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
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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
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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
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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/m2)
< 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
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Diabetes
Coronary artery disease
Peripheral artery disease
Stroke
Hypertension
Hyperlipidemia
Arthritis
Obstructive sleep apnea
Pulmonary disease
PCOS/infertility
Dysmenorrhea
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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
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Mindful eating
Exercise
Healthy self-talk
Diets
 Medication
 Surgery
An Informed Approach
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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
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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…
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Diet over regular soda, 1 can.......15 pounds/year
1 Candy bar/day...........................26 pounds/year
Skim milk over whole, 1cup..........7 pounds/year
1Tbs mustard instead of mayo.......9 pounds/year
2 Scoops ice cream/day................33 pounds/year
Apple juice, 8oz cup.....................12 pounds/year
Orange juice, 8oz cup...................10 pounds/year
2 Beers/day....................................31 pounds/year
Workplace Involvement
Pays Off
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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
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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
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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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