Obesity, It’s Everybody’s Baby

Childhood obesity will ultimately cost someone a significant amount of money; whether it be the parents, the institutions of learning that the kids attend; the kids themselves when they grow up; their employers; the airplane manufacturers who are required to provide wider seats; or the general public, in the form of taxes collected to alleviate medical conditions both congenital and acquired, for the betterment of society as a whole.

The harm generated by childhood obesity involves more than just the individual child’s health. Whether or not it is their fault, and whether or not others spitefully blame them, and regardless of whether it is fair — in one way or another, obese people constitute an expense to society.

On this blog, much attention has been focused on one very important facet of the societal impact of obesity, namely: It eventually touches everyone in some way. In many cases, this impact is physical, as the person joins the ranks of the overweight and obese. Still, hefty as those numbers are, direct physical participation in obesity is not universal. But financial participation is inevitable.

Big research

In 2018, much current information and many previous statistics were consolidated by Hugh Waters and Marlon Graf of the Milken Institute into a major report.

They looked into the costs that health conditions related to overweight and obesity were racking up, because these expenses would ultimately be paid for by “individuals and their households, employers, government, and society.” In other words, sooner or later, directly or indirectly, every person in the country would be liable for these costs. In some cases, it might be considered fair, because 60% of Americans (just over 180 million people) were either overweight and heading inexorably toward obesity, or had already arrived there.

Startling hindsight

Travel back in time for a moment, to 1962. In that year, a young teen could look around and observe an adult population in which only 13.4% of the men and women were obese. In 2016, that same person’s adolescent grandchild could look around and see 39.8% of the grownups in an obese condition. Where there used to be one obese person in a family, now there were three. Where there used to be 100 obese people in an auditorium, now there were 300.

To break it down another way, in that year about 100 million Americans were obese, and about 80 million were overweight, and these two combined statistics accounted for…. wait for it….

$480.7 billion in direct health care costs in the U.S., with an additional $1.24 trillion in indirect costs due to lost economic productivity.

If numbers like this do not cause people to sit up and take notice, nothing will. Just in case the message was not getting through, a mathematician did another calculation, which was announced at the same time:

The total cost of chronic diseases due to obesity and overweight was $1.72 trillion — equivalent to 9.3 percent of the U.S. gross domestic product (GDP).

Another formidable finding went like this:

Obesity as a risk factor is by far the greatest contributor to the burden of chronic diseases in the U.S., accounting for 47.1 percent of the total cost of chronic diseases nationwide.

“By far the greatest contributor…” Strong words, indeed. Where does the “risk factor” accusation come from? Apparently, obesity is implicated as a causative or exacerbating factor in a large assortment of diseases, from head (Alzheimer’s and vascular dementia) to toe (type 2 diabetes).

The report from the nonprofit, nonpartisan think tank notified the public about a major fact. Of all the factors that contribute to the continuing existence of chronic diseases, obesity is the undisputed champion because it “increases insulin resistance, blood pressure, LDL cholesterol, and triglycerides. Further, obesity lowers HDL cholesterol and places the body in a pro-inflammatory state.”

The authors explain how fat cells, even though they are distributed throughout the body, have perfected the technique of ganging up in a network to function as one discrete endocrine organ, and with ferocious effect. The report gives specific examples of how this works, and notes that together, “these multiple related pathways are referred to as metabolic syndrome.”

The report’s Table 8 is frightening, with its presentation of the direct and indirect cost per case (in 2016) of 23 serious conditions. (Two varieties of carcinoma come out on top.)

For the minutiae-minded, the report also offers over 100 source footnotes.

Your responses and feedback are welcome!

Source: “America’s Obesity Crisis: The Health and Economic Costs of Excess Weight,” MilkenInstitute.org,” 10/26/18
Image by World Obesity Federation

The Importance of Hydration Recognized

We have mentioned that businesses are interested in learning how to discourage workers from “doing things on company time that will eventually cost the company many dollars.” One of those factors is the consumption of sugar-sweetened beverages, which have been shown to cause obesity. The particular methodology of this threat is that employees who become obese tend to bend the “bottom line” expensively.

Most people probably do not have a clue about all the history behind the availability (or not) of water in either public locales or in places of business. Over the years, many laws have been argued, passed, contested, and rewritten, over the issue of water in the workplace. Considering the enormous number of different kinds of workplaces that exist, keeping up with the whole field must be an exhausting responsibility. It is good to know that special attention has been paid to the importance of water in preventing obesity.

In the USA, the Occupational Safety and Health Administration requires that potable water be available to workers, and that they should be encouraged to drink it, and cannot be asked to pay for it. The rule is not confined only to readily accessible water for the quenching of thirst, but encompasses every use for which potable (technically, safe to drink) water is utilized:

[…] for drinking, washing of the person, cooking, washing of foods, washing of cooking or eating utensils, washing of food preparation or processing premises, and personal service rooms.

Furthermore, “Each industry contains specific requirements tailored to the conditions of these fields,” including guidance on the provision of “reasonable opportunities” to hydrate. Of course, these considerations may be extended not just out of warm regard, but because companies have caught on to the fact that obesity costs them a considerable amount of money.

Perhaps the availability of good water might help to wean some workers off their habitual high-cal drink habits. Never mind that coffee with three spoons of sugar, and forget about sodas and juices, especially those with added sweetener.

In 2014, the Centers for Disease Control and Prevention produced the multiply-authored and lengthily titled “Impact of Individual and Worksite Environmental Factors on Water and Sugar-Sweetened Beverage Consumption Among Overweight Employees”. It was described as “the first extensive evaluation of the workplace environment and its influence on water and SSB consumption.”

After taking into consideration many reports, the researchers concluded that workplace factors definitely influence the behavior of overweight employees. They found that reduced access to vending machines could steer habits into healthier channels. Consultants also looked further into the roles played by water coolers, vending machines, and break frequency. Here is the bottom line from that study:

Future intervention trials are warranted to determine whether reducing SSB consumption and increasing water consumption could be an effective dietary strategy for worksite-based weight management interventions and whether individual and environmental intervention features mediate or moderate intervention effectiveness.

A few years ago, similar research scrutinized both “intensive-labor and static-type workplaces” and concluded that promoting the water consumption habit “may benefit employees,” which is pretty weak sauce, considering how the phraseology implies “… or it may not.” Well then, could the provision of both water and nudging reminders induce employees to drink lots of water in order to “diminish their tendency to gain weight”?

At the same time, this research project was looking for more than just how to encourage increased water consumption. Managerial and executive eyes were on a bigger prize, and WHPPs (Workplace Health Promotion Programs) were created to serve the need, and a sentence in the Conclusion affirmed the hope.

“If reminders about water intake can be sent to employees in a timely manner, and if they can be informed with the health benefits brought by drinking water regularly, combined with unforced health education, it may be possible to obtain other additional benefits in addition to enhancing employees’ water intake.”

Of course, businesses are not only concerned about employees’ health, and it would be silly to believe they are. But to discover a factor that can improve the lives of workers while at the same time reducing employer costs, well, that is something to write home about for sure.

Your responses and feedback are welcome!

Source: “Summary: OSHA Water Requirements,” ZTers.com, 09/09/24
Source: “Effectiveness of a Water Intake Program at the Workplace in Physical and Mental Health Outcomes,” NIH.gov, 2022
Image by Picsues/Pixabay

Our Jobs, Our Bodies, and Our Kids

Recent inquiries into the enormous cost that obesity imposes on society have covered a number of bases, but (no surprise here) plenty of angles remain to be explored. In observing places of employment, scholars have examined chronic stressors, acute stressors, and even the condition known as “turmoil in the workplace.” Many researchers are particularly interested in the relationship between those factors and the difficulty experienced by workers in maintaining a healthy body weight.

It seems odd that people — many of them lucky to be employed at all — will carelessly endanger their jobs and their health by allowing excessive weight to creep up on them. How can they be encouraged to remain well enough to perform the work adequately, and not take too many sick days? How can they be prevented from doing things on company time that will eventually cost the company many dollars?

It takes all kinds

Researchers looking for answers have created studies that concentrate specifically on middle-aged women. Grad students have scrutinized groups of men who do exhausting labor, and others whose pale shirt collars have never felt a drop of perspiration. They have probed the relationship between something called “job enrichment,” and abdominal obesity in particular, as those two factors may impact even “apparently healthy” individuals.

A typical news item, published near the end of 2017, confirmed what many corporate CEOs and small business owners had already figured out:

The increasingly high levels of overweight and obesity among the workforce are accompanied by a hidden cost burden due to losses in productivity.

That meta-study was called by its authors “a narrative synthesis of the reviewed studies [which] revealed substantial costs due to lost productivity among workers with obesity.” The information, derived from eight electronic databases, pointed out the extent of those indirect costs that might someday, somehow, be eliminated from the figures that populate the corporate budget. It was only one of a great number of academic papers that have explored these possibilities.

But what does this have to do with my kids?

Everything. No matter how much we love our children, and how wonderful we know them to be in every way, the opinion of the outside world may differ. Often, when that assessment is made plain, the results are not happy for anyone. Our kids are growing up in an environment where everyone is increasingly scrutinized from many angles, and information is retained forever.

They deserve our help

A few years from now, our daughters and sons might be secretly weighed every day they show up for work, and then be summarily fired for exceeding the decreed correct weight. These trends are capable of doing real damage, and we need to get a handle on them by understanding why it is probably a mistake to ignore the few extra pounds around a child’s middle. Without being hurtfully judgmental, we can still acknowledge that obesity has the power to mess up her, or his, entire future.

On another level, the situation could become even worse. Imagine this: Your child graduates high school, and the only available job is with a company that severely maintains strict weight standards. A year later, your excellent son is required to fire an employee who also happens to be his best friend since childhood. To both of them, it represents a betrayal, and your boy feels so lousy, he binge-eats to improve his mood, and winds up being fired himself, not long afterward.

Okay, maybe that scenario is a bit dramatic, but whether we like it or not, obesity seems determined to become a larger issue with every passing year. It is a challenge that a lot of kids just might face, if they don’t already. This is why we try to prevent childhood obesity, because people growing into adulthood have enough to contend with.

Your responses and feedback are welcome!

Source: “Productivity loss due to overweight and obesity: a systematic review of indirect costs,” NIH.gov, 10/05/17
Image by milaoktasafitri/Pixabay

Can You Multiply By 10?

The reason for the titular question is the existence of two random documents among many which all point to the same conclusion. The phenomenon known as “presenteeism” has grown immensely, and so has the societal expense associated with it.

Another branch of this knowledge tells us that since obesity is definitely associated with presenteeism, obesity is a problem here as in so many other areas of life. This is just one more of the multiple problems with which obese children who mature into obese adults will have to contend.

The first media production considered here, which appeared on YouTube about 14 years ago, is a very concise (2:27) explanation by Professor Cary Cooper of how presenteeism was at that time costing the American economy about $15 billion per year.

Exhibit #2 is an article published in 2020, a mere decade later, during which time the cost of presenteeism was said to have risen to a towering 150 billion per year. In other words, the annual toll of that phenomenon upon the economy of the USA had multiplied by a factor of 10. And you can bet your bottom dollar on this: In many instances when employees showed up in the workplace only to be unproductive and ineffective, that was, in one way or another, attributable to obesity.

Contemporaneously with the above-mentioned YouTube presentation, by the way, a very scholarly work authored by J. Borak was published by Oxford University Press.

“Obesity and the Workplace” referenced the “global tsunami” of obesity, which was predicted to “certainly demand increasing commitments from occupational health programmes in coming years.” Four obesity-related issues were listed:

1. Enormous negative societal impact
2. Huge financial costs
3. Decreased worker productivity and increased need for support services and disability management
4. Work environments that contribute to increased overweight and obesity

That report quoted a 2006 study whose results had indicated that “annual US obesity-related medical costs were about $86 billion, including $30.3 billion for full-time employed adults.” It also emphasized that obesity “is associated with substantially increased rates of absenteeism (i.e., more days out of work) and presenteeism (i.e., reduced productivity while at work).”

This is the job market our children are preparing to face. Success in employment, or even simply finding employment in which to succeed or fail, will not be solely about degrees or other official qualifications. It will increasingly depend on not being fat.

But… It takes two to tango

On the other hand, plenty of evidence exists to show that work conditions can contribute directly to obesity, so employers had better take some responsibility. Job stress, shift work, and long work hours are mentioned. Consequently, some employers…

[…] have adopted programmes to incentivize weight loss and the maintenance of recommended body weight, encourage exercise, and promote healthy diets.

The results of such interventions are described as encouraging, and deserving of wide support. The same article mentioned a concept of “libertarian paternalism”:

[…] the idea that private and public institutions can systematically (and legitimately) affect behaviour in order to ‘nudge’ people in directions that will make their lives go better, without eliminating freedom of choice. For example… occupational health professionals should encourage employers to make work sites ‘junk food free’, instead providing healthier alternatives in cafeterias and vending machines.

This tactic of benign psychological and circumstantial influence-wielding has certainly been, and today remains, a fertile field for behavioral studies.

Your responses and feedback are welcome!
Source: “Professor Cary Cooper explains presenteeism,” YouTube.com, undated
Source: “The Complete Guide on Presenteeism (w. Example Intervention),” AIHR.com, 2020
Source: “Obesity and the workplace,” DOI.org, 2011
Image by gugacurado/Pixabay

Some Aspects of Presenteeism

As we have seen, the behavior known as presenteeism costs everyone a lot, in ways that are not always immediately obvious. According to a very scholarly work, of which more than seven full pages consist of references…

Studies abound that not only show how prevalent presenteeism is across a range of occupations and sectors… but also position it as more costly than absenteeism.

The first paragraph of “Presenteeism: An Introduction to a Prevailing Global Phenomenon” mentions the current need to “achieve more with less.” The factor that should always matter most is individual health and well-being, which is why we discuss it here. In cases of rampant presenteeism, everyone’s job performance is negatively affected, and productivity is not optimal. This, of course, implies negative financial impact and a bottom line that does not look good. The case is not always hopeless, and strategic management can make a difference.

In the real world, this may mean that, actually, different philosophies or even different value systems are needed. Of course, professional scholars are accustomed to looking beyond superficial meaning. How sick does a person need to be before the illness should be considered serious enough to keep them home? Who gets to decide if a worker is actually ill? And what does “attending work” really mean, anyway? Haven’t we learned from the pandemic that many jobs can be done very adequately from home?

Related inescapable facts

An employee with the flu can be reasonably expected to stay home until well, and past the point of spreading the contagion. Then they return, and even though some productivity has been lost, it’s back to “business as usual.”

Another case history: An employee with a broken arm in a cast has the doctor’s permission to return to work. But maybe that person isn’t really well enough. The fracture may still be painful, which affects the quality of work. So the person might take analgesics, and although the distraction caused by pain is lessened, the medication may cause problems that add up to “presenteeism” — namely, being slower, less effective, and maybe even dangerously mistake-prone.

Further, the cast itself causes awkwardness and discomfort in several ways. You want to keep it clean. It itches inside. Minor chores and actions that you used to do with one hand have to be ineptly performed with the other hand. You run out of patience sooner. Your general energy level is low, and the little extra kindnesses you might have done to make someone else’s day easier will not be attempted. Again, the conditions are there for presenteeism: the state of technically being on the job, but doing it so poorly that when all is said and done, the business actually takes a financial hit.

Still, even that counterproductive scenario will not last forever. Eventually, the fracture will heal, the cast will be removed, and after perhaps a period of adjustment, the worker will be back to normal. The episode of damaging, costly presenteeism will eventually come to a close.

The big but…

In most cases, obesity does not go away, and it usually increases. This implies that the presenteeism-related financial damage caused by obesity will not eventually subside, and the effect will only become more severe.

Your responses and feedback are welcome!

Source: “Presenteeism: An Introduction to a Prevailing Global Phenomenon,” Cambridge.org, 08/09/18
Image by Vika_Glitter/Pixabay