New research from the Northeast Business Group on Health reveals that targeted, personalized programs combined with nutrition and fitness activities could help increase the effectiveness of employers’ efforts to tackle the obesity epidemic.
The study reveals that obesity is one of the biggest drivers of employer healthcare costs, with more than $73.1 billion spent annually. Therefore it is not surprising that NEBGH’s employer members rank weight control as one of the top three conditions that need to be addressed through workplace wellness or disease management.
“Obesity of employees is a concern for employees because they want to attract and retain a healthy and productive workforce with high performance capabilities,” says study co-author and NEBGH’s Medical Director Dr. Jeremy Nobel. “There’s also the need to manage healthcare costs, because obesity significantly increases the risk for diabetes, heart disease, kidney disease, musculoskeletal disorders and cancer.”
Many organizations offer programs such as nutritional education, onsite healthy eating and subsidized gym memberships. However, employers report that obstacles to success include lack of employee engagement due to stigma or embarrassment plus the cost of implementing new programs. There is also uncertainty about return on investment.
Employers can typically determine the health status of their employee population based on aggregate data captured by voluntary, individual completion of confidential health risk assessments. “Individual identities are blinded but average data can be analyzed to gain insight into the particular burden on one employer vs another,” Nobel says.
A targeted and confidential plan of attack
To avoid violating confidentiality, the design of communications to employees about customized programs must be thoughtful and cautious.
“You invite people with very specific and clear messages. For example, you could say ‘if you have a Body Mass Index of 35, this program may be useful for you,’” he continues. “People can self-identify and self-refer into programs like virtual coaching or support groups that are most appropriate and most likely to be effective for them.”
The report features a case study describing successful, personalized interventions by the New Jersey-based utility company Public Service Enterprise Group in partnership with the Chicago-based weight-management company Retrofit.
PSEG’s employees had an average age of 48, were 85% male and 73% overweight or obese. They work in a highly technical environment. Eligibility for the Retrofit pilot required employees to have a BMI of 30 or above and commit to at least one year of the program. The first six months focused on weight loss and the second half of the year on habit formation.
Participants had a coach they could meet with in person or via video, according to their preference. They received a fitness tracker and wireless scale. One hundred and twelve employees enrolled from eight different sites and after four months 92% were still participating. Over the same period, 89% of the group lost weight and a total of 800 pounds were lost collectively. Five employees moved out of the morbidly obese category into a lower risk group.
PSEG used data to demonstrate need and identify a strong enough business case to obtain executive leadership, management and obtain union support. Because of the high rate of obesity in the employee population, in order to scale the pilot, PSEG decided to target the most at-risk employees with a BMI of 35 or greater in the first year of a three-year contract with Retrofit.
Nobel agrees that it is important to base programming on employee data and establish success metrics for a program before it is rolled out.
“In addition to engagement dynamics and weight loss, you can measure improvement in co-morbid conditions like hypertension or diabetes,” he says. “For example you can look at the cohort and say the average abnormal blood pressure of 145 over 95 dropped to a normal reading of 140 over 90 in eight weeks.”