Obesity in America A Growing Epidemic Workplace Strategies

Obesity in America A Growing Epidemic Workplace Strategies and Solutions Janine V. Kyrillos, MD Director, Preventive Health Care Program Medical Coordinator, Weight Management Program Thomas Jefferson University 215 -955 -6180 janine. kyrillos@jefferson. edu Sponsored by Health Advocate, Inc.

Overview § § § 1/3 of U. S. population is obese 2/3 of U. S. population is overweight or obese 74% Increase over 10 year period Costs U. S. companies $13 billion/year Employers have important roles in addressing this epidemic

Outline § § § § Obesity: scope of problem Contribution to rising healthcare costs What is obesity? Role in chronic disease, disability Workplace strategies and trends Questions/discussion Websites/resources

Obesity on the Map

Obesity Has a Hefty Price Tag § ~$117 billion in 2000 ($61 billion direct and $56 billion indirect) § 6 -10% of U. S. health care spending § Health costs >30% higher than normal weight individuals

More on the Bottom Line § § § Costs companies >$13 billion annually More than twice as many sick days Disability, workers compensation Self esteem, emotional factors affect productivity Costs of accommodations, chairs, keyboards

Definitions of Obesity Classification Underweight BMI (kg/m 2) < 18. 5 Comorbidity Risk Low* Normal range 18. 5 to 24. 9 Average Overweight 25. 0 to 29. 9 Increased Obese class 1 30. 0 to 34. 9 Moderate Obese class 2 35. 0 to 39. 9 Severe Obese class 3 (Morbidly obese) 40. 0 Very severe *risk of other clinical problems increased Calculate your own BMI: http: //www. nhlbisupport. com/bmi/

Apples and Pears Waist circumference is tied to cardiovascular risk Tipping Point: Men: >40 inches Women: >35 inches

Obesity Major Player in Many Diseases § § § Diabetes Coronary artery disease Peripheral artery disease Stroke Hypertension Hyperlipidemia Arthritis Obstructive sleep apnea Pulmonary disease PCOS/infertility Dysmenorrhea § § § § § Pregnancy complications Gallbladder disease GERD Skin infections Urinary incontinence Depression Eating disorders Social stigma Cancers: breast, endometrial, colon, prostate, gallbladder, kidney, esophagus… Increase in all causes mortality

Natural Selection?

Energy Balance

Helping Shift the Balance of Energy § Lifestyle modification - Mindful eating Exercise Healthy self-talk Diets § Medication § Surgery

An Informed Approach § § Recognize as chronic disease Responsibility exists at many levels Prevention as individual and society Can make impact in workplace

Why Workplace Solutions? § § § Workplace can be part of the problem Employees willing to pay for it An ideal opportunity for social reinforcement

Workplace Solutions: A Range of Options § Education Community resources Getting involved § Inexpensive approaches § §

Education Strategies: A Simple Way to Start § § Employee newsletter Informational e-mails Bulletin boards Include: – Calories burned from common activities – Mindful eating tips – Local walking/bike trails – Upcoming fitness activities/events

Small Changes Each Day Add Up… § § § § Diet over regular soda, 1 can. . . . 15 pounds/year 1 Candy bar/day. . . . 26 pounds/year Skim milk over whole, 1 cup. . 7 pounds/year 1 Tbs mustard instead of mayo. . . . 9 pounds/year 2 Scoops ice cream/day. . . . 33 pounds/year Apple juice, 8 oz cup. . . . . 12 pounds/year Orange juice, 8 oz cup. . . . . 10 pounds/year 2 Beers/day. . . . . 31 pounds/year

Workplace Involvement Pays Off § § § Scheduling physical breaks during the day Onsite wellness centers, exercise/walking trails Stress management programs Encourage walking/biking to/from work and during breaks Memberships or discounts to health clubs Walking clubs, weight loss competitions

Inexpensive Approaches for Better Nutrition § § Offering healthier food choices at reasonable prices Provide nutritional info in cafeteria Provide healthier snacks at meetings and other employee events Provide bottled water and healthier items in vending machines

Create a Healthy Work Environment § § § Encourage employees to use stairways Discourage employees from eating at their desks Support physical activity breaks during the workday Offer alternative work schedules Have a weekly casual day Provide enough time for lunch so employees can walk or use the gym and don’t eat in a rush

Additional Strategies § § Wellness programs with onsite or online wellness coaches are effective Incentives Ongoing reminders through newsletters, posters, speakers Weight management support groups

Partner with Community Resources § Health fairs § Onsite employee meetings with Overeaters Anonymous or Weight Watchers § § Local speakers or personal trainers Walk-a-thons, bike-athons

Real Experiences § § § CDC Highmark Inc. North Carolina Department of Health and Human Services http: //www. eatsmartmovemorenc. com/ NEAT!

NEAT

Change Is Not Instantaneous

Questions?

Helpful Websites § Centers for Disease Control http: //www. cdc. gov/nccdphp/dnpa/obesity/index. htm § The Center for Mindful Eating http: //www. tcme. org/ § USDA Food Pyramid http: //www. mypyramid. gov/ § Weight-Control Information Network http: //www. win. niddk. nih. gov/index. htm § Yale University Rudd Center for Food Policy & Obesity http: //www. yaleruddcenter. org/index. html § Other sites: http: //www. nutrition. gov/ http: //www. smallstep. gov

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