As a former college professor with a doctorate in exercise physiology and 29 published research papers to his credit, Tom Gilliam has an appreciation for data on health and fitness. And when he views the recent data on employee obesity, it offers anything but a comforting picture for the future of worker health.
Gilliam has conducted physical capability assessments for Fortune 1000 companies since 1982. Along with strength measurements, Gilliam started looking at body weight and noticed a disturbing trend in the data from the year 2000 on. "For the pool of workers applying for jobs in North America, the change in body mass index (BMI), an indicator of obesity, was dramatically changing," Gilliam says. "In 2000, 30 percent of applicants were obese. At the end of 2005, 38 percent of the new hires walking into the workplace were obese." Projecting that trend forward, Gilliam warns that 45 percent of the incoming work force will be obese in 2010.
Why should employers care? Gilliam references an April 2005 Wall Street Journal article in which General Motors stated that an obese employee costs the company about $1,500 more in health services annually than an employee with a healthy body weight. At that time, GM indicated that 26 percent of its active workers and dependents were obese. That meant obesity was costing the company nearly $1.4 billion in additional health care costs each year. And Gilliam notes that the $1,500 figure is expected to rise to $2,500 by 2010.
Gilliam points out that the costs associated with a more-obese work force don't just relate to chronic health conditions such as cardiovascular disease, diabetes and hypertension. He says as workers grow heavier, they also are likely to be absent more and incur a greater chance of injury.
"We have clients where there are individuals who exceed the OSHA [weight limit] of a stepladder," he says. Others have employees whose weight exceeds recommended limits for fall-protection harnesses. Even offices are feeling the effects as employers need to invest in sturdier office chairs and replace them on a more-frequent basis.
"We've reached a point where we have an epidemic," Gilliam says. "It is for real. It is going to take a considerable length of time to fix the problem. There is no quick fix."
Not an Overnight Problem
After being asked by various clients what they could do to combat this problem, Gilliam sat down and wrote, with co-author Jane Neill, R.D., L.D., "Move It. Lose It. Live Healthy.: Achieve a Healthier Workplace One Employee at a Time!" In the book, Gilliam and Neill take the approach that knowledge is power when it comes to losing weight and keeping it off.
"Knowledge works! People choose questionable quick fixes because they don't understand how their bodies function or the role of exercise and good nutrition," they write, adding that armed with such knowledge, "you will make positive changes in your lifestyle that will lead to long-term benefits."
While you'll find plenty of good information in their book, don't expect to find a miracle diet or the name of a health supplement that will melt fat off. "What has happened has taken years to occur. You go to bed tonight, you don't wake up 80 pounds overweight," Gilliam says. As a result, people ignore their gradual weight gain. But something innocuous as gaining 3 pounds a year beginning in early adulthood results, in middle age, in a person being 60 pounds overweight.
Gilliam says many people faced with that situation think they have to lose the weight quickly in 6 weeks or 12 weeks or some other brief time period. "It is going to take you 1, 2 or 3 years to manage your body weight and bring it down to a healthy level," he says. "When people begin to understand that and realize they don't have to make dramatic changes, they get more involved."
What are some of these small step changes? If you drink two soft drinks a day, try replacing one with a bottle of water. That saves you 140 calories a day, or 51,100 calories over the course of a year. That is 16 pounds lost. Add 15 minutes of walking a day to your schedule and take off another 5 to 8 pounds.
"Body weight is all controlled by calories," says Gilliam. "Calories in, calories out. It is a very simple equation. You need to have a better understanding of what calories are coming in and what you can do about calories going out."
Crash diets don't work, he says, because the body resists sudden change. "Located in the brain is a nerve center that acts to control your body weight by controlling your hunger," Gilliam and Neill write. "The body has a 'set point' controlled by this nerve center that keeps our body weight fairly constant even though your body weight can be too much, too little or just right."
Once a person goes off a crash diet, the body will work to resume its previous state and thus regain the lost weight. But if a person introduces gradual changes to their diet and exercise over 1 to 2 years, the body has time to adjust and the weight loss will be permanent.
Gilliam is the first to tell you that "in our society, we're not good with time," so advocating gradual change can be met with less than wild enthusiasm. But he says there are things employers and workers can do to help:
- Be honest with people about the costs of excess weight and the illnesses that come with it. You can make these points in a letter or kick-off meeting, but he cautions not to discount the power of face-to-face conversations.
- Teach employees the basics of weight loss. The only way to lose weight and keep it off, he stresses, is to consume a moderate, nutritious diet and exercise regularly. Fad diets, fitness gadgets and other get-thin-quick schemes won't work.
- Get your employees excited about good nutrition. Create a recipe bulletin board either an old-fashioned cork board or a virtual online one and encourage employees to share healthful, delicious recipes. Host a potluck lunch to which everyone brings his or her favorite healthful dish. Ask employees to take turns bringing in fresh fruits, veggie trays or other low-fat snacks. Remove the junk food in vending machines from the premises.
- Foster and encourage exercise groups. Employees are more likely to sustain an exercise program if they have company. He suggests hiring an aerobics instructor to come in during pre- or post-work hours to lead workouts, and starting a lunch-hour walking group. Employers also can take a vacant room and install a treadmill, stair-step machine and weight bench. Ask everyone to sign a waiver, he notes, so you're legally covered in case of injury.
- Link weight loss to larger family issues. While no wants to be obese, Gilliam points out, most people want their children to be obese even less. Offering to help employees set a healthy example for their children can be a powerful motivator. "I've found that when you say to people, 'Look, every time you open a bag of potato chips and collapse in front of the TV, your kids are watching you,' they pay attention," he says. "Hey, guilt can be a very useful tool. Ask any mother."
Gilliam attributes the renewed corporate interest in wellness programs not only to increasing recognition of the obesity epidemic and growing health care costs, but also to better health data. "With better tracking of health data, we know how much more a person with hypertension costs per year than one without hypertension," he says, adding that this allows companies to monitor if their wellness expenditures are producing a good return on investment.
While occupational safety and health professionals are supportive of wellness programs, Gilliam says successful programs must have top-management support. That means not just financial support, but support for the time that such activities require. "It isn't just a commitment in dollars to print up materials and have experts come in and give talks," he says, "but saying to employees that they can walk away from a machine for 20 minutes and attend a [wellness] session."
For more information, visit Gilliam's Web site at www.healthybody weight.com.