Pre-obesity: What the term means and what you can do now

September 23, 2026about 17 minutesby mybody®x Editorial & Expert Team

In this article

What does pre-obesity mean in a medical report?

Pre-obesity refers to a Body Mass Index of 25.0 to 29.9 kg/m². This is how the German Obesity Society (DAG) defines it in the 2024 version of its S3 Obesity Guideline.

The Body Mass Index, or BMI for short, relates body weight to height: weight in kilograms divided by height in meters squared, hence the unit kg/m². An S3 guideline is a medical practice recommendation at the highest development level, and this one classifies body weight into categories. Below 25 is normal weight, obesity starts at 30, and pre-obesity is the range in between.

An example makes this tangible. Someone who is 1.70 meters tall and weighs 80 kilograms divides 80 by 2.89, the square of 1.70. The result is a BMI of around 27.7, right in the middle of the range.

The prefix “pre” means “before.” It refers to the stage before obesity, which the guideline defines as an increase in body fat beyond normal levels that is associated with health risks.

In everyday speech, pre-obesity is simply called overweight, and the guideline also uses the term “overweight (pre-obesity).” One sticking point remains: in its classification table, the same guideline groups everything from a BMI of 25 upward under overweight, including obesity. Pre-obesity, by contrast, always refers only to the range from 25.0 to 29.9.

Anyone who sees the term in a doctor's letter or a health app initially has a classification of weight and height. What it means depends on information that BMI does not include. The following chapters are about exactly that information.

Since the search for an explanation quickly leads to genetic testing, one clarification first: A DNA test does not explain obesity and does not replace treatment. What it can do at this stage is discussed in Chapter 8.

What does the guideline say about BMI in pre-obesity?

It uses BMI for classification, but does not consider it sufficient on its own for deciding whether to treat. It says the same about waist circumference, or the measurement around the middle of the body.

This sentence appears in the recommendation that specifies when people with overweight or obesity should be treated. It is brief, but shifts the focus away from the number alone.

Two terms here need explaining. A surrogate parameter is a substitute measure: it indicates something that is not measured directly, in this case the amount of body fat. Visceral fat is fat in the abdominal cavity, located between the internal organs.

The guideline explains its own caution. BMI describes body fat percentage only imprecisely; it is a measure of excess weight and only an approximation of excess body fat. It also gives no indication of how fat is distributed in the body.

The World Health Organization (WHO) puts it similarly in its 2025 fact sheet: BMI is a surrogate marker for body fat, and other measurements such as waist circumference can support the diagnosis. For adults, it uses the same thresholds as the German guideline: overweight starts at a BMI of 25 and obesity at 30.

For you, that means the number in your report is the beginning of a conversation, not a verdict. It tells you which weight category you fall into. Your doctor will determine whether this has any implications based on additional information.

How common is pre-obesity in Germany?

According to self-reports, 53.5 percent of adults in Germany are overweight, including those with obesity (RKI, GEDA 2019/2020, published 2022). The sources analyzed here do not provide a separate figure for pre-obesity alone.

The figure comes from the Robert Koch Institute’s (RKI) “Health in Germany Today” survey (GEDA 2019/2020), published in 2022. Participants reported their own height and weight, a method known as self-reporting. The analysis puts the proportion with obesity at 19.0 percent for both sexes.

There are two caveats to this figure. According to the S3 guideline (2024), self-reported figures are lower than those obtained through standardized measurement. And the 53.5 percent includes obesity; the proportion with pre-obesity alone cannot be determined from it.

Men have higher rates than women in the survey, and the proportion increases with age for both sexes. Compared with the 2012 survey, overweight rates have remained unchanged, while obesity has continued to increase, especially among those aged 45 to 64 (RKI, 2022).

According to WHO figures, 43 percent of adults worldwide were overweight in 2022, and 16 percent were living with obesity. A figure that affects more than half of the adults in a country says little about any one person. What matters is what distinguishes your results from those of others.

Pre-obesity in numbers

Sources: German Obesity Society, S3 Guideline on Obesity, 2024 · Robert Koch Institute, GEDA 2019/2020, published 2022

When does pre-obesity require treatment?

According to the S3 guideline, when a BMI of 25 to under 30 is accompanied by a contributing factor, such as high blood pressure or a waist circumference of 88 centimeters or more for women and 102 centimeters or more for men. At a BMI of 30 or above, the BMI itself is already a reason for treatment.

The guideline refers to an indication, meaning a medical reason for treatment. For pre-obesity, it lists four types of accompanying factors, one of which is sufficient.

The first type is health conditions caused by excess weight. The guideline cites high blood pressure, medically known as hypertension, and type 2 diabetes, a form of diabetes. The second is an abdominal fat distribution, in which fat is concentrated mainly around the trunk; it is measured by waist circumference.

The third category is conditions that are worsened by excess weight. The fourth is severe psychosocial distress. Psychosocial means relating to a person's mental well-being and life with others; here, it refers to a significant burden caused by weight in these areas.

This puts the objective assessment between two mistakes. Dismissing pre-obesity as harmless overlooks the fact that the guideline explicitly recommends treatment when accompanying factors are present. Exaggerating its significance overlooks the fact that a BMI of 27 without such factors is not considered a reason for treatment there.

You can check some things yourself, such as your waist circumference with a measuring tape. Your family doctor can determine whether high blood pressure or elevated blood sugar is involved. They are the right first point of contact if you're unsure whether any of these factors apply to you.

Which measures supplement BMI in pre-obesity?

Primarily waist circumference, plus two ratios that compare the waist with the hips or with height. The S3 guideline (2024) specifies a threshold for each of these measures.

According to the guideline, the thresholds for waist circumference and waist-to-hip ratio are based on recommendations from the American Heart Association, a US professional association for cardiovascular health. It also cites the WHO definition. According to that definition, abdominal obesity, meaning obesity concentrated around the abdomen, is present when the waist-to-hip ratio is above 0.90 in men and above 0.85 in women.

Four measures compared · DAG 2024

Here’s an example of the waist-to-height ratio: a waist circumference of 85 centimeters and a height of 170 centimeters give 85 divided by 170, or 0.5. That is exactly at the proposed cutoff.

There’s one sentence from the guideline you should know: “In future, age-specific cutoff values should be used for risk assessment.” This means today’s values apply equally to all age groups. They are a guide, not a custom fit for your age.

Is pre-obesity just a label?

No. The guideline sets clear conditions for treatment based on this finding, and losing approximately 5 percent of body weight already improves cardiometabolic risk factors, meaning risks to heart and metabolic health, according to the S3 guideline (DAG, 2024).

Two contradictory claims about pre-obesity are widely circulated, yet both are off the mark. One downplays the finding; the other makes BMI the sole measure.

Two claims under scrutiny

Both claims have a grain of truth. According to the guideline, pre-obesity alone is indeed not a reason for treatment, and BMI is indeed the number used to classify people. It only becomes wrong with the “only” and the “everything.”

What lies between the two is a finding that raises a question rather than providing an answer. The question is: Is there anything else going on for you? The answer comes from the measuring tape and a conversation at the clinic.

Pre-obesity in women: What’s different?

The cutoff for waist circumference is lower for women: 88 centimeters instead of 102 centimeters for men. In addition, according to the S3 guideline (2024), women have more body fat on average than men at the same BMI.

The second point shows that BMI does not indicate the same thing about body fat in women and men. Two people with a BMI of 27 may have different body fat percentages, and sex is one of the reasons explicitly cited in the guideline.

The proposed cutoffs for the waist-to-hip ratio also differ in the guideline (DAG, 2024): 0.88 for women and 0.95 for men. According to the same guideline, the WHO sets the threshold for abdominal obesity at over 0.85 for women and over 0.90 for men. Only the waist-to-height ratio uses a shared cutoff of 0.5.

A comparison shows what this means in practice. A woman with a BMI of 26 and a waist circumference of 90 centimeters meets a criterion for which the guideline recommends treatment. A man with the same BMI and the same 90-centimeter waist circumference does not.

The proportion of affected people shows the opposite pattern: In the RKI GEDA 2019/2020 survey, the proportion of people who are overweight is higher among men than among women. This does not change the individual finding. The sources used here do not identify any further differences between women and men with regard to pre-obesity.

What can you do now about pre-obesity without a program?

The guideline identifies a combination of dietary changes, increased physical activity, and behavior modification as the foundation of all weight management. According to the guideline (DAG, 2024), the target for a BMI of 25 to 34.9 is to lose at least 5 percent of body weight within six to twelve months.

In the guideline, this combination is called basic therapy. Weight management refers to both the weight-loss phase and the long-term maintenance that follows. Behavior modification means deliberately changing habits.

According to the guideline, the specific components depend on the severity of the condition and the circumstances of care. This article therefore does not prescribe a diet or exercise plan. Instead, it points you in the right direction and refers you to articles that explore individual steps in more detail.

What rate of weight loss is realistic with pre-obesity?

According to the guideline, the usual target is a daily energy deficit of about 500 to 600 kilocalories. An energy deficit means taking in less energy than your body uses. This is expected to result in a weight loss of around 0.5 kilograms per week for up to three months.

After that, weight loss slows as the body activates energy-saving mechanisms. The guideline states: “A new energy balance is usually reached after 3 to 6 months, after which the focus shifts to weight maintenance.” The article How much weight can you lose in a month? shows how this plays out over weeks and months.

Over the course of a year, systematic analyses underpinning the guideline found a weight loss of 5 to 6 kilograms with this deficit, regardless of the type of dietary therapy. This is not a promise for you, but an indication of the range you can use to set expectations.

Pre-obesity and hunger: How can you feel full?

The obvious concern when eating at a deficit is hunger. The guide Losing weight without going hungry explores this and explains satiety and how to put meals together. It does not replace a plan, but shows you what to look to for guidance.

Pre-obesity in everyday life: How can a change become a habit?

The guideline explicitly includes long-term stabilization as part of weight management—that is, maintaining the new weight. The guide How to stick with dietary changes explains step by step how to maintain a change in eating habits over the weeks.

This article does not make recommendations about exercise. The guideline includes increased physical activity as a core component; how to approach it should be discussed with your doctor's office or a qualified professional.

If eating and weight are taking over your everyday life, your doctor's office is the first place to turn. This applies regardless of your current BMI.

Pre-obesity and DNA tests: What can they contribute?

Those looking for a personal starting point during this phase can find a DNA test on weight from mybody®x (MYBODY Lab GmbH). It does not replace any of the components of the guideline and does not predict weight loss success. Genetic predisposition is not destiny.

A position paper by the German Nutrition Society (DGE) noted in 2022 that evidence for the success of gene-based dietary recommendations was still largely lacking (paraphrased from Holzapfel et al., 2022). We therefore see the value of such a test in providing structure and perspective, not in explaining a person's weight.

The article Can a DNA test help with overweight? explains in more detail how to put a DNA test for weight loss into perspective.

What can’t BMI and a DNA test tell you about pre-obesity?

BMI only estimates body fat imprecisely, and a DNA test does not provide a diagnosis. Neither determines whether treatment is indicated; that decision is made based on a medical assessment.

The guideline identifies four factors that can affect the relationship between BMI and body fat: age, sex, ethnicity, and muscle mass. Older adults have more body fat than younger adults at the same BMI. Muscular people and highly trained athletes may have a high BMI because of their muscle mass.

This is crucial for a BMI just above 25. Someone who has built muscle through strength training may fall into the pre-obesity range without excess fat being the reason. According to the guideline, older people have more body fat than younger people at the same BMI. In both cases, waist circumference provides additional information.

A DNA test is not a diagnostic procedure and does not replace a medical examination. It does not measure the values the guideline uses to determine treatment, including waist circumference or blood pressure.

This article also only provides context. It cannot determine whether you have an accompanying condition; that remains the responsibility of your healthcare provider.

Where does pre-obesity end and obesity begin?

At a BMI of 30. From that point, the guideline defines obesity and divides it into grades, beginning with Grade I at 30.0 to 34.9.

Grade II begins at 35.0, and Grade III at 40. What these classes mean and how they differ is explained in the article Obesity Grades 1, 2, and 3 Explained. This article deliberately focuses on the preceding stage.

The classification changes at this threshold. In its 2025 fact sheet, the WHO describes obesity as a chronic, relapsing disease. According to this description, it results from an interplay of factors ranging from genetics to the environment. According to the guideline, a BMI of 30 or higher is in itself sufficient to indicate treatment.

The weight target shifts only later: Up to a BMI of 34.9, the S3 guideline (DAG, 2024) recommends losing at least 5 percent of body weight within six to twelve months; from 35 onward, at least 10 percent.

Pre-obesity is a term for a range of numbers. What it means for you only becomes clear when you consider the measurements alongside it, and the first of these is taken with a measuring tape.

Frequently asked questions

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Sources

1. German Obesity Society (DAG) e.V.: S3 Guideline on Obesity – Prevention and Treatment, Version 5.0, AWMF 050-001 (as of October 2024) – register.awmf.org
2. World Health Organization (WHO): Fact sheet “Obesity and overweight” (as of December 2025) – who.int
3. Robert Koch Institute, Schienkiewitz A. et al.: Overweight and obesity among adults in Germany – Results from GEDA 2019/2020-EHIS, Journal of Health Monitoring (2022) – europepmc.org

BMI categories, treatment indications, waist circumference and other measurements, BMI limitations, basic therapy, weight goals, and rate of weight loss are based on [1]. The definition, BMI’s function as a proxy marker, obesity classification, and global figures are from [2]. The figures for Germany follow [3], as also reported in [1]. The DGE position reflects the position paper by Holzapfel et al., Molecular Nutrition and Food Research 2022, DOI 10.1002/mnfr.202200077. Product information is based on the mybody®x product page; price checked on 23.09.2026.