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Tackling obesity and weight-related health issues can improve a company's bottom line, but it takes more than a short-lived fitness program to see real results.
Employers' voluntary methods to combat workers' weight range from subsidizing gym memberships and nutritionist visits to providing wellness coaches and biometric screenings. Employers also must take care to avoid violating discrimination laws and employee privacy rights (see story, page 17).
But the most successful initiatives build a culture of wellness in the workplace and provide multiple weight-management methods from which employees can choose, wellness experts say.
“Obesity doesn't exist in a silo. It's so connected to other levers that employers can impact,” said LuAnn Heinen, Washington-based vice president at the National Business Group on Health.
Obesity, which can lead to heart disease, diabetes, joint replacements and other problems, weighs on worker productivity and increases medical claims costs.
According to the U.S. Centers for Disease Control and Prevention, 35.1% of adults ages 20 and older were obese and 69% were either overweight or obese in 2012.
The CDC defines overweight individuals as having a body mass index of 25 to 29.9 and obese individuals as having a BMI of 30 or greater.
A Yale University study, released in November, estimated that the national loss in productivity from obesity-related absenteeism totals $8.65 billion a year.
The implications aren't lost on employers. A March survey of 121 U.S. employers by the NBGH and Fidelity Investments found that 73% of employers are offering a weight management program this year, and 9% are considering one in 2016. That compares with 69% offering weight management programs in 2014 and 58% in 2009.
Managing weight in the workplace begins with building “the foundational aspects of employee health and well-being,” Ms. Heinen said, including providing healthy food options, ways to move and stretch during the workday, and physical activity competitions and challenges to add a little peer pressure as motivation, Ms. Heinen said.
Such efforts should be scheduled so they are convenient for workers, with more targeted efforts as programs progress, she said.
“This is not a sprint,” said Charlie Salter, Omaha, Nebraska-based vice president of human resources at ConAgra Foods Inc., where weight management is a central component of the wellness program. “It's really all about cultural change.”
“All roads seem to lead to weight, because it can create issues around diabetes, around cholesterol and around blood pressure, and those are some other risks that we're trying to reduce,” Mr. Salter said.
The packaged food company moved to a progress-based wellness program in 2012 after data revealed that employees with four or more health risks cost the company an average of 21/2 times the health care costs of workers with two or fewer risks, Mr. Salter said.
Now, ConAgra provides financial incentives of up to $1,800 a year in contributions to employees' health savings accounts and reduces employees' health insurance premiums by up to $1,500 if they undergo a health screening, fill out a health risk assessment and show progress by reaching targets related to BMI, cholesterol, blood pressure, glucose and tobacco use.
For example, ConAgra sets the target for BMI between 18 and 26 or, alternatively, losing 5% of total body weight.
The company, which is “careful about being too prescriptive” about how an employee should lose weight, hopes the incentives encourage workers to “determine what's right for them,” whether it be a gym membership or a Weight Watchers program, Mr. Salter said.
Incentives also have boosted participation in Lee Memorial Health System's wellness and chronic disease management programs, which include weight-management components.
Meeting “qualifiers” focused on wellness and chronic disease management can fetch employees a discount of 20% to 30% on their health insurance premiums, said Alison Thurau, Lee Memorial's system director of compensation and benefits.
The Florida-based health system's weight management program allows workers to meet with a dietitian to develop a meal plan and participate in an exercise class at one of the hospital system's two wellness centers, said Dr. Sal Lacagnina, vice president of health and wellness.
The average weight loss for the program is 13 pounds in 90 days, a spokeswoman said.
“De-emphasizing the words that relate to weight, overweight and obesity” and working to show employees that the hospital system is more concerned with overall health has helped encourage participation, Dr. Lacagnina said.
Such an approach removes some of the stigma surrounding obesity, said Paula Andersen, Cincinnati-based director of the national clinical practice at Buck Consultants at Xerox.
“It's important not to come across as though you're targeting a population,” she said, because obesity is a sensitive topic. She added that weight management and healthy lifestyle resources are useful for all employees and should be provided for everyone.
Chicago-based Northwestern Memorial HealthCare's Center for Lifestyle Medicine is one example. Its healthy lifestyle challenge focuses on weight management, but “we don't advertise it as a weight-loss challenge,” said Holly Herrington, one of three registered dieticians who run the program. “People don't feel embarrassed about coming in to lose weight.”
The six- to eight-week program educates employees on setting goals, losing weight and improving health, including healthy eating, reading nutrition labels, tracking calories and exercising, as well as providing sessions led by specialists on getting enough sleep and managing stress, Ms. Herrington said.
The program, begun in 2010, runs twice a year with 50 to 75 employees participating each time, Ms. Herrington said.
Other strategies include having the health plan cover the medical management of obesity and involving a worker's doctor in the wellness program.
“It's really tremendously hypocritical” of an employer to say they're concerned about obesity, but to sponsor “a health plan that makes an employee pay out of pocket for visiting an obesity medical specialist, or that has dauntingly high levels of co-pays for bariatric surgery,” said Ted Kyle, Pittsburgh-based chairman of the Obesity Action Coalition, a nonprofit obesity advocacy organization, and founder of workplace wellness consulting firm ConscienHealth.
He said about three-quarters of small employers exclude obesity treatment from their health plans.
It's also important for an employer to understand that “people don't choose to have a chronic condition like obesity,” he said of the issue, which often is genetic.
Health consultants and employers agree that measuring the return on investment for workplace obesity and weight management programs is difficult, though they believe such programs are worth implementing.
“We're still trying to connect in a very objective and empirical way the connection between health care costs and health risks,” said ConAgra's Mr. Salter.
“There's just so many downstream positive consequences of helping someone to manage their weight” for the individual and organization, Dr. Lacagnina said.
As employers try to rid the workplace of tobacco products, many are including electronic cigarettes and other vapor-based nicotine delivery systems.