Reining in the Rising Cost of Obesity

By Ronald S. Leopold, MD, MBA, MPH

The rapidly rising rate of obesity is a growing health concern for all age groups in the United States. Approximately 44 million American adults — or approximately 1 in 5 — were considered obese in 2001, defined as having a body-mass index of 30 or more, according to the Centers for Disease Control and Prevention (CDC).¹ This reflects an increase of 74 percent since 1991. The impact of obesity not only affects the individuals involved but also has an enormous financial impact on the workplace and on a company’s bottom line.

Obesity costs U.S. companies more than $13 billion annually in medical fees and lost productivity and is associated with 39 million lost workdays, according to the National Business Group on Health.² The costs will likely skyrocket over the next few years, since obesity is rapidly catching up to smoking as the Number 1 preventable cause of death in this country.

The factors contributing to obesity are not expected to recede anytime soon. Work environments are becoming more sedentary every year as we continue to shift from a manufacturing economy to a service economy. It will also take time to improve upon major lifestyle choices linked to obesity such as poor diet and exercise habits. However, as the obesity epidemic comes increasingly under public scrutiny, I believe that Americans will become much more aware of the inherent risks and hazards, and change their behaviors — significantly curbing the upward trend. In addition, Americans will look to lifestyles in other countries such as France, Japan, or Sweden in an effort to find less conventional solutions. These may include such things as practicing Tai Chi, drinking red wine with meals, and decreasing the size of meal portions.

While employees must take responsibility for addressing and combating their own obesity problems and lifestyle choices, it is in the best interest of employers to contribute to the solution as well. Employers have an important role to play in ensuring a healthy work environment and mitigating the financial burden to the workplace resulting from the rise in obesity.

A Burgeoning Problem

A look at obesity-related claims for short-term disability (STD) and long-term disability (LTD) reveals the enormous cost burden for businesses. The proportion of STD and LTD claims submitted to MetLife in 2003 directly due to obesity (i.e., for bariatric surgery such as gastric stapling and gastric bypass) were more than double those submitted in 2001.

Companies with high proportions of female workers ages 35-54 have been most affected by the obesity epidemic. MetLife data indicates that females accounted for 85% of STD obesity claims processed over the past three years; 48% of these claims were from women between the ages of 35 and 54. The primary medical reason for these claims was gastric stapling/bypass and other new procedures, which result in absences from work.

The gender discrepancy is driven by two primary factors. First, women are somewhat more prone to obesity — 33% of women and 27% of men over the age of 20 are classified as obese. Second, they are more likely to seek medical help for obesity, resulting in a greater incidence of bariatric surgical procedures.

The Business Burden

Lost productivity/wages and the medical expenses associated with disability-related absences are two critical costs of workplace obesity. The average absence for a worker who files an obesity-related STD claim is 45 days, a substantial length of time for an employee to be out of the office. Employee absences resulting from obesity adversely affect businesses due to rising healthcare costs, lost productivity, the increased burden on other workers, and the cost of training a replacement employee or paying overtime to other employees to compensate for lost work hours.

At the same time, we should not overlook other diseases that arise from and/or are linked to obesity. Individuals who are obese have a 30-50% greater risk of developing chronic medical problems than those who smoke or drink.³ Common diseases that have been linked to obesity include diabetes, heart disease, hypertension, lower back disorders, and hip, leg, and foot disorders. Based on research by MetLife, the CDC, and the American College of Cardiology, three key conditions linked to obesity — diabetes, arthritis, and heart disease — cost employers more than $220 billion annually in medical care and lost productivity.

Investing in a Healthy Workforce

Obesity rates will vary socioeconomically, geographically, and by type of industry. Each employer should look at its employee populations and examine these factors as well as medical expenses and STD claims information to determine whether obesity is a problem in the workplace and what can be done to curb the problem.

A few options for companies to consider when addressing obesity problems include:

• Making on-site programs, like Weight Watchers, available at work

• Sponsoring or subsidizing health club memberships

• Working with group health vendors to develop more programs to target obese populations

• Implementing a healthy eating campaign, which should include healthy options in cafeterias and vending machines

Companies with larger campuses can encourage employees to walk outside during their lunch hour or stroll by their colleagues’ offices rather than remaining sedentary at their desks and sending email. It is critical to talk with health plan providers about the availability of employee educational materials, disease management programs, and the addition of various medical procedures or programs to benefits plans, such as gastric bypass/stapling.

When considering implementing a targeted prevention or risk reduction program, a company can utilize claims information from both its health care providers and its disability carrier to help determine the return on the investment. Those 10% of employees who are out on short-term disability leave during the course of a year are the same employees who are consuming more than 50% of an employer’s healthcare dollars. For companies with a significant population of obese or near-obese employees, the pay-off is likely to be beneficial.

Though obesity is a national health epidemic, it is, in many cases, preventable. Employers can help employees take the first steps in managing the problem. By so doing, they stand to save billions of dollars annually. Equally important, they stand to improve the health and productivity of their employees.

REFERENCES

1. 1991-2002 Prevalence of Obesity Among U.S. Adults, by Characteristics, Centers for Disease Control and Prevention

2. National Business Group on Health  www.wbgh.com

3. National Business Group on Health  www.wbgh.com

Dr. Leopold is vice president and national medical director for MetLife Disability. He is the author of  A Year in the Life of A Million American Workers, a reader-friendly research guide based on MetLife's extensive disability claims database of more than four million employees. A complimentary copy of Dr. Leopold's book can be ordered online at www.metlifeiseasier.com/disabilityalmanac.

Ronald Leopold. Reining in the Rising Cost of Obesity.

Business and Health

August 2004;22.