Kevin Eberly's Blog | Confronting America's Obesity Epidemic

I’ve talked about how wellness programs aren’t one size fits all. Wellness programs need to be personalized for each company, just as weight loss programs should be personalized for each individual, which is emphasized at The Center for Medical Weight Loss. A combination of factors can help you determine what type of program will be most effective. Castlight Health recently published “Six Drivers of Engagement,” which outlines factors to help you maximize your benefits program. As I go through the list, ask yourself, “How does this reflect my company’s culture?”

Gender: Females register for benefits at a 7.2 percent higher rate than males do. This doesn’t mean you should assume women will sign up without any incentives, but the gender demographic of your company can help you determine how to spread the word. If your company is dominated by men, for example, it may be wise to offer additional incentives or make the healthcare benefits more prominent. You may want to consider holding healthcare-focused meetings to educate and reiterate its importance.

Email: The survey found email is the most effective way to reach employees. Those with direct email access registered at a rate of 17.7 percent higher than those without access. Many jobs give employees instant access to email—it’s hard to miss one. It’s a simple way to grab attention and encourage an employee to take action. If you have the time, sending a weekly newsletter can also be beneficial. Make sure you highlight how a wellness program can be a fun and effective way to manage health. It’s a low-cost way to raise awareness and encourages employees to interact.

Plan Design: When the money is coming out of the employees’ pockets, they’re more conscious about their healthcare decisions. High-deductible plans bring money to the forefront of employees’ minds. Your workers are more likely to take steps to lower the cost of healthcare if it means keeping money in their wallets. This is where wellness programs come in. Present them as a way to lower costs. Emphasize that the healthier you are, the less medical attention you will need.

Incentives: In terms of engagement, the survey found incentives are very effective, with a high incentive seeing a 30.4 percent increase in registration compared with no incentive. Simply, incentives provide motivation if it doesn’t come from within. They can come in the form of monetary rewards, additional time off, gift cards, or company recognition.

Print Promotion: For those who do not have a desk job, digital promotion may not be the best option, which is where print promotion comes in. Hang posters around the office, send mail to the employee’s home address, and give away stickers, pens, or refrigerator magnets. Besides drilling it in employees’ heads, it also brings the conversation outside the office and into the home. Healthcare becomes a discussion about the family, which is a priority in many people’s lives. If healthcare is not a priority for your employee, it may be for his or her spouse, who can provide the nudge to make a change.

There are just too few hours in a day. Or, I should say employees don’t give wellness programs their time of day. 

According to a Global Corporate Challenge report, 86 percent of employees do not participate in wellness programs because they feel they do not have the time to do so. An initiative not being perceived as fun, interesting, or engaging was the second-most cited reason for omitting participation in wellness initiatives, as reported by 45 percent of employees.

If time is really the issue, it’s time we start looking at wellness programs in a new light. According to the report, wellness initiatives need to be easily accessible to employees, a part of the organization’s culture, and integrated into employees’ daily routines—in and out of the office. It’s about altering the thought process: It’s not a break from work, but a part of work. 

The good news is, for the majority of organizations, improving employee health is a main goal. Companies are recognizing the importance of wellness programs, and the next step is to make them an engaging priority. 

The key word: engaging. 

Almost all organizations, 99 percent, report the importance of fun as medium or high. However, only 10 percent of employees report wellness programs reaching high levels of fun. Many commercial wellness programs may be perceived as dull—you pick up meals, eat the same foods, and have few interactions with other individuals. 

This is where The Center for Medical Weight Loss stands out. CMWL’s focus on behavioral counseling sets the program apart from other weight loss centers. Patients build lifelong relationships with their physicians who monitor their weight loss, and the entire staff becomes a weight loss support system. 

According to the report, 84 percent of organizations believe long-term behavioral change is key to wellness strategy. This statistic is reassuring—quick fix weight loss is now the minority. Focus on behavioral counseling sits at the core of CMWL’s values. The program is engaging because it’s individualized, it recognizes weight loss isn’t one-size-fits-all, and it focuses on adopting a new lifestyle.  

So, what’s next? 

Organizations recognize the importance of wellness initiatives. It’s a step in the right direction. However, the report also shows the most at-risk individuals are not taking advantage of the programs offered. Take the time to set up a meeting with at-risk individuals and discuss how you, as an employer, can help them achieve better health. If you understand your employees’ priorities, you can work together to free up some time on their schedules for wellness initiatives; maybe even convince them that they can have fun while they lose weight. 

A recent study researching employee healthcare spending found 10 health risk factors, which could be altered by making lifestyle changes, contribute to more than one-fifth of employer and employee spending.

The study, which was published in Health Affairs, found that 22.4 percent of $366 million spent annually by seven companies was attributed to the following risk factors:

• High blood pressure
• High cholesterol
• High blood glucose
• Depression
• Obesity
• Stress
• Tobacco use
• Poor diet
• Physical inactivity
• Excessive alcohol use

Obesity, no surprise to me, clocked in as the highest cost per capita per year, followed by physical inactivity. Obesity costs alone clocked in at $347 per capita per year.

Yes, it’s jaw dropping. But here’s what gets me: The majority of these risk factors are largely prevented by controlling your weight. If this isn’t a strong enough case for the importance of employee wellness programs, then I’m not sure what is.

Upcoming changes to the Affordable Care Act encourage employers to invest in wellness programs, myself included.

Currently, employers can charge higher insurance premiums without discussing steps with their employees to better their health. Beginning in January 2014, employers will have to refer employees to various wellness programs in order to charge higher insurance premiums for not meeting a specific goal. If an employee refuses to participate, an employer will legally be allowed to increase premiums up to 30 percent higher than the standard premium, as long as employees are given ample time to change their habits through a wellness program.

Essentially, this change, which seems slight, can significantly alter the way we look at changing our lifestyles. This requires employees and employers to have the obesity conversation, regardless of whether they want to. It brings the issue to the forefront of employers’ and employees’ minds. It forces everyone to acknowledge it.

Hopefully, the focus on wellness programs will decrease the cost of these risk factors, leading to reduced overall healthcare costs. It’s a win-win situation.

As an employer, if I’m going be required to invest in and recommend wellness programs to my employees, I’m going to take the time to look at the facts and suggest a program with proven results.

A study published in the American Journal of Medicine found physician-directed medical weight loss produces significant, effective, and sustainable results. It makes sense. We trust our primary care physicians with the majority of our chronic health problems, so why would our weight be an exception?

I strongly believe the majority of these risk factors cited can be controlled with the guidance of trained physicians. Do you think these changes will lower long-term healthcare costs?

Please check Agree or Disagree: Do you agree to the following terms?
“I pledge to keep my weight under control by maintaining a BMI less than 30. If my BMI is currently above 30, I agree to participate in a weight loss program.”

What if a candidate could be removed from consideration for a job by refusing to check “agree” to this question on an application? Or, what if breaking this agreement was grounds for increased health care premiums or higher deductibles?

Is this a crazy proposal? Is it smart? Forward-thinking?

Some companies already have health pledges, similar to the one above, requiring employees to agree to abstain from smoking. Before a potential employee submits an application, he or she is required to check a little white box, signifying his or her agreement to not use tobacco products.

So, requiring prospective employees to agree to keep their weight under control isn’t such a far-fetched idea. Cancer is the No. 2 killer in America, behind heart disease, which sits at No. 1. You prevent certain types of cancer by not smoking; you prevent heart disease, in many cases, by maintaining a healthy weight.

When you put the facts in perspective, suddenly the proposal doesn’t seem quite so crazy.

The most recent company to take a stand toward health is CVS. The company announced all employees who receive health insurance must report their weight, body fat, and glucose levels to the insurer. If employees refuse, they have to pay a $600 penalty. It’s not necessarily a health pledge, but it’s a step in that direction.

Clearly you can’t and shouldn’t discriminate against a potential employee because he or she is overweight, but you can promote a healthy workplace by having an overweight or obese employee pledge to complete a weight loss program. By requiring overweight employees to complete a program with proven results like The Center for Medical Weight Loss, you will see a significant difference in employee productivity and satisfaction and a decrease in overall healthcare costs over time.

If employees are willing to sign a health pledge and stick to it, they should be rewarded with lower premiums. If there is no incentive, you risk losing motivation. This can go a long way in ensuring both healthy habits and preventative care.

Encouraging employees to improve their health can be a positive initiative. If the payer of healthcare costs has knowledge of who is engaging in behavior that could drive costs up for everyone, he or she can begin to figure out how the costs could be reflective of individual healthy living profiles. The key will be to know where to stop, so genetic or pre-existing conditions do not cause penalties or higher premiums to be enacted.

Each company is different. In order to determine whether requiring a health pledge is beneficial for your company, you need to evaluate employee population and company culture.

What do you think? Is a health pledge a good or bad idea?

A recent Danish study found routine annual physicals have little benefit for healthy people. Researchers went as far to conclude routine physicals are meaningless and a waste of money and resources.

The study breakdown: Study participants were randomly assigned either to receive a physical or not receive a physical. Participants were given a routine exam, which included screening tests, advice about lifestyle changes, and a physical exam. The results showed both groups were just as likely to die over a nine-year period.

However, I think the study fails to look at the bigger picture. We have recurring expenses for being in poor health, and if we don’t go to the doctor, how will we know where we stand?

The first step is a checkup. It allows a doctor to diagnose emerging issues early, so you don’t become one of those people who need to be subsidized by other people for avoiding care. Ideally, obesity screenings would be done with an annual physical.

Now, the study did point out that going to the doctor for a specific screening or a vaccine is beneficial for everyone, but researchers do not believe it is necessary to have screenings done every year, stating it costs a lot of money and overuses resources.

Here is where I stand: Prevention does cost money—there’s no denying it. But if you look at the costs of the conditions these annual physicals prevent—obesity, heart disease, diabetes—the cost of prevention comes out significantly lower; millions of dollars lower. The cost of diabetes in the United States, for example, has risen to $245 billion in 2012 from $174 billion in 2007, according to the American Diabetes Association. The number is a 41 percent increase over a five-year period for diabetes alone.

These conditions, which are often caused by obesity, are largely preventable. Annual physicals give doctors a platform to easily monitor and predict conditions over time. When patients come in regularly, meaning they keep up with their annual physicals, doctors can recognize health trends and see when a patient’s health took a bad turn, making it easier to pinpoint why and determine the best course of action.

The U.S. Preventative Services Task Force recommends all adults be screened for obesity annually. As Americans become larger, studies show we eat less healthy than we think. An annual checkup, under the care of a physician, is the most accurate way to monitor your health, and it’s essential these screenings are covered under insurance.

What do you think? Are annual physicals worth the cost?

We spend the majority of our time at the workplace—at least eight hours a day. Most of us are glued to our chairs, have some sort of caffeine beverage within reach, and keep a secret stash of candy, chips, or pretzels to comfort us when we push our stress threshold. Case in point, we’re obese.

The cure to America’s obesity problem starts with building a healthy workplace. It’s where we develop most of our eating habits—healthy or unhealthy—and we take these habits home with us. As an executive of a company, you have the power to encourage healthier habits. Here’s how you can trade in a no. 2 cheeseburger with a side of fries combo for a healthy workplace combo with a side of extra productivity.

Stock the break room with healthy snacks. A break room filled with cookies, doughnuts, and chips won’t do your employees’ health any good, and it affects more than their waistlines. Fattening and sugary foods often come with a crash, which could be why eyes start glazing over in those late afternoon meetings. It’s time companies trash the junk and offer healthier snacking alternatives like fruits, nuts, nutrition bars, and even baked chips. The couple extra bucks you spend on healthier snacks could save you thousands of dollars in medical costs.

Encourage movement. The most recent buzz in the news is that sitting is the new smoking. New research shows spending too much time in a chair can increase your risk of heart disease, obesity, and diabetes. Encourage your employees to really take a whole hour for lunch and to use a portion of that time to be on their feet. Even better, next time you have a meeting with just one or two people, take it outside and make it a walking meeting.

Be a role model. Setting a good example can make all the difference. Healthy living is a domino effect. If one person leads, others are likely to follow. Sometimes it’s just about taking that first step.

Offer wellness programs. Some employees may require professional help to achieve better health. An employee will be more inclined to participate in these programs if their company covers at least part of the cost. However, it’s important to invest in a program with proven results. The Center for Medical Weight Loss comes with a weight loss guarantee. Physicians are specifically trained to coach, mentor, and motivate patients struggling with weight. Providing employees with discounts to health clubs is an obvious and good incentive, but it’s not compelling enough for everyone. A program like CMWL keeps employees on top of their weight loss plan because the program requires meeting with a physician regularly.

Have fun. A fun workplace is a healthy workplace. Laughter and a positive attitude go a long way. When workers genuinely enjoy what they are doing, they are more productive, creative, and feel less stressed. You can have fun and get a lot of work done too!