The obesity epidemic in America is undeniably both a health and humanitarian crisis. However, does that mean that American employers can, or should, have any hand in solving it?

They’ve certainly been trying! A full 53 percent of companies with less than 200 employees have some kind of worker wellness program, and the figure is even larger for large companies at about 82 percent!

Aspects of these programs can range from offers of incentives like gift cards for taking nutritional classes, to free gym memberships or bike sharing programs, to, on the more extreme end, invasive blood tests and health assessments. Some programs even exist in which workers were directly paid for pounds lost!

If you're wondering what's in it for the companies, worker wellness programs are unfortunately less about helping you then they are about helping companies save money. For while there is no known correlation between weight and productivity per se, there are big ones between health and productivity and between weight and health.  

Workplaces that offer their employees health insurance have an even bigger incentive to lower their worker's healthcare costs... which often boils down to lowering their weight.

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These "worker wellness programs" have spawned an 8 billion dollar industry and are encouraged under the Affordable Care Act, which allows companies to make the amount their workers pay in healthcare premiums contingent on participation in such programs, or even on those workers ability to achieve positive health outcomes like weight loss.

Such measures have inspired significant controversy. For one thing, they have been the subject of several lawsuits that claimed they were discriminatory, violating worker's right to medical privacy and unfairly punishing unhealthy employees.A particularly audacious and since discontinued program called G0365 that required employees to earn wellness points by wearing a Fitbit or keep their BMI in the healthy range to avoid penalties was even a precipitating factor in 2018 West Virginia teacher strike!However, such costs might be worth it if these programs actually made a difference to employee health... but do they? Many experts are skeptical, insisting that the evidence that led to the passage of the law in the first place was based on misleading claims.Studies that do report significant weight loss from such programs often rely on distorted statistics and fail to adequately control for confounding factors, most notably the self-selection effect. For instance, a better-designed study suggests that voluntary worker wellness programs may simply appear to work because they are most attractive to workers who are already health-conscious.

While the subjects did indeed report healthier behaviors after enrolling in the program relative to a group who didn't participate, they also showed healthier behaviors and lower health care costs before enrolling in the program.

The study’s authors went on to hypothesize that the true value of worker wellness programs for employers may be as a means of attracting healthier, more motivated workers and keeping such workers at their company!

A more recent randomized study found small differences in self-reported health behaviors in a group of warehouse workers who had taken part in health courses as part of a worker wellness program, but no effect on actual health measures like blood pressure, cholesterol levels, and BMI.

Perhaps this is because most of these "courses" consist of common sense advice that many employees would already know, or could easily find information on themselves if they were truly motivated to change.

Additional research found that these wellness programs don't lead to measurable savings for companies and that the feeling of being micromanaged may instead cause a decrease in employee morale.Other potential negative effects of worker wellness programs include crash dieting, fat-shaming, unnecessary doctor’s visits, and subsequent overdiagnosis of insignificant health “issues.” Not to mention, worker wellness metrics likely rely on metrics like BMI that may be faulty in the first place.

While less invasive forms of worker wellness programs seem unlikely to do harm, it’s hard to predict what can do harm; even something as benign as a lecture on the importance of a healthy diet could be triggering to an employee with an eating disorder, or subsidized healthy meals could encourage employer disparagement of workers who choose more indulgent cuisine.

Others see perks like on-site health care and massage services as cynical bribes to make up for high employer expectations; after all, if  your employer is doing so much to promote your "wellness," the only one you can blame for your illness is you!

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The point has also been made that if extras like reimbursed gym memberships are considered part of an employee’s compensation, a disabled worker who cannot take advantage of such a perk is effectively paid less than a able bodied worker who can.

If there is a way employees and employers can effectively work together to create a healthier workforce, they don't seem to have found it yet. In the end, the only thing that will really motivate you to lose weight is you!

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