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.


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.”


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]

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.


That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.


Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]