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

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?

Some employers have sticker shock when they see the cost of workplace wellness. Understandable, it’s costly, but let’s look at the bigger picture: Studies show for every dollar spent on wellness programs, medical costs fall an average of $3.27, and costs for days that employees are absent fall $2.73. 

It’s easier to understand when you crunch the numbers: Workplace wellness programs are not costing you, but they are actually saving you money. I’ve stressed the importance of obesity prevention, and employers are in a powerful position—they have a say in the health of their employees. I believe that incentives, especially when coupled with leadership from the top, allow employees to understand their employers’ priorities. 

In 2014, the Affordable Care Act will expand employers’ ability to reward or penalize workers who participate in and meet the goals of various wellness programs. When there is change, particularly in healthcare, there are questions. How will this impact employee plans? 

Many expert consultants advocate incentives early on as a way to encourage employees to make proper wellness choices that can have a positive impact on their longer term health and well-being and result in lower future healthcare-related costs. In the future, employees might be choosing health plans from a menu of options and have to pay for the difference of the cost of the plan and a subsidy provided by their employer. If this is the way things unfold, it would be in the best interest of employees to focus on wellness so they can choose cost-efficient health plans in the future. 

Of course, in line with most things in life, providing incentives and penalties have pros and cons. What works well for one employer may not work well for another. Here, I will acknowledge both sides, and let you decide which program will resonate best with your company.  

THE PROS

Incentives can make people happy. By covering the cost of a wellness program, or even just covering a portion of the cost, employers have the ability to take the cost burden of the most efficient programs off of employees’ shoulders. Investing in clinically-proven wellness programs fosters healthier, more productive, and happier employees.   

Financial rewards may generate weight loss results. Studies indicate programs that use financial rewards have positive results and may be effective in producing weight loss. Valued incentives lead to more participation. This could include gift cards, bonuses, or awards of different amounts based on various levels of success. 

Penalties, such as higher health insurance premiums if an employee does not meet the company’s goals, may motivate employees to stick with it. On the contrary, you can also penalize employees who do not meet the company’s wellness standards. In the perfect world, everyone would be healthy simply because they know it’s good for them. But that’s not always the case. Employees are aware that health insurance is costly, and for some, taking money out of their pocket is just the push they need to achieve weight loss. 

Contests and competitions can boost morale and encourage participation. Friendly competition can go a long way. If you work in a competitive environment, it may be beneficial to make wellness a competition. Plus, it puts everyone in the same boat, so it can make sticking to a weight loss plan fun, encouraging, and supportive. 

A wellness program that demands results equals a healthy and wealthy company. Making wellness a priority by providing incentives can attract the best employees to your company. It shows you care about the well-being of your employees, which will in turn make top prospects want to work for you. 

THE CONS

It can discourage employees from participating in the company’s health benefits. For some, the idea of required participation in a wellness program is intimidating. If an employee doesn’t reach the company’s goal and money is involved, it can potentially add stress. Participation then becomes unaffordable and an employee may seek health benefits elsewhere. 

Behavioral differences. We come in different shapes and sizes, and that’s OK. Health is made up of numerous factors, and some are out of a person’s control. For instance, some people are genetically predisposed to high blood pressure, high cholesterol, and even diabetes, and it is important to take these factors into consideration when developing an effective wellness program.