Combating Obesity in the Workplace

Timothy J. Parsons, MPH

If you have read or watched the news in the past few years, you have heard the story. The United States is in the midst of an obesity epidemic. With each passing year the story becomes more grim. Obesity is defined as a body mass index (BMI) of 30 or greater. To put the BMI calculation in perspective, a person who is 5'8" tall weighing 198 pounds has a BMI of 30 and is considered obese. According to the latest Centers for Disease Control and Prevention (CDC) statistics, in 2010 approximately 33.8 percent of Americans were obese. When you add in those that are overweight, the value rises to more than 60 percent of Americans are overweight or obese. Additionally, 12 states have a population that is 30 percent or greater obese. By contrast, in 1985 when the CDC began keeping statistics on obesity, no state exceeded 20 percent. This is an astronomical climb that has mirrored the similar rise in healthcare costs.

The monumental spike in obesity is troubling when you consider the impact that it has on our health. According to the CDC, obesity has been linked to an increased risk of the following diseases:

  • Coronary heart disease
  • Type 2 diabetes
  • Cancer (endometrial, breast, colon)
  • Hypertension
  • High cholesterol
  • Stroke
  • Liver and gall bladder disease
  • Sleep apnea and respiratory problems
  • Osteoarthritis
  • Gynecological problems (abnormal menses, infertility)

In terms of the financial impact that obesity has on healthcare, obesity has led to $147 billion in direct medical expenditures. As a municipality or school district facing rising healthcare premiums each year, this is a pretty substantial chunk of your annual costs and it is one that you can influence in the workplace. The New Hampshire Department of Health and Human Services (DHHS) indicates that employers benefit from healthier workplaces. The benefits include, but are not limited to, enhanced employee productivity, lower healthcare costs, decreased rates of illness and injury, reduced employee absenteeism and improved employee morale. Employees also benefit from reduced stress, improved well-being, self-image and self-esteem, increased stamina and weight loss, and improved health and physical fitness.

What can be done to combat obesity? It took nearly three decades to get to this point and it will take some time to battle our way back to a healthy culture. Just think of the strides that have been made to make workplaces and public places smoke-free. It took twenty years of grassroots efforts. Equally, it is going to take time to create a society that encourages healthier food choices and improved access to physical activity. Until then, there are some opportunities that individuals and workplaces can take advantage of to improve one's health through obesity reduction. The remainder of this article will focus on how municipalities and schools can exact change among their employees and provide resources that can be used to improve worksite health.

The Math of Nutrition and Physical Activity
Weight gain is a matter of somewhat simple math. If we consume more calories than we need, then we will gain weight. If we consume only as many calories as our body needs, then we maintain our weight. Accordingly, if we consume fewer calories than we need, we will lose weight. The last calculation is rather tricky, however. Going back thousands of years to the days of our ancestors, food was not always as abundant. We were still millennia away from conventional supermarkets so humans lived by feast and famine. Human beings became very well adapted at hoarding calories. In times of famine, the human body goes into storage mode where it takes as many calories as possible and stores them as fat. Additionally, the body slows its metabolism down in order to conserve those newly stored calories. This is a double whammy and one of the primary reasons why starvation diets are ineffective. Our body is doing everything it can to keep us alive even if we are already overweight. Not only are you consuming very few calories in calorie-restrictive diets, but you are also tricking your body into believing that it is starving—and sending it catapulting into storage mode. Our hardwiring doesn't seem fair: we can easily gain weight, but it is considerably more difficult to lose it.

So, what is the most effective strategy to lose weight sustainably? The answer is simple: a combination of moderate calorie restriction and increased physical activity. When people hear the words "physical activity" they also hear "exercise" and are harkened back to the days of knee-high gym socks, short shorts and the Presidential fitness test. This very thought makes many cringe and long for a comfortable spot on the couch, where it's easier to watch people exercise than to do so oneself. Have no fear: physical activity is not what it used to be. The days of running until your lungs ached are over. According to the National Heart Lung and Blood Institute, a division of the United States Department of Health and Human Services, physical activity is defined as "any body movement that works your muscles and uses more energy than you use when you are resting." Thus, walking, golfing, hunting, gardening, biking, fishing, hiking and, yes, running are forms of physical activity. The key is to get your body moving. The CDC suggests that Americans get 150 - 250 minutes of physical activity per week. More manageably put, that is 30 minutes of physical activity 5 - 7 days per week.

Changing the Workplace Culture: Better Food Choices and More Physical Activity
Food is a powerful incentive to get people to meetings. It is the social glue that binds all cultures. We connect over food. Removing food altogether from the workplace is incomprehensible. However, choosing and encouraging healthy food choices can help to prevent the current dilemma of candy jars at desks and donuts at meetings. Purchasing healthy foods is not an easy task without some proper guidance, and with the advent of modern food packaging claims, choosing to eat well is not as easy as it once was. The act of buying a healthy cereal alone can induce migraines in the most patient and health-conscious shoppers.

If you are organizing a meeting at your town or school, how do you make the better food choices? There are a variety of website tools that can assist you in finding healthy foods. The New Hampshire Department of Health and Human Services Obesity Prevention Program website offers comprehensive information including food guidelines set forth by the United States Department of Agriculture (USDA), and recommendations made by the CDC as well as many other resources.

Healthy eating in the workplace starts with providing general guidelines to your staff as to what constitutes healthy eating. The University of Minnesota School of Public Health has created Guidelines for Offering Healthy Foods at Meetings, Seminars and Catered Events. This free resource outlines what foods are most sensible. The resource adheres to two basic guidelines: first, offer healthy choices at breakfast, lunch, dinner and receptions; second, consider not offering food at mid-morning and mid-afternoon meetings, presentations and seminars.

The guide offers suggestions for replacing foods higher in fat, calories and sugar with healthier alternatives. For example, at morning meetings offer low-calorie beverages including coffee, tea, iced water, skim or 1 percent milk, 100 percent fruit/vegetable juices and coffee/tea creamers that are low-fat or fat-free. Food offerings at a breakfast meeting may include fresh fruit, fat-free yogurt and small bagels served with low-fat cream cheese, peanut butter, jam or jelly. For afternoon meetings where food is expected or anticipated, try offering bottled water coupled with fresh fruit, offered with low-fat yogurt dip; sliced vegetables, offered with fat-free or low-fat dressing; pretzels, served with sweet mustard; and baked tortilla chips, offered with salsa.

Incorporating physical activity into the workplace proves to be a separate but equal challenge to municipalities and schools. Reduced staffing due to budget shortfalls puts stress on municipalities and schools to do more with less, even finding time for lunch can prove to be a challenge for employees. There are some simple, low-cost tools to increase physical activity in the workplace without purchasing expensive exercise equipment. Workplaces can start a walking club that meets before, during or after work, which offers opportunities for employees to get fit and a chance to socialize as well. Workplaces can also support physical activity by creating a physical activity challenge where employees are rewarded for their efforts through incentives. And, lastly, encourage employees to take advantage of wellness programs offered through their health insurance program. Visit the DHHS Obesity Prevention Program website to learn more about how to improve opportunities for physical activity in the workplace.

Final Thoughts
To make any changes in the workplace, it all begins with support from the top. Research shows that if managers support and participate in workplace wellness programs, the chance of success increases greatly. This can all be done by creating a wellness team or incorporating wellness into your state-mandated Joint Loss Management Committee. Successful committees include equal representation from both management and labor. With a strong committee and management commitment, you will have a platform from which to offer and support future wellness programs and promote a healthier workplace. Learn more about building a wellness committee at the DHHS Obesity Program's Healthy Worksites website.

In the end, employees, employers and taxpayers benefit from a workforce that makes better nutritional choices and participates in physical activity. Healthy employees are happier and engage in the healthcare system less frequently. Employers with healthier employees pay less in overtime and substitute teachers because employees call out less frequently. Taxpayers reap the benefits when schools and towns stay within budget. With better health, everyone wins.

Additional Tools and Resources

Tim Parsons, MPH, is a Health and Safety Advisor for the New Hampshire Local Government Center. Contact Tim at 800.852.3358, ext. 217, or by email.

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