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Employers Should Disband Employee Weight Control Programs
Alfred Lewis, JD; Vikram Khanna, MHS; and Shana Montrose, MPH
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Employers Should Disband Employee Weight Control Programs

Alfred Lewis, JD; Vikram Khanna, MHS; and Shana Montrose, MPH
No corporate weight control program has ever reported savings or even sustained weight loss using valid metrics across a sizable population for 2 years or more, accounting for dropouts and nonparticipants. Further, these programs can harm morale and even the health of the employees themselves.
American corporations continue to expand wellness programs, which now reach an estimated 90% of workers in large organizations, yet no study has demonstrated that the main focus of these programs—weight control—has any positive effect. There is no published evidence that large-scale corporate attempts to control employee body weight through financial incentives and penalties have generated savings from long-term weight loss, or a reduction in inpatient admissions associated with obesity or even long-term weight loss itself. Other evidence contradicts the hypothesis that population obesity rates meaningfully retard economic growth or manufacturing productivity. Quite the contrary, overscreening and crash dieting can impact employee morale and even harm employee health. Therefore, the authors believe that corporations should disband or significantly reconfigure weight-oriented wellness programs, and that the Affordable Care Act should be amended to require such programs to conform to accepted guidelines for harm avoidance.

Am J Manag Care. 2015;21(2):e91-e94
Corporate weight control programs are ineffective at reducing weight; in addition, the nexus between weight loss and savings/productivity improvement is weak. Especially given the costs and potential harms of these programs, the authors recommend phasing them out altogether and reallocating resources towards creating a healthier work environment for everyone.

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Author Affiliations: Disease Management Purchasing Consortium (AL), Waltham, MA; Vikram Khanna Health Consulting (VK), Chesterfield, MO; Independent consultant (SM).

Source of Funding: None.

Author Disclosures: Mr Lewis and Khanna report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article. Ms Montrose completed this research in 2014 as an independent consultant.

Authorship Information: Concept and design (VK, AL); acquisition of data (AL, SM); analysis and interpretation of data (VK, AL, SM); drafting of the manuscript (VK, AL); critical revision of the manuscript for important intellectual content (AL, SM); statistical analysis (AL); administrative, technical, or logistic support (VK); and supervision (AL).

Address correspondence to: Alfred Lewis, JD, Disease Management Purchasing Consortium, 890 Winter St, Waltham, MA 02451. E-mail:
1. Final Rule. Internal Revenue Service, Department of the Treasury; Employee Benefits Security Administration, Department of Labor; CMS, HHS. Department of Labor website. Accessed March 17, 2014.

2. Caloyeras JP, Liu H, Exum E, Broderick M, Mattke S. Managing manifest diseases, but not health risks, saved PepsiCo money over seven years. Health Aff (Millwood). 2014;33(1):124-131.

3. Gowrisankaran G, Norberg K, Kymes S, et al. A hospital system’s wellness program linked to health plan enrollment cut hospitalizations but not overall costs. Health Aff (Millwood). 2013;32(3):477-485.

4. Lewis A, Khanna V. Is it time to re-examine workplace wellness ‘get well quick’ schemes? Health Affairs Blog. Published January 16, 2013. Accessed March 11, 2014.

5. Lewis A, Khanna V. Surviving workplace wellness. The Health Care Blog. Published 2014. Accessed March 11, 2014.

6. Lewis A. Company wellness programs don’t really save money. Harvard Business Review. Published March 8, 2013. Accessed March 7, 2014.

7. Mattke S, et al. Workplace wellness programs study: final report. RAND Health website. Published 2013. Accessed March 7, 2014.

8. Stoddard M. Nebraska’s acclaimed wellness program under fire. website. Published July 15, 2013. Accessed March 7, 2014.

9. Mishra S, Barnard ND, Gonzales J, Xu J, Agarwal U, Levin S. Nutrient intake in the GEICO multicenter trial: the effects of a multicomponent worksite intervention. Eur J Clin Nutr. 2013;67(10):1066-1071.

10. ShapeUp falls down trying to do math for Highmark. They Said What? website. Published July 2014. Accessed January 29, 2015.

11. Wellness Coaches USA 2012 Client Outcomes Report. Wellness Coaches USA website. Published January 2013. Accessed March 17, 2014.

12. Cigna Better Health Guaranteed brochure. Cigna website. Accessed March 26, 2014.

13. Healthcare survey finds spending on corporate wellness incentives to increase 15 percent in 2014. National Business Group on Health website. Published February 20, 2014. Accessed March 17, 2014.

14. Tavernise S. Obesity rate for young children plummets 43% in a decade. New York Times. Published February 25, 2014. Accessed March 10, 2014.

15. The Healthcare Cost and Utilization Project. AHRQ website. Accessed March 15, 2014.

16. Berman J. Obesity costs U.S. companies billions in lost productivity: Gallup. The Huffington Post. Published October 17, 2011. Accessed April 1, 2014.

17. Rodbard HW, Fox KM, Grandy S; Shield Study Group. Impact of obesity on work productivity and role disability in individuals with and at risk for diabetes mellitus. Am J Health Promot. 2009;23(5):353-360.

18. Prevalence of self-reported obesity among U.S. adults, BRFSS 2012. CDC website. Accessed March 20, 2014.

19. “Establishment Data State Employment Seasonally Adjusted. Table D-1. Employees on nonfarm payrolls by state and major industry seasonally adjusted.” Predicted growth rate from December 2012 to December 2013. Author’s calculations. Bureau of Labor Statistics website. Accessed March 20, 2014.

20. Prometheus Unbound. Thanks, McDonald’s: obesity is killing America’s economic competitiveness by ballooning health care costs. Published April 21, 2012. Accessed March 11, 2014.

21. Jaspen B. Like CVS, more employers penalize workers that snub wellness exams. Forbes. Published March 25, 2013. Accessed March 17, 2014.

22. Singer N. On campus a faculty uprising over personal data. New York Times. Published September 14, 2013. Accessed March 17, 2014.

23. Danagoulian S. The hassle of wellness programs: do peers and health status matter? Presented at the Population Association of America 2014 meeting. Accessed January 30, 2015.

24. Kruger J, Yore MM, Bauer DR, Kohl HW. Selected barriers and incentives for worksite health promotion services and policies. Am J Health Promot. 2007;21(5):439-447.

25. Delta GB and General Counsel. The big fat truth about use of incentives for wellness programs. The Institute for Healthcare Consumerism website. Accessed March 11, 2014.

26. Cawley J, Price JA. A case study of a workplace wellness program that offers financial incentives for weight loss. The University of Texas, Arlington website. Published March 21, 2013. Accessed March 17, 2014.

27. A call for action and civil resistance for Penn State employees. Wordpress website. Published July 30, 2013. Accessed March 17, 2014.

28. US Attorney’s Office of Western Missouri. KC employee pleads guilty to fraud scheme to cheat health insurance program. US Department of Justice website. Published May 30, 2013. Accessed March 7, 2014

29. Lewis A, Khanna V. The strange case of the C. Everett Koop National Health Award. The Healthcare Blog. Published August 8, 2013. Accessed March 14, 2014.

30. Wellness Underground. If you give a CEO a wellness program. Published 2014. Accessed March 17, 2014.

31. Krogsbøll LT, Jørgensen KJ, Gøtzsche PC. General health checks in adults for reducing morbidity and mortality from disease. JAMA. 2013;309(23):2489-2490.

32. McCartney M. Patients deserve the truth: health screening can do more harm than good. The Guardian. Published January 3, 2014. Accessed March 20, 2014.

33. Screening for lipid disorders in adults. US Preventive Service Task Force website. Released June 2008. Accessed March 20, 2014.

34. Screening for colorectal cancer: recommendation statement. US Preventive Service Task Force website. Released October 2008. Accessed March 20, 2014.

35. Why ‘Biggest Loser’ wellness programs don’t work. LaCarte Wellness website. Published May 20, 2011. Accessed March 7, 2014.

36. Barton County Memorial Hospital weigh down competition. website. Published March 18, 2014. Accessed March 18, 2014.

37. Pappas S. The ‘Biggest Loser’ has big problems, health experts say. LiveScience website. Published February 21, 2010. Accessed March 7, 2014
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