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Research shows cost of employee obesity

Health care expenses rise with body mass


A study that attempts to quantify the cost of obesity in the workplace should help health benefits professionals persuade upper management that weight management programs will yield a return on investment, health benefit experts say.

However, some health benefit experts say the study, which estimates obesity costs U.S. employers $73.1 billion annually in increased medical costs and lost productivity, may be underestimating the scope of the problem because it does not also take into account disability and workers compensation costs.

Others questioned whether the impact on productivity losses may have been overstated because it relies heavily on presenteeism data, which was self-reported.

“The Costs of Obesity in the Workplace,” which was published in the October issue of the Journal of Occupational and Environmental Medicine, attempts to quantify per capita and aggregate medical costs and the value of lost productivity, including absenteeism and presenteeism, as a result of workers being overweight or obese.

To measure the impact of obesity on medical costs, researchers used the Medical Expenditure Panel Survey, a survey by the Agency for Healthcare Research and Quality that quantifies annual medical spending by type of service and source of payment.

Absenteeism and presenteeism—a lack of productivity from those present at work—were assessed using Consumer Health Sciences' U.S. National Health and Wellness Survey, the largest self-reported patient database in the health care industry, and the Work Productivity and Activity Impairment questionnaire, an instrument commonly used by health researchers to assess employee productivity loss related to health.

The study found that per capita medical expenditures, presenteeism and absenteeism costs ranged from $9,507 for normal weight men—those with body mass indexes between 18.5 and 24.9—to $15,561 for obese men with a body mass index of 40 or higher. For women, the per capita costs ranged from $10,241 for normal weight to $16,969 for those whose BMIs were 40 or higher.

Overall, the estimated value of medical expenditures, absenteeism and presenteeism resulting from excess weight was $73.1 billion per year. 82% of this expense was equally split between medical expenditures and presenteeism, while 18% resulted from increased absenteeism.

Researchers said this figure is roughly equivalent to the cost of hiring an additional 1.8 million workers per year at $42,000 each.

Marianne Fazen, executive director of the Dallas-Fort Worth Business Group on Health, said the study will be “helpful to employers to justify the programs they have in place for weight management. I know they have been taking a leap of faith in many cases waiting for an ROI. This will certainly give them more ammunition for justifying those costs to senior management.”

Moreover, “in this economy, with all the layoffs and high unemployment, I'm thinking what a case this is for investing in weight management,” she said.

“Even though it is hard to uncover the direct cost of obesity in claims data, studies like this make it possible to infer what the cost is,” said Laurel Pickering, director of the New York Business Group on Health. “Employers really should do what they can to address obesity because it does have a huge cost on the organization.”

But Thomas Parry, president of the Integrated Benefits Institute in San Francisco, says that while the study “certainly says obesity is associated with far more than medical a sense it underestimates the impact of productivity.”

For example, it doesn't include how obesity affects occupational and non-occupational disability costs, he said.

LuAnn Heinen, a vp at the National Business Group on Health in Washington and director of the NBGH's Institute on Innovation in Workforce Well-being, agreed that if the impact of obesity on short-term disability, long-term disability and workers comp claims were included in the study, the cost estimate would have been higher.

But Shelly Wolff, national leader for health and productivity at Towers Watson & Co. in Stamford, Conn., questioned the validity of the presenteeism data, suggesting it may have been overstated.

“When two-thirds of the costs are attributable to presenteeism, it makes you wonder whether it's being accurately measured. Presenteeism is a proxy of productivity, not an absolute. It's not unlike health risk questionnaires that are self-reported data,” she said.

However, Cristi Travis, CEO of the Memphis Business Group on Health, said that “even though it's self-reported data, it's the best measure we've got. Getting feedback from employees about how they feel out these issues is valid. And even if presenteeism is taken out of the equation, it's still a lot of money when you put the absenteeism and medical costs together.”

The study is available online to subscribers and purchasers on the Journal of Occupational and Environmental Medicine website at currenttoc.aspx.