Comorbidity Risks

Rising Obesity Rates Should Concern Employers

Obesity could push up health care and workers’ comp costs, but wellness programs may dull the impact.
By: | September 10, 2014 • 4 min read

According to a new report released by Trust for America’s Health and the Robert Wood Johnson Foundation, obesity among U.S. adults shows no signs of waning. Six states saw increases this past year, while no state saw a decline. The obesity rate exceeds 20 percent in every state. Nationwide, one-third of adults are obese.

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The effects of obesity on workplace productivity and injury recovery time are well-documented.

A 2010 Duke University study quantified the per capita cost of obesity among full-time workers by accounting for medical costs, lost productivity at work due to illness or injury, and absenteeism. By their calculations, an obese woman with a BMI greater than 40 costs her company $16,900, while an obese man with the same BMI costs $15,500.

The American Medical Association’s decision last year to classify obesity as a disease could potentially add to those costs. Workers who become obese as a result of an injury — either due to inactivity or the side effects of a treatment — could theoretically file a secondary claim seeking compensation for their weight gain. A 2010 study from the National Business Group on Health found that 67 percent of employers surveyed listed “employees’ poor health habits” as a primary challenge in maintaining affordable health coverage.

Employers have clear incentives to spur overweight employees to drop pounds and improve their health.

“The workplace is one of the best places to address the issue, for considerations like workers’ comp costs and also general health and health care costs,” said Robert Goldberg, chief medical officer and senior vice president at Healthesystems. “Medical issues are a distraction to the worker, and it takes them away from work. That’s even in the absence of a work-related injury.”

“Employers can incent people to join programs,” said Amy McAllister, director of clinical development and support for Alere Wellbeing, which offers wellness programs to employers , “but that won’t necessarily lead to weight loss.”

Instead, she said companies need to embrace a culture of wellness supplemented by comprehensive, individualized programs. That means trading in free cookies at meetings for healthier options, but also offering personalized coaching programs.

Workplace wellness programs can help contain the current epidemic of lifestyle-related diseases, the main driver of premature morbidity and mortality in the United States.

“The U.S. Preventive Services Task Force has found that the most successful programs are very individualized. You have to find what motivates the individual,” she said. Coaches would help employees set goals best suited to their health needs. Comprehensive programs would also take a behavioral approach that utilizes cognitive behavioral therapy to induce lifestyle change.

“I think it’s all about education and lifestyle modification,” Goldberg said. “Get people moving. Provide education on dietary changes, on how to buy and prepare healthy food. Most people will do what they’ve always done; they’ll cook and eat the way they learned and will get stuck in daily routine.”

Outside of a wellness program, education can also be weaved into treatment plans for workers who do sustain a work-related injury.

“Typically part of the physical rehabilitation of an injury include some kind of functional component like physical therapy, and as part of that, there should be education,” he said. “If appropriate, on-site exercise can be a part of that therapy so people can learn what to do to increase their exercise capability on a daily basis even when they’re not coming to therapy.”

A 2013 report by the RAND Corporation and Department of Labor stated that “lifestyle management programs as part of workplace wellness can reduce risk factors, such as smoking, and increase healthy behaviors, such as exercise. We find that these effects are sustainable over time and clinically meaningful. Workplace wellness programs can help contain the current epidemic of lifestyle-related diseases, the main driver of premature morbidity and mortality in the United States.”

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The survey also found that 51 percent of all employers with 50 or more employees currently offer some type of wellness program.

Why not more? While they may reduce costs in the long run, comprehensive programs can initially run up a large bill. The RAND study reported that it can take five years for a program to become cost-neutral, and even longer to generate a positive return on investment. For companies with limited resources, it’s a risk they may opt out of.

But with 42 percent of U.S. adults projected to be obese by 2030, that opinion is likely to change.

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]

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The R&I Editorial Team can be reached at [email protected]