Selection for feed efficiency (FE) is a hot topic in dairy cow breeding. Dry matter intake (DMI) and residual energy intake (REI) are mostly discussed as new selection traits. Selection for lower DMI or REI seems to increase FE if other traits, such as milk yield or health, are not affected negatively. However, genetic relationships with other traits have not been adequately investigated because of the difficulties in recording sufficient feed intake data for genetic evaluations. The aim of this study was to examine the genetic relationships between FE-related traits and liability to diseases throughout lactation. First, heritabilities for all traits are presented. Subsequently, genetic correlations between DMI, energy-corrected milk yield, energy balance (EB), and REI on the one hand and 3 disease categories (mastitis, claw and leg diseases, and all diseases) on the other throughout lactation in German Holstein (GH) dairy cows are illustrated. Production and health data from the projects optiKuh and eMissionCow were used. Data consisted of weekly observations recorded over a 325-wk period in 2,387 GH and over a 300-wk period in 632 Fleckvieh (FV) primiparous and multiparous dairy cows from 13 dairy research farms in Germany. Variance and covariance components were estimated univariately or bivariately with linear random regression models for production data and threshold random regression models for health data. Heritabilities for DMI, EB, and REI were on average 0.17 and 0.15, 0.14 and 0.15, as well as 0.11 and 0.14 in GH and FV, respectively. Heritabilities on the underlying scale for mastitis, claw and leg diseases, and all diseases were on average 0.17 and 0.16, 0.18 and 0.12, as well as 0.15 and 0.11 in GH and FV, respectively. In GH, almost all genetic correlations were negative, especially in early lactation. Within the first 50 d in milk, genetic correlations between DMI and REI on the one hand and disease categories on the other ranged from -0.25 to -0.14 for mastitis, from -0.31 to -0.13 for claw and leg diseases, and from -0.58 to -0.30 for all diseases. Consequently, selection for lower DMI or REI could lead to a higher liability to diseases, especially in early lactation. A possibility to mitigate these undesirable side effects could be lactation stage-specific selection for FE. For FV, further studies with more data are needed to assess genetic relationships.