At least 30 percent of Americans are obese and 64 percent are overweight, according to the National Institute of Diabetes, Digestive and Kidney Disease. This translates into higher health care spending — between 1987 and 2001, obesity is to blame for 27 percent of the increase in health care costs.
A study by Dee W. Edington, Ph.D., of the University of Michigan, shows average annual medical costs for normal-weight individuals is $2,225, while costs for overweight individuals are $2,388 and costs for the most severely obese are $3,753.
LuAnn Heinen, director of the Institute on the Costs and Health Effects of Obesity, says, “Obesity costs U.S. employers more than $13 billion annually, and it also adversely affects the quality of life and health of the workers.”
The high cost of obesity to employers can be seen in lost productivity, increased absences, increased health care claims and an increase in life and disability insurance. Obese and overweight employees have twice the absenteeism rate of their normal-weight co-workers.
While genetics play a role in the incidence of chronic conditions, obesity is a driving force in the increases in chronic conditions such as diabetes, heart disease, stroke, hypertension, gallbladder disease, osteoarthritis, sleep apnea and several types of cancer. In addition, multiple studies link obesity to increased mortality for cancer patients.
Other studies report that:
* As compared to normal Body Mass Index of 20 to 24.9, the mean annual total costs were 25 percent greater among individuals with BMI of 30 to 34.9 and 44 percent greater among those with BMI of 35 or greater.
* The seriously obese are 48 percent more likely to have health care claims of more than $5,000 and miss one additional week of work in one year.
* There is a significant increase in the number of adolescents being diagnosed with noninsulin dependent diabetes.
* Employers spend 77 percent more on prescription drugs for the seriously overweight
Employers are concerned about the obesity epidemic and how it can affect their costs, productivity and absenteeism. Many are offering a variety of benefits to assist their work force in adopting healthier lifestyle practices.
Elaine Mischler, M.D., executive vice president and chief medical officer for Avidyn Health, says, “If you are overweight, it significantly increases the impact of disease on your body. Put another way, obesity equals 20 years of aging, and with 60 percent of the adult population overweight or obese, I have several clients that are experimenting with premium designs to encourage attention to a healthy lifestyle.”
Primary approaches used by employers include removing snack machines, installing gyms or walking paths, subsidizing fitness memberships, subsidizing weight loss programs, providing pedometers and offering Weight Watchers at work. One of the most important and effective techniques is to combine these with materials and programming to educate employees on the negative health effects of obesity.
Other strategies employers are using include:
* Adjusting plan maximums and co-payments for obesity treatments
* Covering risk appraisals
* Covering bariatric surgery and weight-loss medications
* Requiring less expensive weight loss programs as a pre-requisite to surgery
* Implementing a lifetime cap on coverage for bariatric surgery
There is clearly an obesity epidemic in the United States. And as long as we make food available in excessive portions on every street corner around the clock and remove all natural incentives to energy expenditure, it is hard to imagine how this will change.
As long as employers remain health plan sponsors, they will bear the greater burden for the cost of this disease. The good news is that employers have tremendous influence on managing this health problem through aggressive plan design and worksite initiatives.
SALLY L. STEPHENS, R.N., is president of Spectrum Health Systems. Stephens founded Spectrum Health Systems, an independent health management company, in 1997 to provide Fortune 100 quality health risk management programs to middle-market employers. Reach her at (317) 573-7600 or [email protected]
