The Skinny on Obesity
Employers and employees agree that the workplace is an appropriate site to wage the battle against fat, according to a recent study. Generally speaking, such wellness initiatives require a financial incentive to prompt workers to participate.
By Scott Westcott
Obesity is big news in the human resource world these days -- and new research indicates that employees welcome workplace initiatives to help battle the bulge.
While a recent piece in BusinessWeek entitled "Hide the Doritos! Here comes HR" cast human resource professionals as advocating sometimes pushy approaches to encouraging better eating habits and weight loss, new research confirms both employers and employees believe work is an appropriate place to address weight-management issues.
The
research
, unveiled May 22 by the
Strategies to Overcome and Prevent (STOP) Obesity Alliance
and the National Opinion Research Center at the University of Chicago found 80 percent of employees, regardless of weight, agree healthy lifestyles/weight-management programs belong in the workplace.
At the same time, 71 percent of employers view offering obesity-related services as appropriate -- and 73 percent of those employers view the offering of obesity-related services as effective.
Still, less than half of the employers say their companies give enough attention to the obesity problem.
"The workplace is where adults spend the bulk of their time and employers can play an important role in promoting healthy lifestyles and providing options to overcome obesity," said Dr. Richard H. Carmona, a former U.S. Surgeon General and chairman for the STOP alliance, a Washington-based coalition that fights obesity.
Carmona made the comment at a press conference where the research findings were released.
Indeed, employers are developing or implementing a wide range of approaches aimed at encouraging employees to lose weight and adopt healthy lifestyles.
At the press conference,
DMAA: The Care Continuum Alliance
, a Washington-based organization of individual and corporate stakeholders seeking improved healthcare, announced that the Service Employee International Union might soon implement a new obesity program that DMAA has designed.
The new package of benefits blends the most recent scientific evidence on effective obesity management strategies with pricing structures that are universally accepted by insurers to help HR or health professionals build a program that fits with their workplace. The benefit is designed as a "rider," which would be a supplemental package of services offered at an additional premium, such as vision or dental care.
DMAA President and CEO Tracey Moorhead says the benefit design is not a "plug and play" approach.
"It's not possible to produce one benefit that meets the needs of all populations," Moorhead says. "Our goal was to compress future benefit-plan development time by laying a groundwork based on the best available scientific evidence and national practice guidelines.
"We're not telling human resource executives what to do," Moorhead says. "What we are doing is showing them there is an opportunity to create a plan that works best for a particular organization."
While crafting that plan, HR professionals would be wise to gain a full understanding about how obesity programs fit with Health Insurance Portability and Accountability Acts and the Americans with Disabilities Act, says attorney Tom Bixby, a partner in Neal Gerber Eisenberg's Health Law Practice Group in Chicago.
Bixby, who counsels health insurers, HMOs, and other health plans on issues such as wellness programs, says that "generally speaking," wellness programs are rarely effective without incentives for employees.
Yet if incentives are offered, HIPAA prohibits discrimination based on health factors.
Employers can offer wellness-program incentives, he says, but the incentives cannot exceed 20 percent of the cost of health insurance and must offer a "reasonable alternative standard" to employees who would not be capable of achieving the incentives because of a health factor, such as morbid obesity.
Bixby says a reasonable alternative standard for obese employees might be that they would receive an incentive benefit if they lost 20 pounds in the course of a year.
Employers are all over the map when it comes to their understanding of legal issues connected with wellness programs, he says.
"I think some of them are rushing into it without thinking through the potential legal issue while some are avoiding these types of programs altogether because of legal worries," Bixby says. "Our view is implementing a wellness program has some risks, but as long as an employer is willing to be flexible and use common sense, that is a risk that can be managed."
Meanwhile, as employers become increasingly aware of obesity issues and the impact on employee performance and healthcare costs, they need to be cognizant of not violating the law during the hiring process, says Nina Stillman, a partner who handles employment law for Morgan Lewis & Bockius.
Stillman says the most recent court rulings have found that "just being overweight" is not protected by ADA. "That's even in regard to morbid obesity, unless the condition was caused by a medical condition, such as a thyroid problem," she says.
The issue gets stickier, however, because state laws vary widely. Stillman says, "virtually every state has its own discrimination law," with some expressly stating that employers cannot discriminate based on a person's weight.
"Some companies have gone public in those states in which it is legal to say, "we are not going to hire people who smoke or who are overweight,'" Stillman says.
Regardless of whether it is during the hiring process or with existing employees, employer focus on obesity is likely to increase as healthcare costs continue to challenge the bottom line and employees demand more robust wellness plans.
"Facing rising healthcare costs, employers are willing to address obesity head-on in the workplace," says Jon Gabel, a senior fellow at the National Opinion Research Center at the University of Chicago and principal investigator in the study.
"By their actions," he says, "businesses seem to be saying that 'regardless of whose fault it is, obesity is my company's problem and I need to do something about it.' "
June 3, 2008 Copyright 2008© LRP Publications
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