Therapeutic Fasting in Germany: Tradition and Medical Guidance

Key points at a glance

• Therapeutic fasting in Germany goes back to the physician Otto Buchinger (1878–1971), who turned fasting from a folk remedy into a medically led method.
• Fasting after Buchinger is the conscious, time-limited abstention from solid food and stimulants – not a zero-calorie diet and not primarily a method for losing weight.
• The professional foundation today is the Medical Society for Fasting and Nutrition (ÄGHE), from which the guidelines on fasting therapy come; further studies can be consulted there.
• Medically supervised fasting combines history-taking, physical examination and an accompanying range of therapies with a calm, individually tailored course.
• The Naturhotel Tannerhof in Bayrischzell has carried this tradition forward for more than 70 years and three medical generations – Fasten in der DNA des Hauses, fasting in the DNA of the house.

Therapeutic fasting as a German health tradition

Anyone searching today for therapeutic fasting in Germany stands in a long line. Here, fasting for health is not a short-lived fashion but a tradition more than a century in the making, one that joins medicine and inner reflection. Its origin lies in the medical work of a man who first experienced fasting in his own body and then shaped it into a guided method: Otto Buchinger.

Fasting after Buchinger is the conscious, time-limited abstention from solid food and stimulants. It is not a zero-calorie diet and not primarily a way to lose weight, but more than a diet – a therapeutic method, a cleansing on many levels and an encounter with oneself. This definition still holds, and it is the common denominator of a tradition that has endured in Germany across generations. Anyone wishing to read the method in detail will find it on the Tannerhof page on the Buchinger method, embedded in the hub on therapeutic fasting and the Schlanke Tanne.

At the Naturhotel Tannerhof this tradition is especially tangible. Therapeutic fasting came to the house through Johannes von Mengershausen of the second family generation and has since been carried on through three medical generations, more than 70 years in all. His handed-down words still shape the attitude today: Beim Heilfasten entdecken Sie eine neue Freiheit: die Unabhängigkeit von fester Nahrung. Fasten bedeutet Stille, Hinhorchen auf das innere Geschehen und Besinnung auf das Wesentliche. – in fasting you discover a new freedom, independence from solid food; fasting means stillness, listening inward and a return to what is essential. Beside it stands, brief and lasting, Otto Buchinger's own line: Fasten regt den inneren Arzt an – fasting stirs the inner physician.

Otto Buchinger and the origin in Germany

Otto Buchinger was born on 16 February 1878 in Darmstadt and was a physician. In September 1917 he fell seriously ill – a throat infection with rheumatic inflammation of the joints that nearly cost him his life and impaired him for a long time. After the war, a conventional cure did not help him. The turn came only with a fasting cure under the Freiburg physician Gustav Riedlin which, as Buchinger later described it, activated his powers of self-healing. From this personal experience grew a medical life's work.

Buchinger's achievement was to move fasting from folk medicine into a medically led method. In 1920 he opened the Dr Otto Buchinger sanatorium in Witzenhausen; in 1935 he moved the clinic to Bad Pyrmont. In the same year his main work, Das Heilfasten und seine Hilfsmethoden, appeared, in which he described the method in detail. He joined the physical side – the abstention, the fluid intake, the movement, the warmth – with an inner, contemplative side. This union of medicine and reflection is to this day the hallmark of therapeutic fasting in Germany.

Out of this work has grown a practice that is studied scientifically today and applied in many medically led houses in Germany – including the Naturhotel Tannerhof, introduced by Johannes von Mengershausen and carried on since through three medical generations. So the national tradition joins with a concrete, family-run history in Upper Bavaria.

The ÄGHE: the professional foundation of fasting

A health tradition does not live on history alone but on professional care. In Germany this task falls to the Medical Society for Fasting and Nutrition (ÄGHE), an association of doctors who give therapeutic fasting a scientific grounding. The guidelines on fasting therapy come from it, and further studies on fasting therapy can be consulted there.

The guidelines were originally published in 2002 by an expert panel in the journal Forschende Komplementärmedizin und Klassische Naturheilkunde and updated after 2013 as an expert-panel update of the consensus version. They describe methodology, patient selection, contraindications and the medical supervision of fasting. Among the areas placed under professional supervision are obesity and metabolic syndrome, high blood pressure, rheumatic diseases, fibromyalgia, osteoarthritis, chronic pain syndromes and migraine. Which of these themes apply in an individual case always belongs, at the Tannerhof, to the medical assessment.

How well longer fasting is tolerated is shown by a large observational study by Wilhelmi de Toledo and colleagues from 2019, published in PLOS One. It followed 1,422 people over fasting periods of four to twenty-one days after the Buchinger method. Adverse effects occurred in fewer than one per cent, with none severe or lasting; physical and emotional well-being rose markedly in all groups. Of 404 participants with existing health complaints, 84.4 per cent reported an improvement, and 93.2 per cent of all participants experienced no hunger during the fast. Findings like these make it understandable why therapeutic fasting has held its place in Germany as a serious medical practice.

What characterises medically supervised fasting

Medical supervision is not strictly mandatory for fasting, but it is sensible – and it is the real mark of the German fasting tradition. It distinguishes guided therapeutic fasting from a fasting week someone attempts alone at home. What the supervision involves can be pinned to a few points:

• A medical intake consultation at the start, conceived holistically: history-taking, physical examination including bioimpedance analysis to measure body composition, and a review of medications.
• An individual agreement on duration, accompanying treatments and the rhythm of building back up – together with the person fasting, not by template.
• Supervision of the course by a medical team experienced in fasting that keeps an eye on values and circulation as much as on individual well-being.
• A closing discussion that reviews what has changed and advises on nutrition afterwards.

At the Naturhotel Tannerhof, therapeutic fasting is always medically supervised, because here the medical experience of the house belongs together with the fasting process. The doctors at the Tannerhof are experts in fasting. Setting and medical supervision carry equal weight: fasting in a moving landscape becomes more intense, and the supervision gives the process direction. Billing for the medical services runs through the private practice at the Tannerhof.

The accompanying range of therapies is deliberately broad, because fasting is more than a change of diet for a few days. The medical treatments include bioimpedance analysis, IHHT altitude training depending on the programme and, where medically suitable, ozone autohaemotherapy. Added to these are compresses and packs such as the liver-supporting hayflower compress, aroma compresses and mud and warm packs; baths and affusions such as the Kneipp alternating affusion and magnesium-rich detox baths; massages such as the fasting massage, the detox massage with Königsöl or the acidosis massage, lymphatic drainage and foot reflexology. Breathing therapy is part of it too. For the mental side there is psychotherapeutic coaching, nature coaching, business and communication coaching and art therapy. Experience with fasting is anchored throughout the house, from reception through the restaurant to the therapists, and fasting guests take their meals in the Fasterstube, the dining room reserved for them.

Why people in Germany fast

The motives vary. Many guests are looking for a mental slowing-down, a counterweight to overstimulation and constant acceleration. Others want the relief of doing without abundance, in which eating is reduced to the essentials – often with a more intense pleasure in food afterwards. Still others come with a medical concern or with the wish to reorder their everyday life after fasting.

In the body, two processes run at the same time during fasting; they are often mixed up but can be told apart clearly. One is fat burning: as the quickly available carbohydrate stores decline, the metabolism switches within the first few days from glucose to fatty acids and ketone bodies. The other is autophagy – the body's own recycling and cleansing processes at the cellular level, in which cell components are broken down, reused and reordered. How fundamental this mechanism is was shown by the Nobel Prize in Physiology or Medicine 2016, awarded to Yoshinori Ohsumi for the discovery of the mechanisms of autophagy. Put more vividly: all the recycling processes are driven on, everything is being cleaned – cellularly, vascularly, in the connective tissue, in the gut, in the brain, in the liver and kidneys.

To this come mental effects. Often the need for sleep decreases while sleep itself grows lighter. Some people experience a fasting euphoria through the altered serotonin metabolism, varying from person to person. Fasting creates a caesura and an abundance of time with and for oneself. Whether therapeutic fasting suits an individual case nonetheless always belongs, at the Tannerhof, to the medical assessment – in pregnancy, while breastfeeding and with anorexia it has no place in the planning, and with chronic illness or ongoing medication a telephone medical pre-consultation can be requested before arrival.

The Tannerhof: a fasting tradition in the mountains

A tradition becomes tangible when it has a place. The Naturhotel Tannerhof lies in Bayrischzell, in the upper Leitzach valley, around 75 kilometres south-east of Munich, with a view into the valley and towards the Wendelstein. The house sits in the midst of the pre-alpine landscape between the Wendelstein and the Sonnwendjoch and remains easy to reach. It is a family-run nature hotel in its fifth family and fourth medical generation, founded in 1905 – not a spa clinic with a mountain backdrop but a house that explains, out of long experience, what fasting is. Mein Versteck in den Bergen – my hideaway in the mountains.

The place is more than an address. There are the roughly 16 hectares of grounds, the mountain brook, the alpine meadows, the air huts of 1905 and the four hut towers by Florian Nagler, the orangery as a long retreat under plants, and the BadeHarpfe with its Finnish sauna, panorama relaxation room, endurance and strength fitness area and the 25-metre outdoor natural pool that opens the view between the Wendelstein and the Sonnwendjoch. The paths around the house and the clear, pure mountain air give fasting over several days a form of its own.

Movement remains part of the fast, measured in moderate doses. Moderate base endurance training and moderate strength training are available, as are yoga, Feldenkrais, Tai Chi, resistance-band training and breathing therapy. Summit tours and running are possible, only at a pace that suits fasting – der Körper nährt sich von innen, the body feeds itself from within. Anyone who likes to combine fasting with quiet tours through the mountain landscape will find the Hiking and Fasting combination at the Tannerhof. Anyone wishing to see the concrete framework of a fasting stay and book it online will find it in the Body Detox programme.

A fasting week and its transition

A fasting week does not begin with the soup. Before arrival, the doctors at the Tannerhof recommend one or more relief days at home, for instance a fruit, potato, vegetable or raw-food day – how many is for the guest to decide. The length of stay and the fasting package are already booked at this point. In the intake consultation on the first fasting day, the concrete course is agreed together within this framework and can be adjusted, in particular extended.

During the fasting days, herbal tea, mineral water, lemon and ginger water, mild vegetable broth and freshly pressed fruit or vegetable juices carry the rhythm, together with around three litres of fluid a day. In the evening, buttermilk or a plant-based protein source is added as preferred, and if needed a base preparation against acidic metabolic products and uric-acid crystals. A spoon of honey or an espresso may bridge a low point without leaving the character of the fast behind.

How long one fasts is a recommendation, not a rule. At the Tannerhof, five fasting days and upward are recommended, because otherwise the changeover gets little room. For first-time fasters a week is a fine size: about seven fasting days plus two to three days of building back up, around ten days in all. For health concerns longer is welcome, with close medical supervision. The building-up phase is not an afterthought to the fast but its continuation by other means: breaking the fast still counts as a fasting day, with the apple and very conscious chewing, after which the gradual return to solid food and stimulants follows over roughly a third of the fasting time. In the closing discussion with the accompanying doctors, nutrition afterwards is discussed too. If a lasting change is wanted, the Schlanke Tanne Low Carb, the house's own low-carb way of eating, can follow on. Intermittent fasting in a 16/8 rhythm is not a substitute for Buchinger but the recommended way to carry the benefits of compact fasting into everyday life. Wenn statt Verzicht der Gewinn an Genuss und Lebensfreude im Vordergrund steht – when it is not doing without but the gain in enjoyment and joie de vivre that stands in the foreground.

So, out of a national heritage and a concrete place, something comes together that is larger than a brief act of doing without. Perhaps that is exactly the old Tannerhof line in today's form: Mensch, werde wesentlich – become essential.

Discover therapeutic fasting at the Tannerhof

The Naturhotel Tannerhof has offered fasting after Buchinger for more than 70 years: medically supervised, experienced in fasting across every department and embedded in Bayrischzell, between the alpine meadow, the mountain brook and the view towards the Wendelstein. Anyone wishing to see the concrete framework and book it online will find it in the Body Detox programme, on the page on the Buchinger method and in the hub on therapeutic fasting and the Schlanke Tanne.