There is no doubt that America’s chronic weight problem has become an urgent issue nationwide: Nearly 1 in 3 U.S. adults are overweight,1 and 2 in 5 meet the clinical definition of obesity.1 In a single year, chronic diseases driven by the risk factor of obesity and overweight accounted for $480 billion in health care costs.2
However, we have reached a watershed moment societally and scientifically. With greater understanding of the causes of obesity and new treatment options, there is hope for the millions of Americans living with obesity or overweight. As a society, we’re becoming more aware of misplaced blame and biases and shifting the discussion to emphasize health for all. Clinically, we’re expanding treatment options as GLP-1 medications are proving effective in obesity care, especially when combined with behavior change programs.3
As our knowledge grows, we’re beginning to recognize that this isn’t a conversation about fitness or vanity, it’s purely about health. Based on evolving science, the American Medical Association (AMA) recognized obesity as a disease in 2013. The primary objective was to change how the medical community tackles this complex issue in order to drive better prevention and management of obesity-related conditions. The recognition of obesity as a chronic condition marked a significant shift away from the belief that obesity is the result of personal choice or a lack of willpower.
Treating obesity as a chronic disease acknowledges the underlying metabolic, genetic, and environmental influences that increase obesity risk. It also facilitates acceptance of and insurance coverage for evidence-based treatments, including behavioral therapy, anti-obesity medications, and bariatric surgery.
Scientific advancements are shifting the approach to weight health from relying solely on willpower and lifestyle changes to a more comprehensive, full-spectrum strategy that combines behavioral programs with a range of clinical treatments and medications when appropriate. A full-spectrum platform should provide science-proven treatments for each acuity level.
Making obesity treatment widely accessible while containing costs can be achieved at scale. Within our economic system, employers have tremendous influence and purchasing power to help reduce the costs of weight health care while providing quality care. About 86% of U.S. private-sector employees work for establishments that offer employer-sponsored health insurance.4
In the emerging market for GLP-1s, employers have two particularly relevant cost management levers : digital medicine programs and collaboration with pharmacy benefit managers (PBMs). Digital medicine programs can add guardrails in the form of behavior change programs, step therapy, and prior authorizations. PBMs can create formularies and negotiate cost savings and rebates with drug manufacturers.
Beyond economics, employers have tremendous influence. From diversity, equity, and inclusion to environmental issues, employers have demonstrated their power to drive meaningful social change. Weight stigma is the discrimination and negative beliefs directed at people based on their weight. Weight stigma often leads to the devaluation of people due to their weight, perpetuating negative attitudes, stereotypes, prejudice, and discrimination. Forty percent of U.S. adults report experiencing weight-related stigma at some point in their lives. In the workplace, this can take the form of teasing, taunting, and microaggressions.5
While weight stigma is a societal issue, its prevalence presents an opportunity for employers to lead the way in increasing awareness and shifting the narrative to banish weight bias. The rapidly evolving weight health landscape has opened the door to increased discussion about weight stigma and new approaches to address the issue.
The direct business costs associated with obesity are well-documented, and the comorbidities of obesity impact the bottom line. Employees with overweight and obesity are more likely to develop weight-related comorbidities, including type 2 diabetes, hypertension, sleep apnea, cardiovascular disease, and certain types of cancer.6 In turn, employees with these conditions drive reduced productivity, higher absence rates, and increased healthcare costs.
Costs per employee with obesity are:7
Employees with obesity are also at greater risk of more severe on-the-job injuries. According to a study by the National Institutes of Health, workers with obesity were up to 68% more likely to experience injuries than workers with lower weights.8
Employers are realizing that they can pay reactively, or they can invest proactively by providing access to quality weight health care, thereby reducing their costs over the long term. When individuals with at least one chronic condition lose sufficient weight to move from being obese to overweight, annual healthcare expenses are reduced by 20%.9
In addition to improving physical health and lowering the risk of chronic conditions, better weight health can also lead to a more positive self-image and renewed productivity and ambition at work. WeightWatchers members reported a 13.6% improvement in quality of life at work and a 40.5% increase in self-esteem.10
By utilizing their resources, economic clout, and ability to lead by example, employers are uniquely positioned to empower and accelerate social change within their organizations and across society. Employers can build a foundation for a healthy approach to obesity care by establishing a workplace culture that actively seeks to eliminate weight bias and weight stigma.
Employers are uniquely positioned to shift the focus of employee benefit programs from weight loss to weight health. By offering employees access to a full spectrum of weight health solutions, from behavioral health to clinical support, they can meet the diverse needs of their employee population. When reviewing their healthcare plans, employers can identify opportunities to provide comprehensive coverage for weight health, such as behavioral therapy, nutritional counseling, and weight-loss medications.
Let’s shift the weight together and put the focus on health. Request a demo from WeightWatchers for Business.
1 Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats, Centers for Disease Control and Prevention. 2020. Updated February 8, 2021. Accessed June 12, 2024. www.cdc.gov/nchs/data/hestat/obesity-adult-17-18/obesity-adult.htm
2 Waters H, Graf M. America’s Obesity Crisis: The Health and Economic Costs of Excess Weight. October 2018. Milken Institute. Accessed June 13, 2024. https://milkeninstitute.org/report/americas-obesity-crisis-health-and-economic-costs-excess-weight
3 An observational study among 157 WW Clinic members who switched from a second generation GLP-1 medication to bupropion, naltrexone, or metformin and we assessed their weight loss 13 weeks later.
4 U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ). (2022). MEPS Insurance Component Chartbook 2022.
5 Pearl RL, Himmelstein MS, Puhl RM, et al. Weight bias internalization in a commercial weight management sample: prevalence and correlates. Obes Sci Pract. 2019;5(4):342-53. ^Puhl RM, Lessard LM, Himmelstein MS, Foster GD. The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries.
6 Fruh S. M. (2017). Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. Journal of the American Association of Nurse Practitioners, 29(S1), S3–S14.
7 Employees with obesity may have higher loss of work productivity than those with normal weight, Endocrine Society, June 2023.
8 Gu, J. K., Charles, L. E., Andrew, M. E., Ma, C. C., Hartley, T. A., Violanti, J. M., & Burchfiel, C. M. (2016). Prevalence of work-site injuries and relationship between obesity and injury among U.S. workers: NHIS 2004-2012. Journal of safety research, 58, 21–30.
9 Thorpe K, Toles A, Shah B, Schneider J, Bravata DM. Weight Loss-Associated Decreases in Medical Care Expenditures for Commercially Insured Patients With Chronic Conditions. J Occup Environ Med. 2021;63(10):847-851.
10 Pagoto S, Xu R, Bullard T, et al. An Evaluation of a Personalized Multicomponent Commercial Digital Weight Management Program: Single-Arm Behavioral Trial. J Med Internet Res. 2023;25:e44955.