Weight affects the bottom line

Duke study says obese workers cost employers more; discrimination backlash is a risk

As more employers scramble to help workers lose weight, there is growing evidence that obese employees are costly to companies' bottom lines.

Workers' compensation costs for obese workers were far higher than for their slimmer counterparts, researchers at Duke University Medical Center reported Monday.

Extremely obese employees filed twice the number of workers' compensation claims, their medical costs from those claims were seven times higher, and they stayed out of work 13 times longer after a work-related injury or illness than did workers who are not obese, according to a paper published in the journal Archives of Internal Medicine.

The study adds to a growing body of research about the economic costs of obesity.

Much of the discussion has focused on health-care expenses generated by complications such as heart disease and diabetes.

Duke's analysis shows that overweight workers are costly for employers in other ways, as well, said Truls Ostbye, a professor of community and family medicine at Duke who co-wrote the study.

The study looked at workers' compensation data for 11,728 Duke University employees who received health-risk appraisals over a seven-year period.

"It isn't just an individual problem, but it is a society problem for sure," Ostbye said. "It is something that employers may want to pay more attention to, because it does affect their bottom line."

But experts said the growing focus on obesity in the U.S. work force also raises the risk that companies will discriminate against obese job candidates.

Recognizing obesity's role in their rising health-care costs, many employers are throwing money into programs that help workers manage their weight, control diabetes and lower their cholesterol levels.

With little research so far on the programs' effectiveness, local researchers are trying to examine what works best.

Ostbye's next study will look at the effectiveness of Duke's Live for Life program, which offers annual health-risk assessments to employees and in-depth help for those who need assistance losing weight or improving other measures of their health. The university and medical center are one of the state's largest employers.

A few miles away, researchers at The University of North Carolina at Chapel Hill will soon start evaluating the effectiveness of Web-based and incentive-based weight-loss programs.

As many as 40 percent of employers are giving workers products, cash or health insurance discounts to lose weight, said Laura Linnan, the study's principal investigator and a professor at the UNC School of Public Health.

"Employers are banking on the fact that they're working, but there's really not much evidence about their effects one way or the other," she said.

Linnan and her colleagues will study about 1,200 overweight employees from colleges and universities across the state, from UNC-Asheville to Edgecombe Community College. The 18-month experiment will look at how much weight the employees lose and whether they can keep it off, she said.

Earlier studies have been encouraging. A basic version of the Web-based program helped employees lose weight, Linnan said.

And a study testing incentives showed that offering employees $7 per pound also was effective in encouraging weight loss, said Eric Finkelstein, a health economist at RTI International in Research Triangle Park and associate director for the RTI/UNC Center of Excellence in Health Promotion Economics.

But new data about the costs of obesity -- and employers' increased focus on obese and overweight workers -- set up the possibility of workplace discrimination, Finkelstein said.