Healthy and Unhealthy Wellness Programs

Healthy and unhealthy wellness programs are taking shape for the new year as new laws and regulations governing them come into effect. Advocates for reducing the impact of obesity caution that penalties and incentives based on body weight can easily become a hidden form of discrimination that will only make the problem worse.

CBS News in Boston reports that people who are slim and fit like the idea of slapping people with obesity with higher health insurance costs. Speaking for the Obesity Action Coalition, Ted Kyle offers caution:

Body size is not a simple matter of choice. Employers need to be very careful about discriminating against folks. The regulations for wellness programs very explicitly say wellness cannot be a subterfuge for discrimination.

A new position statement from the Obesity Society advises against wellness penalties based on BMI. Instead, the Society recommends using incentives to promote healthy behaviors and participation in health promotion programs. The statement raises six issues with BMI penalties:

  1. BMI penalties target a chronic disease instead of health behaviors that are more directly under a person’s control.
  2. Penalties based on BMI alone ignore the fact that what constitutes a healthy weight can be different for every individual.
  3. Substantial scientific evidence shows that expecting every employee with obesity to lose large amounts of weight and maintain it is unreasonable, even with the best treatments available.
  4. Many employer health plans exclude intensive evidence-based treatment for obesity, creating a catch-22 for the people affected.
  5. Substantial economic, racial, and ethnic disparities in the prevalence of obesity mean that financial penalties will disproportionately target minorities and people who cannot afford another penalty.
  6. Treating employees differently based on their BMI will serve to deepen the weight bias that already interferes with treating obesity and compounds the harm.

Sound wellness programs put positive energy into promoting healthy behaviors, not penalizing people for a chronic disease. Employers who truly want to promote the health of employees will start with ensuring they provide a healthy workplace and a health plan that covers intensive, evidence-based treatment for obesity.

Click here to view the story from CBS News in Boston, here to read the Obesity Society position on wellness incentives, and here to read more in the Wall Street Journal.

Healthy Berries, photograph © / flickr

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