Wellness Toolkit for Obesity and Weight Loss

Introduction

Obesity is a common, serious and costly chronic disease that affects nearly half of U.S. adults. Furthermore, obesity-related conditions—such as heart disease, stroke, Type 2 diabetes and certain types of cancer—are the leading cause of preventable, premature death. Obesity is also associated with poorer mental health outcomes and reduced quality of life.

Why Focus on Obesity and Weight Loss

The American Medical Association recognized obesity as a disease in 2013 based on increasing evidence that genetic, biological, and environmental factors were driving the condition. Like any other disease, obesity can have a complex ripple effect on one’s overall health. In fact, obesity is also linked to more than 60 chronic diseases. When compared to those with a healthy weight, people affected by obesity are at a higher risk for the following severe diseases and health conditions:

Prescription Weight Loss Drugs

The popularity of weight loss drugs has reached a fever pitch in the United States. This trend has made its way into the workplace, with employees increasingly asking their employers about coverage for popular drugs used for weight loss, such as Wegovy. Other drugs intended to treat Type 2 diabetes, like Ozempic or Mounjaro, are also in high demand for off-label weight loss use.

The recent string of popular weight loss drugs are types of glucagon-like peptide 1 (GLP-1) receptor agonists. Originally developed for the treatment of Type 2 diabetes, these drugs work by lowering an individual’s blood sugar levels. GLP-1 drugs have the side effect of sending fullness signals to the brain, which produces an anti-appetite effect leading to weight loss. They may also delay the time it takes for the stomach to empty after eating, increasing feelings of satiety and fullness.

The majority (62%) of individuals who were interested in GLP-1s wanted to lose more than 20% of their body weight. Additionally, 41% wanted to lose 25% or more of their body weight, and 23% wanted to lose 30% or more of their body weight. Most (59%) would be willing to take weight loss medication for the rest of their lives to maintain their ideal body weight.

Employer Options for Promoting Weight Loss

Many employers are committed to trying to help employees lose weight. These employers recognize the connection between obesity and other serious diseases. They understand the impact that obesity has on the workplace (e.g., increased health care costs and absenteeism) and want to improve employee health and well-being.

Employers can play a key role in supporting weight loss. To support employee weight loss, employers may consider the following options:

Addressing Obesity Through Workplace Initiatives

Many traditional forms of addressing obesity in the workplace, such as the utilization of workplace wellness programs, often come short of yielding sufficient program participation and successful results. Furthermore, sustained engagement and long-term results are typically uncommon with generic workplace initiatives. Because obesity is expected to remain a significant public health issue, employers will need to think outside the box to adequately address this disease among their respective workforces.

An Action Plan for Addressing Obesity

Many employers have various well-being programs, workplace policies and employee benefits offerings that can collectively address obesity. However, a thoughtful and comprehensive plan is needed to adequately manage this disease in the workplace.

Organizational leaders need to keep in mind that workplace initiatives related to obesity are ongoing efforts that require continuous evaluation and optimization. This section explores a general process for employers to follow when addressing obesity in the workplace.

Take Inventory

To begin, employers will need to have a solid understanding of health and wellness challenges in general and then assess what’s working—and what’s not—among their respective workforces. It’s vital to take inventory of current strategies or policies and assess their effectiveness. In order to do so, employers should consider asking the following questions:

·?????? What is the organization’s overall health and wellness strategy?

·?????? What workplace wellness programs are currently in place?

·?????? Are employees aware of and utilizing these programs?

·?????? Has any feedback been received regarding these programs?

·?????? How effective are these programs? Important program areas to review include:

o?? Employee engagement

o?? Employee productivity

o?? Employee absenteeism

Assessment and reflection are just as critical in understanding how programs measure up. Along with getting a clear view of program effectiveness, employers might consider improvements or updates to increase employee utilization and overall results. With this in mind, employers should consider asking these additional questions:

·?????? Does the workplace culture support healthy living behaviors?

·?????? What are the barriers to success?

·?????? Have employees been given an opportunity to share what they’re interested in or need from workplace wellness programs?

Since workplace programs are organizational investments, employers will want to ensure that both employees and their respective companies get the most value from these initiatives. Asking employees may seem simple, but it’s a great place to start to validate program effectiveness and identify any resource or support gaps.

Additionally, health organizations have created free tools to help employers assess their overall health culture in the workplace. The American Heart Association offers an organizational self-assessment tool called the Workplace Well-being Scorecard to evaluate the culture, structure, processes and outcomes of an organization’s current wellness program. The CDC’s Worksite Health ScoreCard can also help employers assess whether they have implemented evidence-based health measures specifically aimed at managing obesity-related diseases and risk factors.

Consider Weight Loss Drug Coverage

Many employers still consider weight loss a lifestyle problem instead of a health issue. As a result, they don’t believe weight loss drugs are medically necessary. However, as employee attitudes and demands shift, some employers may be unable to avoid a more deliberate approach to employee obesity. While the use of use of GLP-1 drugs for weight loss is relatively new and uncertainty remains regarding its long-term effectiveness, it is in high demand among employees.

Employers should consider the following when deciding whether to cover weight loss drugs:

·?????? Expensive treatments—Adding weight loss drugs to a health plan would likely substantially increase an employer’s health care expenses, especially since using drugs like Ozempic to manage weight loss is extremely expensive. These costs could be difficult to absorb, especially if multiple employees receive the drugs to lose or manage their weight.

·?????? Drug design—GLP-1 drugs were not originally designed to treat weight loss. In situations where individuals use them for this purpose, they may not be effective if used for a short period of time. This can significantly increase employer health care costs. Employers may also want to consider these drugs’ possible side effects and the fact that they are relatively new.

·?????? Health plan coverage—Because most GLP-1 drugs aren’t approved by the FDA for weight loss, most insurers will not cover them when used for that purpose. If they are not covered by health insurance, workers must pay out of pocket to use the drugs for weight loss. Moreover, even if an individual obtains coverage of a GLP-1 drug for weight-related treatment, it does not guarantee permanent coverage for this purpose, which could negate any weight-related benefits if they lose coverage in the future.

·?????? Prerequisites and limits—Some organizations require employees to participate in lifestyle modification programs as a prerequisite for prescription weight loss drug coverage, while others ask employees to participate voluntarily. According to a recent survey of over 150 employers and health by pharmacy benefit consulting company Pharmaceutical Strategies Group, 22% of employers who cover FDA-approved weight loss drugs require employees to participate in a lifestyle modification program in order to be eligible for the drugs. For 20% of employers, participation in such programs is voluntary. Additionally, some employers limit the coverage of weight loss medications in terms of either dollars or duration of treatment.

·?????? Alternative Options—Employers can also explore alternative approaches by providing weight loss benefits to employees, including covering psychology-based weight loss programs to support employees in losing weight. In some cases, these programs offer prescriptions for obesity drugs, like Wegovy, for approximately $120 per month, as well as cheaper weight loss medications that can help reduce food cravings.

Tailor Offerings

With the information gathered from the previous step, employers can tailor specific measures to address their workplace culture surrounding food, physical activity and sedentary time. By using insights and feedback from workplace assessments, employers can also factor in obesity treatments via the health care plans they offer.

Employers may also incorporate work-life balance initiatives that touch on contributing risk factors of obesity, such as sleep and stress. It comes down to understanding weight stigma, reviewing employees’ needs and preferences, and crafting ideal programs to match unique desires. Above all, the end goal should be ensuring program utilization and delivering sustainable solutions.

Define Success

As with any solid workplace program or policy, employers need to define what success looks like. The only way to know if a program is successful and impactful is to measure progress and results continually. That can only be done if employers have clear program goals in mind.

A program’s purpose may vary, but in almost every situation, the ultimate goal is to improve overall employee well-being and thus reap the rewards of a healthy workforce. A written plan provides continuity amid employee turnover and can hold employees (or a dedicated wellness team) accountable to the agreed-upon goals, objectives and timelines.

Address Stigma

The overall perception of obesity should also be addressed in the workplace. In addition to avoiding stereotypes and respectfully portraying individuals in organizational materials, a fundamental principle of health communication for employers is the use of people-first language. Widely adopted in recent years, people-first language describes a person as having a condition or circumstance—not the person being defined by this condition. This toolkit includes people-first language, but consider the following obesity-related examples for additional insight:?

In addition to being mindful of word choice in written and oral communication, employers should consider the following ways to address weight stigma and bias in the workplace:

·?????? Recognize obesity as a disease by offering more than strictly behavioral interventions, which usually aren’t sufficient.

·?????? Review the language and graphics used in communications and update any stigmatizing content.

·?????? Raise awareness among employees about weight bias, stigma and the importance of recognizing obesity as a disease.

·?????? Reject weight stigma as an organization.

·?????? Promote a more inclusive and positive work environment.

Weight stigma has no place in the workplace. There are many ways employers can help remove bias and foster supportive work environments for all employees.

Engage Employees

Employers should focus on building a workplace culture of health and wellness to best engage employees instead of fixating on weight loss. For example, employers could engage employees in behaviors that promote proper nutritional habits, mental health, physical activity, stress management and sleep hygiene. Employers could even go one step further and incorporate the importance of employee health into their organizational mission statements, visions or objectives. That type of promotion demonstrates an employer’s commitment to overall well-being in the workplace.

As with most things, timing matters, and good habits are often difficult to develop when it comes to wellness. Here’s an outline of key engagement milestones for employers to consider when implementing health and wellness programs aimed at addressing obesity within their respective workforces:

Employers should carefully consider these time periods and determine how they can help employees stay engaged past these critical milestones.

Start Today

Employers play an important role in preventing and managing obesity, especially since U.S. adults spend a substantial amount of time at work. Employers should reevaluate their health and wellness benefits, policies and programs to ensure they are inclusive and impactful within their workforces. If such offerings don’t exist yet, then there’s an opportunity to start today and develop wellness initiatives and resources that can help develop healthy lifestyles both in and out of the workplace.

As with anything in the workplace, employees have varied needs and preferences, so a one-size-fits-all approach likely won’t be the most impactful. The most impactful strategies will be those tailored to employees’ unique needs.

Reach out for any support regarding setting up wellness or weight loss plans!

Jeff Bastien, Principal Employee Benefits

p. 774-239-4139