Wellness Program Says Jump — Employees Say, How High?

Data from the Healthy Blue Living wellness program was just published online in Translational Behavioral Medicine. And the wellness program presents a sunny picture of compliant employees with obesity wearing a pedometer that uploads their physical activity to the employer’s wellness program. But the fact is, these employees must participate and meet daily step count goals if they want to keep the full health benefits their employer offers.

Since the people who are singled out for this program have obesity, they likely need their full health benefits. So it’s not surprising that 43% of the eligible population would participate and that on average, the pedometers would register 6,523 steps per day, just above the minimum 5,000 required for an employee to keep full health benefits. After all, not doing so could cost an employee up to $2,000 per year, which is a stiff penalty for a low-income family that disproportionately and increasingly bears the burden of obesity.

The real problem though is that this program represents a big experiment without informed consent. No evidence exists that a coercive intervention like this results in sustainable improvements in obesity or reduced healthcare costs. In fact, the promotional literature for Healthy Blue Living from the Blue Care Network of Michigan shows pretty limited effectiveness for the program against the BMI goals they’re telling people they should meet. They list outcome statistics under a headline saying “Healthy Blue Living has proven that it helps members change behavior.”

74% with high blood pressure are now within a healthy range

69% with high blood sugar are now at an acceptable level

61% with high cholesterol are now at an acceptable level

57% who agreed to stop smoking did

16% who agreed to get their weight under a BMI of 30 have

That’s right. Fully 84% of people singled out for this program because of obesity could not meet the arbitrary goal of a BMI under 30. That would not be surprising for people who devote their careers to treating obesity. The goal of treating obesity is to help people achieve and maintain the healthiest weight they can, without chasing an arbitrary ideal weight. Goals are absolutely individual. One size clearly does not fit all.

Make no mistake about it, wellness programs can be very helpful if they adhere to evidence-based principles for what works. And people can do a lot to improve their own health, regardless of any risk factors that are beyond their control.

But the foundation of this program is that if you don’t have a BMI under 30, you can’t  qualify for full health benefits without wearing an electronic monitor and reporting your physical activity to prove you deserve health benefits. And until your BMI is less than 30, it’s not good enough.

Such thinking might work if you subscribe to the prevailing bias that people with obesity are lazy and undisciplined. We do not. Most people with obesity are frustrated by their condition and the difficulties it presents. Most have tried to lose weight and learned what most obesity medicine doctors already know. It’s very hard work and dramatic, sustained weight loss is rare.

So why is it reasonable to think that an employer with a coercive program can do what skilled doctors and motivated patients cannot?

Click here to read more about the study in Science Daily, click here to read the study, and click here to read promotional literature about Health Blue Living from the Blue Care Network of Michigan.

Dog Clears the Jump, image © Martyn Franklin, Negaro Imaging / flickr

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