Hit or Miss: Obesity in Wellness and Health Plans

Wellness and health plans increasingly purport to address obesity, but the the actual experience for people in those plans is a bit of hit or miss. Some plans appear to be thoughtfully designed to encourage people to live the healthiest lives they can. Others not so much — their focus is more on marginalizing people with health issues, shifting costs onto them, or nudging them out of health plans.

Often the progressive wellness plans are found at large employers with highly skilled employees, where retention and productivity are core values. But smaller companies are innovating, too.

For example, Excelas, a medical consulting firm in Cleveland with just 44 employees, has garnered good publicity for its wellness initiative. Says founder and president Jean Bourgeois:

The immediate objective is to improve the health of the staff. If our programs lead to a reduction in our health care costs over time, as we believe they will, that’s the end game that benefits our company as a whole.

The program includes stress reduction, nutrition, and walking programs. Employees can earn up to three paid days off, based upon the number of steps they take in the walking program. Office coordinator Cyndi Takacs says, “Earning time off with pay is a great motivator to get me moving.”

Experiences at other companies are not as positive, with employees finding them intrusive, demeaning, and often focused on arbitrary weight goals more than health. The following comment from the Shakesville forum paints a pretty clear picture:

Our insurance company will waive their various weight stuff if you sign up for “Healthy Lifestyle” phone counseling. Which is supposed to help you set healthy, realistic goals and improve your general health. Which is great and all, except that healthy, realistic goals a) always seem to involve weight-loss first and foremost, and b) are very focused on the One True Diet – to such an extent that I’m pretty much lying to the phone counselor about what and how I eat. The way that is working for me (and making my endocrinologist very happy), doesn’t fit her view of “healthy” — never mind that my blood work is all improving, and my energy is up, and I’m getting stronger. If I’m not eating the proper way and dropping weight in the approved manner, I must not be doing it right.

Intrusive, punitive, or demeaning plans will inevitably create a backlash. Employers should tread lightly.

Click here to read more in USA Today, here to read a report from Optum Health on workplace wellness, and here to read more in the Shakesville forum.

Birthday, photograph © Hamed Saber / flickr

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