Similar results were observed between 2016-2020.

CONCLUSIONS: The results suggest that rate and duration of sick leave increase with obesity class. As this might have an impact on productivity losses and societal health burden, structured obesity prevention and treatment should be implemented more intensively.