Managing Obesity in the Workplace

In 1997 the World Health Organisation (WHO) formally recognised obesity as a global epidemic.  The WHO estimates that at least 400 million adults (9.8%) are obese (1).   Similarly in Australia, overweight and obesity is recognised as a major public health issue, and ranks alongside smoking as the most important preventable cause of ill health (2).  The prevalence of obesity has more than doubled over the past decade with current obesity rates of 19% for men and 22% of women (3).

Overweight and obesity is responsible for a large proportion of the total burden of disease. The Australian Institute of Health and Wellness (AIHW) report that overweight and obesity contributed to 7.5% of the total health burden or the total of ill-health, disability and premature death that occurred in Australia in 2003 (4).  Obesity is linked to five of the top eight chronic diseases of Australians including cardiovascular heart disease, type II diabetes, arthritis, depression and stroke (4).

Research also demonstrates that obese people have much higher rates of ill-health as well increased overall mortality risk; someone with a BMI of 35 has 2½ times the risk of premature death compared to a person with a BMI of 20 (5).

Obesity in the workplace
In the workplace, the incidence of obesity is also growing.  A 2010 AIHW report identified increasing numbers of obese employees across a range of occupations.  The most recent estimates are 18.7% of the working population; 20.9% males and 16.5% females (6).  The effects of obesity have particular relevance in the workplace as obesity is also associated with decreased physical function, increased risk of injury, and reduced productivity (7).  Another recent study found that extremely obese workers had difficulty performing necessary work functions and struggled to complete work in the expected time due to feeling tired, weak, and short of breath (8).

Wesley Corporate Health has been conducting Health Risk Assessments on Queensland employees for 20 years and our data shows that 22% of employees are obese and an additional 37% are overweight.

The economic costs of obesity
The economic costs for obesity are large. These economic consequences include direct costs from increased health care services and indirect costs associated with lost economic production (9).  Calculations in the United States indicate that in comparison with people of normal weight obese people have a 36% higher annual health care costs which amounted to $147 billion dollars in 2008 (10). Another study in England measured the indirect costs of obesity (i.e. lost productivity and absence from work due to ill health or premature death) to be twice the direct health care costs (9).

Determinates of obesity in the workplace
Obesity is strongly correlated to poor diet and physical inactivity both which are highly prevalent in Queensland.  Decreased leisure time and increased time spent at work also contribute to increasing obesity trends.  In addition to this, the study found that employees were increasingly reliant on convenience food due to these increased work demands (7).

Fortunately obesity and the resultant chronic disease it causes is preventable. The best time to take action is before the onset of chronic disease.

Obesity prevention programs - what works?
The workplace offers great potential for health improvement.   Benefits of workplace interventions include access to a large population, increased opportunity for follow up and the ability to support interventions with changes to worksite infrastructure and policies.  It is an ideal setting to adopt interventions that aim to reduce the incidence of obesity.  Workplaces also offer great communication channels through intranet and messages boards.

A recent report released by the Physical Activity Nutrition and Obesity Research Group (PANORG) at the University of Sydney summaries the best evidence currently available relating to the effectiveness of nutrition and physical activity interventions that have been implemented in the workplace.  The report concluded that there is strong evidence that multi-strategy workplace interventions that address physical activity and nutrition are effective for increasing physical activity, promoting healthy eating and preventing obesity.

Effective types of physical activity strategies include:

• Providing prompts to encourage stair use
• Providing access to places or opportunities for physical activity
• Providing education or peer support

Effective strategies to address nutrition are those that modify the food environment are:

• Food labelling
• Point-of-purchase promotions
• Providing access and improving availability of healthy food choices in canteens and vending machines

There is also evidence that providing counselling, individual behavioural skills training and involving workers in program development and implementation are important elements of effective interventions.
The type of intervention employed depends on the facilities and environmental features of your workplace.  The Centre for Disease Control and Prevention (CDC) has released a free web-based workplace obesity prevention program called LEAN Works!  The resource offers interactive tools and evidence-based resources to design effective worksite obesity prevention and control programs including an obesity cost calculator to estimate how much obesity is costing your company and how much savings your company could reap with different workplace interventions.  Click the LEAN Works! link to find out more information about how you can plan, build, promote and implement a workplace obesity prevention program in your workplace.

References

1. World Health Organisation. (2002). World Health Report. Retrieved Aug 11, 2010, from http://www.who.int/whr/2002/overview/en/index.html
2. Perkins, A. (2003). Obesity: National and local policy directions. Healthlink The Health Promotion Journal of the ACT Region, Autumn ed, 14-15.
3. Eckersley, R. (2003). Losing the battle of the bulge: Causes and consequences of increasing obesity. Healthlink The Health Promotion Journal of the ACT Region.
   Australian Institute of Health and Welfare. (2010). Australia's health 2010. Retrieved Aug 28, 2010, from http://www.aihw.gov.au/publications/aus/ah10/ah10.pdf
4. Douglas, K. (2003). Facts and figures on obesity in Australia and the health consequences. Healthlink The Health Promotion Journal of the ACT Region, Autumn ed, 7-8.
5. Australian Institute of Health and Welfare. (2010). Risk factors and participation in work. Retrieved Aug 28, 2010, from http://www.aihw.gov.au/publications/index.cfm/title/10741
6. Gemson, D., Commisso, R., Fuente. B., Newman, J., & Benson, S. (2008). Promoting weight loss and blood pressure control at work: impact of an education and intervention program. Journal of Occupational Medicine, 50, 272-281.
7. Gates. D., Succop, P., Brehm, B., Gillespie, G., & Sommers, B. (2008). Obesity and presenteeism: the impact of body mass index on workplace productivity. Journal of Occupational and Environmental Medicine, 50 (1).
8. World Health Organisation. (2007). The challenge of obesity in the WHO European Region and the strategies for response. Retrieved Sep 1, 2010, from http://www.euro.who.int/__data/assets/pdf_file/0010/74746/E90711.pdf
9. Centre for Disease Control and Prevention. (2010). Lean Works: Leading employees to activity and nutrition. Retrieved Aug 11, 2010, from http://www.cdc.gov/leanworks/index.html
10. Queensland Public Health Forum. (2002). Eat Well Queensland 2002-2012: Smart Eating for a Healthier State. Retrieved Sep 1,2010, from http://www.health.qld.gov.au/qphf/documents/30434.pdf
11. Physical Activity Nutrition Obesity Research Group. (2009). Evidence module: workplace physical activity and nutrition interventions. Retrieved Sep 1, 2010, from: http://sydney.edu.au/medicine/public-health/panorg/pdfs/Evidence_module_Workplace.pdf