In one of ShapeUp’s initial posts following the release of the results of its Annual Survey Large Employer Wellness Survey, they emphasized that obesity is a key driver of employer health care costs, and the survey results found that employers view addressing obesity as an important goal.
ShapeUp concluded:
Anyone serious about controlling behavior-driven health care costs in America would be wise to zero in on weight loss interventions aimed at large, self-insured companies.
Anyone?
In fact, employers who invest in weight management are likely to be doing so to excess.
Obesity is an important problem and drives costs, especially costs associated to conditions that are linked to obesity, like diabetes, hypertension, lipid disorders, and so forth.
The problem is that we do not have evidence-based behavioral solutions to obesity that have been shown to work, long-term, with an employee population. Certainly, we need both the government and private sectors to be investing in research to identify strategies to prevent and remediate obesity. But should employers focus on obesity — at the risk of under-resourcing more treatable, or more readily preventable - conditions?
(In their webinar Debating the Results of the Employee Wellness Survey, ShapeUp shared slides — generously available on their blog — that positioned obesity in a class of its own in terms of being treatable with diet and exercise and near the opposite end of the spectrum, interestingly, from sleep.)
One of the many reasons that employer wellness programs consistently fail to deliver a measurable return-on-investment is because we invest too much in the wrong things. There will never be a positive ROI for programs that don’t work. Our society needs to address obesity with a broad cross-cultural solution and a long-term timeframe. Think 20 years, not one year. Worksite interventions and programs like ShapeUp will be integral components of these solutions.
In the interim, we have other significant drivers of health care costs that have well-documented treatments. Tobacco use is one, and it is being effectively addressed. Depression may present another opportunity for significant health improvement and a positive ROI. Interventions for depression can include things like screening with followup, value-based benefit design that promotes use of talk therapy for employees (and dependents) on antidepressants, and programs that promote medication adherence and more effective use of specialized care.
Other potential opportunities may exist in hypertension, healthy sleep, possibly musculoskeletal problems, and others. Some of these may not be the “behavior driven health care costs” to which ShapeUp refers, but employers cannot cherry-pick which health outcomes and expenses they choose to address. They will look to get most bang for the buck.
And, of course, obesity itself is not a behavior. In fact, I personally believe that becoming more physically active is the single most important behavior (after tobacco cessation) any sedentary person should adopt in order to improve their health and their life. As such, there is an important role for ShapeUp and similar programs. But I believe the evidence fully supports the promotion of physical activity on its own terms, just as it supports the promotion of healthy eating, without needing to justify these behaviors by linking it to the obesity frenzy.
ShapeUp may take exception to my assertion that employers do not have evidence-based behavioral solutions for obesity. After all, they published, as co-authors with acclaimed obesity-researcher Rena Wing et al, results of a study that demonstrated the ShapeUp platform to be an effective population-based treatment for obesity. We’ll step aside form the Survey to briefly discuss the ShapeUp obesity study in the next post.
(This post is third in a series. For the full series, click here).
Zeroing in on Weight Loss May Be a Bad Idea — The ShapeUp Survey, Pt 3
In one of ShapeUp’s initial posts following the release of the results of its Annual Survey Large Employer Wellness Survey, they emphasized that obesity is a key driver of employer health care costs, and the survey results found that employers view addressing obesity as an important goal.
ShapeUp concluded:
Anyone?
In fact, employers who invest in weight management are likely to be doing so to excess.
Obesity is an important problem and drives costs, especially costs associated to conditions that are linked to obesity, like diabetes, hypertension, lipid disorders, and so forth.
The problem is that we do not have evidence-based behavioral solutions to obesity that have been shown to work, long-term, with an employee population. Certainly, we need both the government and private sectors to be investing in research to identify strategies to prevent and remediate obesity. But should employers focus on obesity — at the risk of under-resourcing more treatable, or more readily preventable - conditions?
(In their webinar Debating the Results of the Employee Wellness Survey, ShapeUp shared slides — generously available on their blog — that positioned obesity in a class of its own in terms of being treatable with diet and exercise and near the opposite end of the spectrum, interestingly, from sleep.)
One of the many reasons that employer wellness programs consistently fail to deliver a measurable return-on-investment is because we invest too much in the wrong things. There will never be a positive ROI for programs that don’t work. Our society needs to address obesity with a broad cross-cultural solution and a long-term timeframe. Think 20 years, not one year. Worksite interventions and programs like ShapeUp will be integral components of these solutions.
In the interim, we have other significant drivers of health care costs that have well-documented treatments. Tobacco use is one, and it is being effectively addressed. Depression may present another opportunity for significant health improvement and a positive ROI. Interventions for depression can include things like screening with followup, value-based benefit design that promotes use of talk therapy for employees (and dependents) on antidepressants, and programs that promote medication adherence and more effective use of specialized care.
Other potential opportunities may exist in hypertension, healthy sleep, possibly musculoskeletal problems, and others. Some of these may not be the “behavior driven health care costs” to which ShapeUp refers, but employers cannot cherry-pick which health outcomes and expenses they choose to address. They will look to get most bang for the buck.
And, of course, obesity itself is not a behavior. In fact, I personally believe that becoming more physically active is the single most important behavior (after tobacco cessation) any sedentary person should adopt in order to improve their health and their life. As such, there is an important role for ShapeUp and similar programs. But I believe the evidence fully supports the promotion of physical activity on its own terms, just as it supports the promotion of healthy eating, without needing to justify these behaviors by linking it to the obesity frenzy.
ShapeUp may take exception to my assertion that employers do not have evidence-based behavioral solutions for obesity. After all, they published, as co-authors with acclaimed obesity-researcher Rena Wing et al, results of a study that demonstrated the ShapeUp platform to be an effective population-based treatment for obesity. We’ll step aside form the Survey to briefly discuss the ShapeUp obesity study in the next post.
(This post is third in a series. For the full series, click here).
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This entry was posted on March 8, 2012, 7:59 am and is filed under Commentary, Employee Wellness Programs, Reporting, ROI, ShapeUp, Uncategorized. You can follow any responses to this entry through RSS 2.0. You can leave a response, or trackback from your own site.