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Generally speaking, if you go to a doctor and get a sick note (Arbeitsunfähigkeitsbescheinigung) then you are unfit for work. Matter of fact the name in German already says you are unfit to work. It does not pass any judgement as to why.

It's never illegal to go to a doctor and get a sick note.

In rare cases, if it can be proven that you did it on purpose or with gross negligence, the people who paid for your sick leave (in this case probably your Krankenversicherung, in case of an accident the gesetzliche Unfallversicherung) can refuse to pay or demand their already paid money back. Please note that those are serious cases. Like hitting a sign-post head-on with your car while speeding under the influence of alcohol on your way to work. That can be ruled as self-inflicted or at least gross negligence and the insurance can refuse to pay. It's still not illegal to take sick leave because the truth is that the person is not fit for work after colliding with the sign post (the DUI is another matter). But it's basically unpaid and that's costly.

Sick leave is also a protected state, you cannot be fired for being sick, not even in the above case of the DUI (although you might be fired for having a DUI on record if your job is being a driver at the company). A company might find a few phony other reasons to fire people that they think had too much sick leave though or if the person is a contract worker just not renew the contract when it runs out.

So yes, you can eat that pizza again. It's not even proven that that pizza made you sick. Now from the perspective of your boss, after the third or fourth time you have to go home sick after eating there, I would seriously question your personal judgement. But making bad decisions is not illegal.

No, it is not illegal to become sick, regardless of the cause. Sick time may or may not be paid by your employer, depending on their policies.

It may not be the wisest thing to do at lunch, knowing you have work still to do afterward.

This is not about German law, but I would GUESS probably not, otherwise where would we draw the line?

Would it be illegal to not eat healthy? Would it be illegal to care for a sick wife? Would it be illegal to consume alcohol on the weekend. These are just a few factors that can contribute to becoming sick.

Having said that, if you acted in a reckless manner that caused you to miss work, and that caused some damage to the business, that would probably be frowned upon, though not illegal.

If you endanger your own health and safety while at work, that is a different story.

In the USA, I imagine Germany too, only way it would be "illegal" is if you were contractually obligated to not be reckless or engage in reckless activities. I imagine this is for top officials such as CEOs or maybe a sports star, not common workers. Even with that clause, they typically mean something like engaging in parachuting or something with a known danger, not eating spicy food.

With that said, you may be asked to bring in a doctor's note. That wouldn't be unfair for your employer to request such thing. In the future, avoid food you know will cause illness. Not so much for work reasons but for health reasons.

I eat pizzas on a regular basis but last time I went with co-workers, we ate at this pizza shop and the spinach on mine must have been rotten or something because I got really sick afterwards. I went home and came back to work the next day. No questions or issues since that's what sick leave is for. I do not go to that pizza place any longer, though, but next time I would be more careful about what toppings I choose at the establishment.

Did you intentionally make yourself sick for the express purpose of using sick leave? If not, then no fault exists.

Clarification: I live in the UK, but our laws on sick leave area based on EU regulations, which I imagine Germany to be as well.

Getting sick from a pizza you've bought in good faith is bad luck, but hardly illegal.

If you kept eating there in order to persistently get sick, your boss might ask questions about your reasoning though. I've heard the rants of managers who got annoyed with people getting food poisoning from the same fried chicken shop for example. That particular workplace was shift work and only paid sick leave if you had a doctor's note though.

It's my experience that there's statutory sick pay, which is long term and issued by the government rather than the company, and there's company sick pay, which has a limited number of days based on length of service. Those days are full pay. If your employer suspects you're trying to milk those days then they will likely ask for evidence of the sickness either via a doctor's note or an assessment by a doctor of their choice. If that happens and you have been making yourself ill or injuring yourself on purpose, then you're busted.