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Workplace Wellness Can Be Hazardous to Your Health

Al Lewis wears multiple hats, both professionally and also to cover his bald spot. As founder of Quizzify, he has married his extensive background in trivia with his 30 years experience in healthcare to create an engaging, educational, fully guaranteed and validated, question-and-answer game to teach employees how to spend their money and your money wisely. As an author, his critically acclaimed category-bestselling Why Nobody Believes the Numbers, exposing the innumeracy of the wellness field, was named healthcare book of the year in Forbes. As a consultant, he is widely acclaimed for his expertise in population health outcomes, and is credited by search engines with inventing disease management. As a validator of outcomes, he consults to the Validation Institute, part of an Intel-GE joint venture.
Recently, the economics of wellness were summarized in this blog. It turns out there is a reason no one has claimed the $3 million reward for showing wellness saves money: it doesn’t.

Today is part 2 in the series, covering the health hazards of wellness. As with the previous article, it will largely link to other studies and claims made by the perpetrators themselves.

The hazards fall into 6 categories:
  1. Actual, well-documented, harms to an exposed population
  2. First-person case studies and reports
  3. Crash-dieting risks
  4. Flouting of established clinical guidelines
  5. “Hyperdiagnosis” leading to unneeded medical care
  6. Incorrect or potentially harmful advice that employees are told to take

Actual, Well-Documented Harms to an Exposed Population
There is only 1 data point demonstrating actual harm to a population exposed to wellness.  That may be because a significant amount of data is required for such a demonstration. Further, the data must be incontrovertible. The vendor is Wellsteps, and the population is the Boise School District. It is incontrovertible because it is the vendor’s own data presented by the vendor itself. Hence, there is nothing to controvert—no one is challenging it.  

It showed a substantial deterioration in health status of Boise’s teachers, measured both subjectively and objectively. It has already been summarized in The American Journal of Managed Care blog.

What is distressing about this outcome, as regards the wellness industry as a whole, is that is Wellsteps is not an outlier. Quite the opposite, Wellsteps won the wellness industry’s top award for quality in 2016, precisely for this work with Boise. If this program is the best, one can only imagine how much harm is does by vendors who are not the best—especially, those who are not willing to disclose their data. As the leading wellness promoter, Ron Goetzel, PhD, acknowledges, “many unsuccessful programs are not reported.” This figure includes “thousands,” he says, while only 100 (presumably including Wellsteps, since he runs the committee that bestowed the award upon them) are deemed by him to have succeeded.

First-Person Case Studies
Employees rarely put their names on first-person reports of wellness program harms, fearing retaliation from supervisors. However, the Bazelon Center collected quite a number of them, while maintaining confidentiality, from employees with eating disorders. Social worker Rhonda Lee Benner, who provided some of these case studies, wrote:
I have worked with hundreds of patients over the 13 years during which I have worked with people with eating disorders. In the past 2 years, I have seen a number of patients who were quite negatively impacted by the wellness programs at their place of work.

Here are summaries of detailed case studies: A Slate article on wellness prompted many more first-person stories of wellness harms:
  • My husband’s [health maintenance organization] gave me a choice of either going to Weight Watchers or doing a minimum amount of walking every day. While I had cancer. And if I didn’t do it, my husband and I were going to be charged thousands of dollars more out-of-pocket each year. Luckily, my husband found a new job while I was in the hospital having my double mastectomy.
  • I am a triathlete and ultrarunner. My [blood pressure] tends to run dangerously low unless I eat a ton of salt. After a bunch of tests and doctor’s appointments, because I kept feeling like I was going to pass out any time that I wasn’t moving, I was just told to eat more salt. But then I was dinged on our automated questionnaire because it said I eat too much salt.

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