Consider the following statistics:
- Reuters estimated obesity costs U.S. businesses a total of $13 billion a year. This includes costs such as additional fuel to transport obese people.
- The May/June American Journal of Health Promotion reported that total health claims for morbidly obese employees cost their employers more than double what claims for normal-weight employees cost. Total health claims include claims for medical, sick day, short-term disability and workers’ compensation benefits. Employers spend an average of $3,830 per year on benefits for normal-weight workers, and $8,067 for obese workers (2011 dollars).
- Extreme obesity increases the risk of dying at a younger age from cancer and many other causes, including heart disease, stroke, diabetes, and kidney and liver diseases. The study, led by researchers from the National Cancer Institute (NCI), found that extreme obesity reduced lifespan more than smoking.
- More than one-third of U.S. adults (34.9 percent) are obese, while 6.3 percent are morbidly obese, with a body mass index of 40 or more. This roughly translates to an average-height person carrying an extra 100 pounds.
Many organizations are realizing the effect obesity has on their bottom line. To estimate costs for your organization, see the free online Obesity Cost Calculator from the U.S. Centers for Disease Control at www.cdc.gov/leanworks/costcalculator/index.html.
Weight Loss and Wellness
While some employers see overweight and obesity as matters of personal responsibility, others are evaluating the benefits of wellness programs to help employees better manage their health. A wellness program aims to improve and promote health and fitness. Examples include smoking cessation programs, diabetes management programs, weight loss programs and health screenings.
Weight Loss Incentives with the ACA
The Affordable Care Act allows an employer or health plan to offer premium discounts, cash rewards, gym memberships, and other incentives to participate. It also makes available $200 million in grants to help employers with 100 employees or fewer to implement wellness programs.
Wellness programs fall into two categories: “participatory programs” and “health-contingent programs.” Rewards under participatory programs do not depend on an individual’s health status. They can consist of reimbursing participants for a fitness center membership or rewarding employees for attending a health education seminar or completing a health risk assessment. A “health-contingent wellness program” requires individuals to meet a specific health-related standard to earn a reward.
To encourage participation, employers and plans can offer premium discounts of up to 20-30 percent for most wellness programs, and up to 50 percent for smoking cessation programs. To avoid discriminating against individuals with disabilities, any health-contingent wellness program must provide alternative actions for participants who cannot meet their biometric targets.
Health Risk AppraisalS
Some studies have found that wellness programs return an average of $6 for every dollar spent; others have found results to be less clear-cut. To get the most from your wellness program, start by conducting a health risk appraisal with employees. HRAs obtain information on demographic characteristics (e.g., sex, age), lifestyle (e.g., diet and physical activity habits), personal medical history, and family medical history. They can also collect physiological data (e.g., height, weight, blood pressure, cholesterol levels) to use as baseline measures for planning and evaluation purpose. Conducting HRAs to collect employee information on risk factors helps target your worksite obesity program toward employee needs.
To gain employee support for your wellness program, be aware that employees don’t like the idea of tying rewards to participation or achieving health goals. In a recent Kaiser Health Tracking Poll, 80 percent of employees who get health coverage through their employer say it is appropriate for employers to offer participatory wellness programs. However, 62 percent disapproved of charging higher premiums for not participating, and 75 percent disapproved of charging more for being unable to meet wellness goals.
Please note that employers should not use weight as a criterion in hiring or other personnel decisions. Weight discrimination is a serious problem, and other wellness factors also contribute to healthcare costs, such as tobacco use, misuse of alcohol or drugs, a sedentary lifestyle and poor diet.