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A weighty health care issue - Employers need to embrace wellness programs to fight obesity

Premium content from Dallas Business Journal - by Ashley Forbes Kellogg
Date: Friday, November 26, 2010

Does anyone remember how long it’s been since the airlines dropped weight requirements for flight attendants? Here’s a clue: At the time, they were still called stewardesses.

With rising costs in health care, companies must consider the financial issue of body weight and its bearing on retaining and acquiring employees.

There are few things that are more clearly and directly threatening to personal health than being overweight or underweight. Being overweight dramatically raises the odds of becoming diabetic. Diabetics cost on average $6,604 more than nondiabetics in direct health care costs, have 72 percent higher work absentee rates and are 20 percent less productive, the National Council on Aging found.

Experts predict that the number of Americans diagnosed with diabetes will double in the next 25 years due to the aging of the population, along with obesity rates. Medical spending for this population is projected to almost triple. And diabetes is but the tip of the iceberg.

Can companies (legally) afford not to consider weight as a factor in hiring, restructuring and
layoffs, or would that be considered job discrimination? These days, how smart can it be for
employees to stand around and smoke outside their buildings?

Numbers don’t lie

Jacqueline Kelleher, the wellness coordinator at Dallas-based MHBT, a major supplier of
commercial insurance, said “clients are measuring the health of their employees, including fasting (for a test of) blood glucose, and are basing employee premiums on participation in such programs.” Many companies, she said, are basing employee incentives on the outcomes of these tests.

Nearly everyone knows on some level — both personally and professionally — the importance of maintaining a healthy weight. We all have much to be grateful for and our health has to be at the top of that list. But the majority of us struggle with this issue; we do not relate the cause and effect of what we eat. McDonald’s would go out of business overnight if a Big Mac immediately popped up under our skin (whole) 30 seconds after eaten.

Another provocative thought: This group of overweight workers that has or could become
chronically ill makes up about 20 percent of an employee population and costs on average 55 percent of employers’ health care costs, the Boston Consulting Group found. Members of this group also don’t typically take advantage of wellness or fitness programs offered by their employers or medical programs.

Guilt only goes so far

Guilt is like a rocking chair: It gives you something to do but doesn’t get you anywhere. Many
health care companies have ineffectively tried to convince people that it’s the small events like a spike in blood pressure that build to ultimate catastrophic disease and complications. The reason that disease management has historically failed is that it does not address a distinctively human attitude: denial.

Dallas-based HealthPoints is a disease management company that tackles this human tendency head-on. HealthPoints’ leadership tried to find such a system while running the care and disease management program at United Healthcare.

“From a corporate standpoint, this is an appealing population to target for cost savings. These employees are likely to be already generating costs, and unaddressed, these costs will only accelerate,” said Rebecca Dubowy, chief medical officer at HealthPoints.

The quicker you can associate the behavior with the goal, the more likely positive results will occur.

“For the diabetic, it is easy to deny the importance of periodic advice provided by caregivers,” said Dubowy. “It’s all too easy to deny the danger of high glucose readings long after the event has been survived. Effective intervention must happen quickly and offer a teachable moment.”

HeathPoints has found that intervention based on consistent contact works. Other essential
elements of HealthPoints’ approach in dealing with human behavior:

The program must be easy.

Setting expectations is key. An opt-out program is far more effective than an opt-in program.

Education must be pushed to participants vs. pulling people toward their goal.

Relating human behaviors to goals is an interesting field of study. It’s the ultimate contest of
control between our minds and our bodies. Let the games begin. But on the other hand, maybe it can wait until after the holidays.

KELLOGG is president of ForbesRobinson,, a business development consulting firm specializing in event-driven marketing. She can be reached at



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