The Costs of Obesity in the Workplace

Finkelstein, Eric A.; DiBonaventura, Marco; Burgess, Somali M.; Hale, B.C.

doi:10.1097/jom.0b013e3181f274d2

Cited by 267 publications

(250 citation statements)

References 11 publications

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“…This increase has resulted in significant costs to the US healthcare system. Although they comprise only 37% of the employed population with obesity (BMI Z30), individuals with a BMI Z35 generate nearly two thirds of the annual excess costs to employers, attributable to obesity, which amounts to 4$40 billion per year [2].…”

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confidence: 99%

Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study

Funk

Jolles

Greenberg

et al. 2016

Surgery for Obesity and Related Diseases

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Background: Less than 1% of severely obese US adults undergo bariatric surgery annually. It is critical to understand the factors that contribute to its utilization. Objectives: To understand how primary care physicians (PCPs) make decisions regarding severe obesity treatment and bariatric surgery referral. Setting: Focus groups with PCPs practicing in small, medium, and large cities in Wisconsin. Methods: PCPs were asked to discuss prioritization of treatment for a severely obese patient with multiple co-morbidities and considerations regarding bariatric surgery referral. Focus group sessions were analyzed by using a directed approach to content analysis. A taxonomy of consensus codes was developed. Code summaries were created and representative quotes identified.Results: Sixteen PCPs participated in 3 focus groups. Four treatment prioritization approaches were identified: (1) treat the disease that is easiest to address; (2) treat the disease that is perceived as the most dangerous; (3) let the patient set the agenda; and (4) address obesity first because it is the common denominator underlying other co-morbid conditions. Only the latter approach placed emphasis on obesity treatment. Five factors made PCPs hesitate to refer patients for bariatric surgery: (1) wanting to "do no harm"; (2) questioning the long-term effectiveness of bariatric surgery; (3) limited knowledge about bariatric surgery; (4) not wanting to recommend bariatric surgery too early; and (5)

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mentioning

confidence: 99%

Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study

Funk

Jolles

Greenberg

et al. 2016

Surgery for Obesity and Related Diseases

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“…In Germany in particular-the site of the experiment discussed in this paper-66 percent of the male and The associated economic burden of obesity is tremendous [Bhattacharya and Sood 2011]. Incremental medical expenditures and the value of lost productivity, including absenteeism and presenteeism (health-related limitations at work), as a result of overweight and obesity are estimated by Finkelstein et al [2010] to range from $322 for overweight to $6,087 for grade III obese men (morbidly obese or having a body-mass index (BMI) ≥ 40 kg/m 2 ). For women, estimates range from $797 for overweight to $6,694 for grade III.…”

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confidence: 99%

Who responds to financial incentives for weight loss? Evidence from a randomized controlled trial

Paloyo

Reichert

Reuß‐Borst³

et al. 2015

Social Science & Medicine

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There is a paucity of evidence on the heterogeneous impacts of financial incentives on weight loss. Between March 2010 and January 2012, in a randomized controlled trial, we assigned 700 obese persons to three experimental arms. We test whether particular subgroups react differently to financial incentives for weight loss. Two treatment groups obtained a cash reward (€150 and €300 with 237 and 229 participants, respectively) for achieving an individually-assigned target weight within four months; the control group (234 participants) was not incentivized. Participants and administrators were not blinded to the intervention. We find that monetary rewards effectively induced obese individuals to reduce weight across all subgroups. However, there is no evidence for treatment-effect heterogeneity for those groups that were incentivized. Among those who were in the €300 group, statistically significant and large weight losses were observed for women, singles, and those who are not working (all above 4 kg in four months). In addition, the magnitude of the reward matters only for women and migrants. The effectiveness of financial incentives to reduce weight nevertheless raises sensitive ethical issues that should be taken into consideration by policymakers. In a randomized controlled trial involving 700 obese persons assigned to three experimental arms, we test whether financial incentives have heterogeneous effects over subgroups on weight reduction. Two treatment groups obtained a cash reward (€150 and €300 with 237 and 229 participants, respectively) for achieving an individually-assigned target weight within four months; the control group (234 participants) was not incentivized. Participants and administrators were not blinded to the intervention. We find that monetary rewards effectively induced obese individuals to reduce weight across all subgroups. However, there is no evidence for treatment-effect heterogeneity for those groups that were incentivized. Among those who were in the €300 group, statistically significant and large weight losses were observed for women, singles, and those who are not working (all above 4 kg in four months). In addition, the magnitude of the reward matters only for women and migrants.

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“…Medical spending attributed to overweight and obesity accounted for 8.2% of total spending, between $19 and $28 billion, for private insurance in 1998 (10). Furthermore, overweight and obese full-time employees have higher medical expenditures and rates of absenteeism than normal weight individuals (9,11) and extreme obesity (BMI 35) has been associated with decreased productivity (12). Many articles have been published examining the impact of obesity on the development of CV RFs and outcomes (13)(14)(15)(16), the impact of RFs on CV events (17)(18)(19)(20)(21), and costs of RFs (18,22), but currently there is no literature examining the impact of BMI on the prevalence of specific combinations of CV RFs, CV events, and, finally, costs to employer health plans using observational data.…”

Section: Introductionmentioning

confidence: 99%

“…Obesity (BMI 30) is increasing among adults in the United States and in 2007-2008, the overall age-adjusted prevalence of obesity was 34%, with 32% among men and 36% among women (8). Furthermore, 68% of adults in the United States are overweight or obese (BMI 25) (8) and overweight individuals (BMI 25-29.9) make up a large part of the workforce at 38% with obese individuals comprising 29% (9).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of cardiovascular risk factors, events, and costs across four BMI categories

Brixner

Bron

Bellows

et al. 2013

Obesity

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Objective: The purpose of this study was to analyze the 1-year cost of cardiovascular (CV) events by body mass index (BMI) subgroups from a US employer health plan perspective. Design and Methods: Patients aged 20-64 years from the GE Centricity Electronic Medical Record, National Health and Nutrition Examination Survey, and MarketScan databases were used to determine prevalence of risk factors (RFs) and CV events and 1-year costs. Risk factors included hypertension (HTN), diabetes, and hyperlipidemia (HLD) and CV events included myocardial infarction, angina, heart failure, and stroke. CV event costs were determined from claims by ICD-9 code in patients with overweight/obesity. Results: Of 220,136 patients identified in GE, BMI was 25-26.9 in 19.4%, 27-29.9 in 30.4%, 30-34.9 in 27.9%, and 35 in 22.3%. Patients with diabetes, HTN, and HLD increased with BMI from 1.8% (25-26.9) to 11.4% (35) in males and 1.1% to 6.8% in females. Prevalence of CV events increased from 0.1% with no RFs up to 10.2% with multiple RFs. The average 1-year cost per patient increased from $1122 to $2383 as BMI increased. Conclusions: Patients with higher BMI values had an increased prevalence of RFs and CV events, which lead to higher average 1-year costs.

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The Costs of Obesity in the Workplace

Abstract: Successful efforts to reduce the prevalence of obesity, especially among those with a body mass index >35, could result in significant savings to employers.

Cited by 267 publications

References 11 publications

Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study

Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study

Who responds to financial incentives for weight loss? Evidence from a randomized controlled trial

Evaluation of cardiovascular risk factors, events, and costs across four BMI categories

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