The Fight Against Fat Goes on the Offensive in the Workplace

By one estimate, obesity-related conditions cost organizations $12 billion a year. Companies are putting diet and exercise plans in place to combat the trend.

October 3, 2003

Small talk no longer revolves around today’s weather or last night’s sports scores in the offices of Highmark Inc., a 12,000 employee health-insurance company in Pittsburgh. Instead, employees and executives may be asking each other, "How many steps have you walked today?"

    The new conversational topic began last summer, when a comprehensive employee health screening returned these dismal results: more than half of the 4,000 employees surveyed weighed too much, and almost three-quarters of them exercised too little. As a health insurer, Highmark is well aware that obesity and inactivity drive increased health-care costs, so in an effort to encourage workers to get moving and shed pounds, it launched a "10,000-Step Challenge," which dramatically changed the company culture and health habits.

    More than 2,800 Highmark employees signed up. They donned company-issued pedometers to track their steps, with the goal of reaching 10,000 a day. Workers formed a "Steppers" support group, and 15 employees, including a few executives, were selected to track their weight-loss and walking progress on the company intranet. Results were impressive. Participants lost an average of six pounds during the 12-week program, and 62 employees lost more than 10 pounds each. Though the program has officially ended, many workers continue to wear their pedometers.

    Highmark also offers group, personal and online weight-management programs; nutritional counseling; low-fat meals and snacks in its cafeterias and vending machines; discounts on nutritional products and services; and an employee fitness center. It’s one of a growing number of companies that are literally taking steps to trim employees’ waistlines. "Employers have really sharpened their focus on obesity--and that focus is justified," says Camille Haltom, a health-care consultant with Hewitt Associates, a human resources consulting firm that recently published a report on initiatives aimed at managing obesity and other health conditions. "The number of Americans who are obese is increasing, obesity-related chronic conditions are increasing, and obesity drives up health-care costs."

    Obesity has roughly the same association with chronic health conditions as 20 years of aging, according to the Centers for Disease Control. It contributes to heart disease, diabetes, arthritis and some types of cancer. The Surgeon General reports that more than 9 percent of the nation’s health-care expenditures--about $117 billion--and 300,000 deaths annually are directly related to obesity and physical inactivity. And a study published in the American Journal of Health Behavior showed that annual medical expenses for Dallas city employees ballooned from $114 for normal-weight individuals to $573 for the overweight to $620 for the obese.

The Surgeon General reports that
more than 9 percent of the nation’s health-care expenditures--about $117 billion--and 300,000 deaths annually are directly related to obesity and physical inactivity.

    As more evidence that corporate America is suddenly paying attention to the pounds its employees carry, in June theWashington Business Group on Health, which includes 175 large private and public-sector employers, founded the Institute on the Costs and Health Effects of Obesity. It will propose strategies to decrease obesity among workers, serve as a resource for large employers and help reduce the impact of weight-related conditions in the workplace. "The financial impact of obesity on business is truly shocking--never mind the quality of life for the individuals involved," says Helen Darling, president of the Washington Business Group on Health. She estimates that organizations lose more than $12 billion per year because of higher health-care utilization rates and medical claims, lower productivity, increased absenteeism and elevated insurance premiums. "This is not an ‘it’s nice to be thin’ issue," she says. "It’s a business issue that directly affects the bottom line."

    But despite the benefits of weight-loss-at-work programs, many companies have steered clear of them. "It’s a sensitive subject," Haltom says. "Anything that drives health-care costs is fertile ground for concern, but employers may be fearful of identifying individuals who are obese because there’s a perceived stigma and they have a fear of appearing discriminatory. There is the potential of putting human resources in ‘big brother’ territory, and they certainly don’t want to go there."

    The solution, she says, is to offer an assortment of voluntary programs and incentives for those who are motivated to take advantage of them--with no "disincentives" in place for those who are overweight. "You can’t set up an atmosphere of blame," she says.

    To help employers find the right approach, the institute, which is made up of leading corporations and federal health agencies, plans to launch an online resource center and corporate summit that will bring large employers together to discuss obesity-related challenges. It has also published a "tool kit" for employers, which highlights successful weight-management programs and strategies ranging from offering healthier cafeteria foods with nutritional labels to stocking water and no-cal beverages in vending machines to hosting on-site Weight Watchers’ meetings through its Corporate Solutions program. As Highmark’s experience indicates, such strategies really work. "Employers are beginning to measure the financial and clinical impact of these programs, and early signs are encouraging. They have the potential to influence behavior and provide cost savings, reduce absenteeism, and improve the welfare of employees, dependents and retirees," Hewitt’s Haltom says.

    The CDC--which perhaps is better aware of the costs of obesity than any other organization--has encouraged its own employees to eschew the elevator by making stairwells more appealing, with a fresh coat of paint, new carpeting, artwork and motivational signs, as well as piped-in music. More examples: Almost 200 Colorado organizations--from the city of Denver to the daily newspaper the Pueblo Chieftain--have signed up with Colorado on the Move, a U.S. Department of Health and Human Services-endorsed program that recruits companies to help employees fight obesity. The grass-roots initiative has since gone nationwide and was recently relaunched asAmerica on the Move. Other common measures include financial incentives such as reimbursement for weight-control programs or monetary rewards for participating in a fitness program, on-site exercise facilities, employer-sponsored teams and tournaments, and health and nutrition education.

    Chris Downie does it all at Spark-People, an online coaching company in Cincinnati. The company’s 25 employees have access to a personal trainer and fitness center, encouraging exercise rather than smoking or coffee drinking. Breaks are encouraged, and workers who stick to their own exercise goals for a year receive a $1,000 bonus. The company café is stocked with healthy foods and a garden in the back of the building produces squash, cucumbers, tomatoes and peppers for employees’ use. If a meeting starts to drag, it’s a company tradition to drop everything and race up three flights of stairs to get the adrenaline flowing. Four employees have lost more than 30 pounds since joining the company, and an intern who lost 50 pounds now participates in marathons.

    Ohio Northern University found that convenience dramatically boosts participation in workplace weight-loss programs. Last year, the university began offering a one-time $500 allowance toward physician-prescribed weight-loss programs or medications, but just seven of the 520 employees took advantage of the benefit. This year, the university partnered with MPS Weight Loss & Wellness, a local weight-loss program. Participation among faculty and staff jumped to 40.

    A recent study suggests that the workplace may, in fact, be the ideal setting for slimming down. In Scotland, University of Glasgow researchers ran a 24-week weight-loss program for oil-refinery employees and found that more than half of the participants lost at least 5 percent of their original weight, and almost two-thirds kept off most of the pounds during follow-up maintenance.

    It’s even better if exercise, such as lunch-hour walks, is incorporated into such plans, says Dr. Jana Klauer, a weight-reduction specialist at the New York Obesity Research Center at St. Luke’s-Roosevelt Hospital Center. "You go to work every day, so that means you’ll exercise every day. And you get a daily boost of support and motivation from coworkers."

Workforce Management, October 2003, pp. 74-76 -- Subscribe Now!