Obesity is a Critically Important Health Issue 

By Murray L Harber

Obesity can affect a person’s overall health and daily performance in negative ways by adding more health risks that contribute to other related medical issues, which use up needed financial resources due to high total healthcare costs. As a result, obesity is an important economic and clinical health concern for all aspects of our society, different communities across the Southeast, and especially for the many employers doing business in the Southeast. 

Obesity in the United States continues to be a growing concern in all age levels as rates rise year after year. For employers, obesity and its comorbidities can be a burden to its health plan, to its employees, their engagement, and its organization’s health.  Our recent efforts in working through the COVID-19 pandemic has heightened the awareness of health risks, specifically metabolic health issues such as chronic weight management and obesity in general as areas of focus for health improvement. A few years ago, an expert made a statement that due to the obesity epidemic in our children, they would have a lower life expectancy than their parents. This is startling. Knowing that our children will live life with a chronic disease that could shorten their life. Employers who are including preventative obesity care and weight management programs within your employee health and wellbeing program can help to improve the overall health of the population and reduce the negative aspect of poor health. Employers can do the same within your employer-sponsored health plan as part of a comprehensive health management effort that can also reduce absence or improve productivity. Making sure you as an employer are able to promote what your plan offers in each part of the health risk reduction continuum is critical in the success of the efforts. 

It makes sense, and has been proven for too many years, that well designed, comprehensive employer health programs can save money over time with immediate cost savings can come from implementing effective disease management programs. Such obesity management programs canmitigate health plan waste and improve health outcomes. A recent multi-employer study showed that obesity levels are associated with higher costs, as weight increases so does direct and indirect costs (Ramasamy A et al. J Occup Environ Med. 2019;61(11):877-886.). They quote an at weight person costs are around 11k and those at obesity three level costs 28K, a 1.5 increase in direct and indirect cost. Employees who are overweight usually have more absences, show reduced presenteeism and productivity, and have other co-morbidities such as depression, arthritis, and possible other health concerns. The aim is to be a supportive employer who provides resources to help employees and their families with resources to help them with their weight management journey. 

ACTION STEPS

The goal of any employer should be to offer a variety of proven work environment and policy supports with employee benefits that give access to promoting value-driven healthcare, health improvement programs, and specifically in weight management/chronic disease concerns. The US Preventive Services Task Force recommends worksite programs intended to improve diet and/or physical activity behaviors based on strong evidence of their effectiveness for reducing weight among employees. [www.communityguide.org].  

Employers can have a profound impact on an employee’s lifestyle choices by providing options and opportunities for healthy choices while also providing employee benefits and discounts to programs and services. Employers’ health plans should include access for all options with access to properly supervised Weight Management, use of Anti-Obesity Medications, as well as clinical management programs should Bariatric Surgery be required.

For Everyone

In the area of primary prevention or preventative services, employers can provide employees and their family members a variety of resources for selfcare, healthcare, lifestyle modification, and support to navigate the healthcare system. Offering a supportive workplace culture with recommendations for the remote worker that encourage proper posture, ergonomics, healthy breaks, healthy snacks/hydration, stretching, taking walks, and other health activities which can help in building a foundation of supports. 

Discounts with local community businesses that encourage healthy lifestyle choices are key to engaging employees and family members. Common discount programs include local fitness centers, fitness subscriptions, smoothie shops, therapeutic massage, and food/supplement-based weight management programs. Most plans today have access to tele-health providers, and some can have access to an onsite clinic where a clinical team of health professionals can help and support what works personally to support interest in weight loss for the apparently healthy individual as well as overweight or obese individual member in a plan. 

For those at Risk and with Medical Conditions

There still is a “Covid-19 hangover” of impacts for those with existing medical conditions or recovering from a virus infection. The more health risks a member has the higher cost they are to themselves, a health plan,  employer, and their community. As an individual accumulates health risks, their chances of getting a chronic disease such as obesity, diabetes, and heart disease are drastically increased. These chronic diseases are key drivers within employers’ group health plan and should be addressed to mitigate a migration of an emerging cost to one of the largest costs.  

It is recommended that people in secondary and tertiary stages to strive to lose 10% of your body weight as it has been shown to help people feel better, have a sense of accomplishment, drastically reduces other health risks, slow or reverse chronic disease progression. 

Some of the specific employers opportunities to take action include the following.

• Promote programs and services available through your health plan offerings regularly, not just once a year.
• Provide more targeted employee benefits for weight management such as a Medical Weight Management Program which uses a physician-led care team to educate and guide through an approach which could include the use of appropriate supplements, Anti-Obesity Medications (AOMs), and related efforts that may avoid bariatric surgery. 
• Review and update how tertiary care would include bariatric surgery for weight loss to manage complex chronic conditions causing life’s threatening issues and quality of life concerns with patients. Bariatrics have been shown to reverse chronic disease where people get off their medications, their joint health improves, and their mental health improves to where their health status improves and quality of life advances. 

In summary, obesity and its associated chronic metabolic, cardiac, or some oncology diseases reduce life span, quality of life, and increases lifetime health care costs. Covid-19 has heightened awareness as those with obesity risk factors are more likely to get COVID-19 and have worse symptoms, and in the youth more likely at risk to die. Employers could be offering a comprehensive list of weight management supports, resources, and programs for employees and their families.