Obesity, Depression, and Costs

As we have seen, the opinion is widely held that research done so far on the relationship between employment and associated physical and mental disorders is insufficient. In some jobs and with some people, there may be a tendency to escape work whenever possible, on the thinnest of excuses. From the bosses’ side, there may be a tendency to take advantage of people who need jobs by making them do dangerous tasks and then blaming them if injury occurs. It would come as no surprise to learn of lawsuits and strikes related to these issues.

The history of labor has encompassed very complicated and conflict-prone areas. Hard-fought decisions have been made about who is entitled to compensation for being absent from work; as well as who is allowed to show up and underperform (presenteeism), which in the long run costs the company even more.

Obesity is one of the conditions that can influence worker productivity. If our kids are overweight or obese, it is likely they will grow up to be obese adults, and this relationship to work will be just one of the many problems they will be challenged to deal with.

Wider information, please

Archived studies on the subject have been recognized as excellent, but too narrow in scope. One example (published in 2020) focused on almost 3,000 Japanese office workers, of whom 70% were male. According to the researchers,

Ten health risk factors for presenteeism have been identified, including health-related behaviours such as smoking, lack of physical activity, high blood pressure, perception of health and stress. Studies have reported that workers with arthritis, allergies, fatigue, depressive symptoms, hypoglycaemia, overweight and obesity were at higher risk of presenteeism.

In the same paper, mention was made of such impactful organizational policies as sick pay, attendance management, and permanency of employment.

What about profit and loss?

Recently, Investopedia.com looked back at a 2016 study from Social Psychiatry and Psychiatric Epidemiology, which showed that…

[…] presenteeism associated with depression costs $5,524 per person annually in the U.S., five to 10 times higher on average than costs associated with absenteeism.

And of course, there is an extensive connection between depression and obesity. A 2015 article said,

Human obesity has serious consequences on health, including increased risks for depression, noninsulin-dependent diabetes mellitus, cancer, rheumatoid and osteoarthritis, hypertension, and heart disease. In addition, obesity has been found to reduce the quality of life for both men and women and markedly reduces life expectancy…

Those facts are quite depressing. Depression has been called the enemy of motivation, and one thing from which it can definitely demotivate a person is the desire to wake up, get spiffed up, and travel to a hated job.

And another thing…

It is possible that depression is being promoted for profit. This will not be gone into here, but the following quotation is worrisome in its implications, given all the ways through which obesity’s overall expense to society is likely to increase:

[M]any people who once called themselves alcoholics and drug addicts now say they are “dually diagnosed” with “major depressive disorder” and “bipolar disorder.”[…] Today, when alcoholics and drug addicts leave rehab, they are lifelong Pharma customers… For this lifelong, chronic and lucrative condition — resting on the now disproved chemical imbalance theory — they can remain on drugs like SSRIs for decades.

Whatever degree of legitimacy is represented there, it is bound to involve obesity in a large number of cases, and to be inimical to good employment relationships. Closer to home is a 2020 report from Sweden titled “Childhood obesity linked to higher risk of anxiety, depression and premature death.” Among other statements, we find:

Children with obesity have a three times higher risk of mortality in early adulthood compared with children in the general population and are more likely to suffer from anxiety and depression.

When these children grow up and become employed, their tendencies toward impaired physical health and depression are certain to impact their effectiveness at work, which in turn raises the employers’ costs to a greater or lesser extent in every business and in government jobs too, with the result that all these costs are passed on to customers and also eventually to every other facet of society.

Your responses and feedback are welcome!

Source: “Presenteeism among workers: health-related factors, work-related factors and health literacy,” Occupational Medicine, November 2020
Source: “Presenteeism: What It Is and How It Works,” Investopedia.com, 01/06/25
Source: “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity,” Academia.edu, 2015
Source: “Drugmakers Continue to Profiteer on ‘Free’ Mental Health Programs,” Academia.edu, 11/04/24
Source: “Childhood obesity linked to higher risk of anxiety, depression and premature death,” News.ki.se, 03/18/20
Image by KarlToon/Pixabay

Obesity, Pain, and Presenteeism

Pain is an obesity issue, because “musculoskeletal or joint-related pain in the feet, knees, ankles, and back” can make certain maneuvers difficult or impossible. Obese people often cannot move very well because of arthritis, and, of course, the relative lack of mobility leads to increased obesity. Carpal tunnel syndrome also shows up more often among heavier workers.

It might seem that a very obese person would be more difficult to knock over, but other factors are involved. The authors suggest that, in heavy individuals, balance and coordination are compromised. Obesity is also connected with sleep apnea and heart disease, both of which cause shortness of breath and general weakness, two definite drawbacks in a work situation.

According to an Australian study of long-term health conditions and obesity released in 2020, the mechanisms of the phenomenon are still obscure to the point where “little is known.” That paper’s conclusion “implies that interventions to improve workers’ health and well-being will reduce the risk of presenteeism at work,” an observation that one reviewer with an attitude dryly states “does not actually qualify as helpful.”

A 2018 study, using data compiled around 10 years earlier, compared various occupations in terms of how, and how much, productivity is affected by weight. Not surprisingly, obesity had the most profound impact in the physically demanding field of construction. Arts and hospitality was the next most affected category, which seems like an odd pairing since the arts can include extremely strenuous physical activity like performative dance, while hospitality could encompass standing behind a counter giving out room keys in a hotel.

Perhaps in this context, hospitality only includes the personnel who clean the premises, change the bedsheets, and so forth. A surprising number of jobs might turn out to include repetitive motions, awkward body positioning, and other challenging requirements.

At any rate, the conclusion there was that “Obesity differentially impacted productivity and costs, depending upon occupation,” which could not have come as much of a surprise to anyone. Between 2004 and 2011, all American industries saw weight increases in their average workers. This much was definitely stated:

When examined by occupational group, the highest age-standardized obesity prevalence was found for US adults working in the Motor Vehicle Operator occupational category (39.2%), with the lowest prevalence for those working in the Health Diagnosing and Treating Practitioner (15.4%) category.

These facts should also not be startling, because the drivers of trucks and buses are perpetually seated, while employees in the health field have a relatively high awareness level of the dangers of obesity. An interesting insight emerged from a large study in the Netherlands, which…

[…] reported that obesity was predictive of developing musculoskeletal symptoms, especially among workers whose jobs had low (vs high) physical workloads… Yet, the researchers acknowledged that their findings could alternatively be explained by individuals with musculoskeletal symptoms tending to self-select into occupations with fewer physical job demands.

In the field of manufacturing, when physically demanding tasks are involved, excess weight definitely impairs productivity, especially in terms of needing “additional time to complete physically demanding tasks.” In the realm of office workers, management and professional occupations tended to see higher costs “attributable to obesity-related absenteeism across a number of primarily office-based positions.”

Impairments in productivity and higher medical expenditures tend to characterize obese individuals with cardiometabolic risk factors like hyperlipidemia, diabetes, and hypertension. During the time period encompassed by that study, it was found that almost two-thirds of the expenses incurred by businesses were attributable to morbidly obese employees.

The authors noted that such studies tend to focus on only one or perhaps a few occupations, so…

[T]here exists a dearth of empirical research investigating the impact of obesity across varying occupational groups. Such research is critical, as excess weight may be associated with differing degrees of burden depending on profession and job responsibilities.

Your responses and feedback are welcome!

Source: “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity,” Academia.edu, 2008
Source: “A longitudinal exploration of the relationship between obesity, and long term health condition with presenteeism in Australian workplaces, 2006-2018,” PLOS.org, 08/26/20
Source: “Impact of Obesity on Work Productivity in Different US Occupations: Analysis of the National Health and Wellness Survey 2014 to 2015,” NIH.gov, 2018
Image by RosZie/Pixabay

More About Absenteeism, Presenteeism, and Obesity

The authors of a 2008 meta-study described the obesity-related costs (that take such a toll on society as a whole) as “astounding.” “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity” found that “the annual presenteeism cost for moderately or extremely obese workers was $1783.81, which is $506 higher than the cost for other workers.”

The study’s subject groups categorized as moderately and extremely obese experienced the highest absenteeism, averaging 91.08 absentee hours “for personal health reasons.” Financially, presenteeism is dreaded because…

[…] absences do not necessarily cost the employer the full value of the worker’s time to the extent that these are unpaid absences and that other workers are able to cover the missing shifts. Meanwhile, presenteeism is always a cost to employers because the worker is receiving a full paycheck despite reductions in productivity.

All in all, this accounts for a sizable chunk of the annual $900 billion that American employers pay for medical expenditures.

As numerous other studies have confirmed, the price paid by businesses for employee obesity is up there in the mega-bucks range. Unfortunately, much more work is needed on the minutiae of “Why?” When the cost derives from absenteeism and/or medical services rendered, this is easily understood.

What seems elusive is the exact process by which, when obese employees are involved, presenteeism (showing up for work but underperforming) is so wasteful. Is it just that they move more slowly when picking up a phone or straightening a stack of papers? Do they take longer lunch breaks, or spend more on-duty time moving back and forth to the snack machines? Do they fall asleep at their desks? What, exactly, is the issue?

Employees are on the job, but not functioning effectively because of medical or psychological conditions. But how does this manifest? We are told that the moderately and extremely obese workers experience the most limitations, as measured by the time needed to complete some tasks, and sheer inability to perform others.

In a broad sense, that tracks. If employed as a ballet dancer, a person with a BMI of over 35 would obviously fail. But how does the extra poundage inhibit or prohibit, for instance, a journalist? Presumably, the fingers on the keyboard would still be just as fast and accurate.

The particular questionnaire utilized in this study comprised 25 items falling into four categories:

The time scale addresses difficulties with meeting job expectations and scheduling demands. The physical scale focuses on workers’ ability to perform their normal job tasks as influenced by bodily strength, movement, endurance, coordination, and flexibility. The mental-interpersonal scale examines cognitive tasks, sensory input, and interactions with others. The output scale focuses on the quantity, quality, and timeliness of meeting job demands.

But the details involved in particular office tasks are not described. We know what the workers in a warehouse do. They move heavy physical objects from one location to another, which presumably requires an energy expenditure that helps prevent them from putting on weight. (Although, don’t count on it.) Still, a job in a plant or warehouse environment usually implies the ability to bend, stretch, squat, push, and walk.

But in an office setting, how heavy is a pencil or a file folder? Someone in the Information Technology department might need to lift a computer once in a while, but in general, what physical task is so daunting that a worker in the top obesity classification would be slowed down, stopped, or injured by its performance?

Okay, the IT person probably has to get under a desk now and then, to check on or reorganize some wiring. For a morbidly obese employee, this would be a struggle, costing time and possibly medical expenses.

It is easy to see why fitting beneath a desk, in the category of physical demands, could be problematic. However, seemingly, it would also qualify as a time issue, because the other employee who should be using that machine to complete work is unable to. Adding insult to injury, hashing out these procedural details adds to the time it takes to finish such studies.

Your responses and feedback are welcome!

Source: “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity,” Academia.edu, 2008
Image by Pexels/Pixabay

Presenteeism and Obesity

A prominent and ever-growing cause of financial loss to businesses is obesity, as described in the previous post. That post included as a subheading “The big but…” which is indicative of the problem in general: Obesity is such an easy target for mockery.

One difficulty with this topic is the temptation to succumb to flippancy and make jokes about the ruinous cost to widen the doorways in workplaces, and replace collapsed chairs… which would be wrong. The humor temptation might be why obesity, as a contributing factor to presenteeism, does not cause as much concern as it should.

But for some very dedicated scholars and business experts, the problem is (to reference another corny old joke) “serious as a heart attack.” They and their colleagues have discovered that in the world of work, presenteeism (reporting for duty but performing less than optimally) is actually more expensive than absenteeism, or not showing up at all. Now, why, in the business realm, is obesity seen as exceptionally harmful to the bottom line?

A worker with a broken wrist will eventually have the cast removed and, after a period of readjustment, will probably return to their original state of productivity. A pregnant worker may need some extra leeway, but will eventually become, instead, the parent of a child who is elsewhere during working hours. That situation offers its own challenges to an employed woman, but most are able to return to their pre-motherhood level of usefulness on the job.

Another big but…

However, in most cases, obesity does not go away. Usually, it increases. Over time, whatever negative effect an employee’s obesity has on the situation will probably not change for the better, and will probably change for the worse.

But how, exactly, does obesity contribute to presenteeism, and how does it do that in an especially impactful and intractable way? Exactly how do our collective tons of excess body fat add to the price of doing business, and thus increase the amount that consumers pay for every product, service, and commodity?

Not surprisingly, it is possible to find a raft of academic papers exploring the relationship between excess weight and presenteeism. The connections may not be immediately obvious to the casual eye, but they certainly exist. There are many reasons why a person’s Body Mass Index might affect their ability to do top-notch work. Also, there is said to be a “threshold effect,” meaning that the workers with a BMI of 35 or higher are significantly less productive than their slimmer counterparts.

Moderately or extremely obese workers… experienced the greatest health-related work limitations, specifically regarding time needed to complete tasks and ability to perform physical job demands. These workers experienced a 4.2% health-related loss in productivity, 1.18% more than all other employees, which equates to an additional $506 annually in lost productivity per worker.

In 2010, journalist Alyssa Zamora described the work done by Eric Finkelstein and many others at Duke-National University of Singapore. Researchers took into consideration “three factors: employee medical expenditures, lost productivity on the job due to health problems (presenteeism), and absence from work (absenteeism).” Furthermore, health problems cost more than medical expenditures.

Zamora wrote,

Collectively, the per capita costs of obesity are as high as $16,900 for obese women with a body mass index (BMI) over 40 (roughly 100 pounds overweight) and $15,500 for obese men in the same BMI class. Presenteeism makes up the largest share of those costs.

Bottom line: “The cost of obesity among U.S. full-time employees is estimated to be $73.1 billion.”

Your responses and feedback are welcome!

Source: “Obesity and presenteeism: the impact of body mass index on workplace productivity,” NIH.gov, January 2008
Source: “Obese Workers Cost More Than Healthcare, Absenteeism,” Duke.edu, 2010
Image by louisehoffman83/Pixabay

Is Obesity Everyone’s Business?

Here is one final look at an archived piece of health journalism from Dr. Bruce Y. Lee, which featured seven myths about obesity under the punning title, “Obesity is Everyone’s Business.” The general topic of this sequence of posts is the overall cost to society of treating and/or preventing obesity, and especially the way in which it has increasingly affected the cost of doing business.

In a very pragmatic demonstration of cause and effect, the author enumerated some of the
“immediate and long term physical, psychological, and social ailments” caused by obesity, which in turn affect a person’s effectiveness on the job. It should be mentioned that upper-level executives are just as prone to debilitating illness as the most humble new hire in the shipping department. The difference is that the folks in the higher ranks are more advantageously positioned to hide the deficiencies in their work output.

The check makes a difference

Also, executives can much more easily afford health-producing commodities like high-quality food, vacation time to recover from stress, membership in fitness establishments, and so on. However, in recent years, there has been some improvement in the equality with which corporations try to affect the basic health of their people.

Many physical ailments may be detrimental to an employee’s productivity. Depending on what field of commerce they are in, the damage from workplace machines, noise, and substances in the air can be quite serious. Even psychological issues (depression, anxiety, etc.) are perfectly capable of minimizing the usefulness of a worker at any level. A conscientious manager never wants to see conditions deteriorate to where workers experience sickness, pain, lack of energy, and the consequent lowering of morale.

Hopefully, that consideration results at least partly from generous human considerations. It is possible, after all, to operate simultaneously on two different planes of consciousness. Management can care and, at the same time, remain conscious that any and all physical and mental dysfunction in the workplace leads directly to lowered productivity, increased healthcare expenses, and shrinking profits.

This quoted paragraph illustrates some of the trends that motivated the business world to take a hard look at the consequences of obesity in the workplace. As previously mentioned,

A study by researchers at Duke University tabulated that obesity-related absenteeism and presenteeism cost U.S. employers $73 billion annually. [W]hile normal-weight employees cost on average $3,838 per year in healthcare costs, overweight to morbidly obese employees cost between $4,252 and $8,067.

Once researchers have wrapped their heads around some numbers, they enjoy expressing the significance of those figures in various ways. In this case, the authors also calculated the dollar amount of Body Mass Index points above the normal range. Once the border of obesity territory has been broached, statically speaking, each BMI point was said to represent an additional amount of around $200 per year that the company would pay out in healthcare costs for that employee.

The broad overview matters

Getting back to Dr. Lee, he formatted his Forbes.com article as a series of propositions which turn out not to be true; or myths. As Myth #5, he specified: “Obesity has little to do with overall business strategy, management, operations and finance.”

On the contrary, this author emphasized the big picture and maintained that “Employee weight and health can be a bellwether or ‘canary in a coal mine’ of how the overall business is functioning overall.” Why? Because a person’s normal weight can say a lot about their dedication, discipline, and work ethic, as well as function as an indicator of “the social, cultural, and financial situation and environment.”

In various industries, many members of the workforce have learned (the hard way) to keep the majority of their job-related opinions to themselves. Surveys and requests for feedback about company policy are often thinly-disguised traps designed to identify underlings who might be inclined to cause trouble. If “management” really cared about the average worker (the thinking goes), that collective noun would have caught on a long time ago, and realized that the whole outfit, from top to bottom, needed refurbishment.

Instead of initiating feedback requests that could be viewed with suspicion, the wise executive might be well advised to consult a psychologist familiar with the health manifestations of discontent — because obesity can definitely be interpreted as one of them.

Your responses and feedback are welcome!

Source: “Obesity Is Everyone’s Business,” Forbes.com, 09/01/15
Image by daha3131053/Pixabay