Battling obesity Featured

8:00pm EDT August 26, 2007

The health risks associated with obesity present unprecedented challenges to large employers by increasing health care costs and making health coverage less affordable for small and medium employers. This is particularly evident when the indirect and direct costs of obesity are considered in tandem with the link between obesity and the most expensive, chronic health care conditions.

“With almost two-thirds of the U.S. adult population either overweight or obese, America is experiencing an obesity epidemic,” says Sally Stephens, president of Spectrum Health Systems. “The simple reason why obesity is on the rise is that many people eat too much and exercise too little.”

Obesity is such a serious issue that some employers are beginning to offer additional, more drastic, weight loss options in their health care packages. Bariatric surgery is now an option many business owners are considering including in their health care plans.

Smart Business spoke with Stephen about the new weight loss concern for employers and using bariatric surgery in an attempt to treat the problem.

Why is a personal issue, such as an employee’s weight, a concern for employers?

Employers have to be concerned with an employee’s weight and overall health because it correlates with company costs and an employee’s performance. According to a study in the American Journal of Health Promotion, obesity-related conditions cost employers $12 billion a year due to higher health utilization and medical claims, lower productivity, increased absenteeism, and higher health and disability insurance premiums.

Another study, from General Motors’ health plan, concluded that overweight and obese individuals had annual medical bills up to $1,500 higher than persons with a healthy weight. The obesity epidemic creates significant challenges to the U.S. work force. Obesity and its related health conditions hurt the health and well-being of the current work force.

In addition, the increased incidence of obesity among children and adolescents — which large employers pay for as dependents — poses an even greater problem.

What weight loss options can employers provide their employees?

Today, there are far more options for employers to address the obesity issue. In 2003, a coalition of large private and public sector employers and health organizations founded the Institute on the Costs and Health Effects of Obesity. The Institute’s broad strategy is to leverage corporate resources to respond to the nation’s obesity epidemic.

Employers can encourage healthy lifestyles and support national efforts to reverse the rising trend of obesity. Some options include: provide education about the negative effects of obesity; through active health promotion programs, encourage people to become more active and fit by using internal staircases, fitness centers and participating in brisk walking programs; include company and union representatives in all health-oriented planning; set up cafeteria and vending choices that emphasize healthy and low-calorie snacks and drinks, and that include content information, especially calorie and fat grams on all food items; emphasize stress management programs; offer health plans that provide health risk appraisals with physician/nutritional counseling; and encourage health plans to include aggressive healthy lifestyle and weight-management programs.

How is offering bariatric surgery a benefit to an employer?

The main reason employers would cover bariatric surgery is for the return on investment. There is evidence that aggressive treatment for obesity, especially morbid obesity, reduces the risk of chronic conditions, resulting in reduced costs. Health policy analysis and business groups, even those intrigued by case studies, describe research as mixed on the question of whether this sort of disease management effort will actually save money in the long run. This is mainly due to employee turnover.

Does an employer have any say in who qualifies for this coverage?

Yes. As the prevalence of morbid obesity increases, employers will be forced to look for cost-effective strategies to improve the health of their employees. However, it seems that employers are not necessarily jumping on the weight loss bandwagon, and the numbers of those qualifying for the surgery are relatively small in number. A 2003 study by Mercer Human Resource Consulting, showed that 52 percent of employers did not cover bariatric surgery at all.

Until recently, nearly all private insurance carriers accepted the guidelines laid out by the 1991 National Institutes of Health as qualifications for weight loss surgery. The recent explosion in the number of surgeries performed has resulted in many carriers adding qualifiers to the NIH guidelines, such as six or 12 months of a continuously medically supervised diet.

SALLY STEPHENS is president of Spectrum Health Systems. Reach her at or (317) 573-7600.