Waistlines & bottom lines

TRENTON, N.J. -- A year ago, Ellen Lipschitz was so overweight she couldn't climb three steps without stopping to rest. Now she's 93 pounds lighter and her high blood pressure has dropped.

A scientist who tests drug compounds at Hoffmann-La Roche, the 55-year-old Lipschitz credits Weight Watchers meetings and daily exercise -- all at her office.

"I'm so proud of what I've done," she said. "If we didn't have it at work, I probably wouldn't be doing it."

The pharmaceutical company subsidizes many such programs for employees trying to slim down, and about 60 percent of its 5,000 U.S. workers participate.

It's part of a growing trend to address a fatter work force. One employee benefits survey reports that nearly one-third of the U.S. businesses it polled help pay for gym memberships -- up 35 percent in just four years.

"There is a real movement because obesity has increased so much in this country in the last 10 years," said health management consultant Stephanie Pronk of Watson Wyatt Worldwide.

With two-thirds of U.S. adults overweight or obese, many businesses are offering workers weight-loss programs to try to reduce their hefty costs for obesity-related problems, from heart disease and diabetes to arthritis, stroke, certain cancers, depression and lost productivity.

The cost of obesity to U.S. businesses -- for health care, sick leave and life and disability insurance -- is estimated at $12.7 billion, according to a recent study in the American Journal of Health Promotion.

Another study, in the journal Health Affairs, estimated that cost could top $30 billion. Meanwhile, company health insurance premiums jumped an average of 13 percent last year, according to the nonprofit Kaiser Family Foundation.

The most common corporate programs include educational materials, on-site fitness centers and Weight Watchers meetings, reimbursements for gym memberships, blood pressure and cholesterol screenings, and nutrition counseling.

"The larger, more sophisticated self-insured employers are doing this more than the fully insured ones," said Craig Gunsauley, managing editor of Employee Benefit News. "Even though the payoff may not come for many years, employers know that healthy employees make less health-care claims and are more productive."

The trend is more common at companies offering managed care health plans than preferred provider or fee-for-service plans, experts say.

Pronk said some businesses started paying for diet pills several years ago and, in the last two years, some have even begun paying for stomach-shrinking surgery such as gastric bypass -- costing up to $40,000 -- for those dangerously obese. Drug manufacturer Wyeth has been doing that for years.

The Society for Human Resource Management's annual survey of several hundred employee benefit managers found 31 percent subsidize or reimburse gym membership fees. That's a 35 percent jump from 1999 to 2003.

Twenty-two percent provide on-site fitness centers, up from 20 percent in 1999; 24 percent offer a weight-loss program, up from 23 percent; and 11 percent provide nutrition counseling, up from 8 percent.

Varies by industry

Which benefits are provided varies widely by industry. For example, half the high-tech companies surveyed by the human resource management group subsidize gym memberships, 48 percent of insurance companies provide weight-loss programs, and 54 percent of educational services businesses had on-site fitness centers.

In June, the Washington Business Group on Health, which represents large private and public employers, created the Institute on the Costs and Health Effects of Obesity. The group's 175 member companies provide health coverage for more than 40 million U.S. workers, dependents and retirees.

Already, 19 major companies -- from Ford and IBM to Pepsico, Aetna and Honeywell -- have joined the institute's board. Others, including two restaurant companies, are interested, said institute president Helen Darling.

"What we're trying to do is help employers be understanding and be supportive of people who choose healthy lifestyles," she said.

Initial strategies the institute is recommending include encouraging use of stairs in office buildings, creating walking paths nearby, offering health risk appraisals, holding nutrition and exercise classes on-site at lunch and after work, and forcing vendors to include healthy foods in cafeterias and vending machines, as well as better food labeling.

Health and Human Services Secretary Tommy Thompson plans to meet with business leaders in the next few weeks to discuss their efforts to fight obesity among employees, according to a spokesman. In July, Thompson met with insurance executives to urge them to fight obesity by discounting premiums for people with healthy lifestyles.

Innovative health insurance programs and employers have begun offering plans that give workers financial rewards for exercising, dieting and other healthy behavior, said Dr. Kelly Victory of Whole Health Management, which provides companies with on-site wellness programs and medical care.

Destiny Health of Oakbrook, Ill., has a point system for earning health club discounts and free movie tickets or weekends at hotels. PacifiCare Health System of Cypress, Calif., in October will begin offering reduced co-payments to members of employer-sponsored managed care plans who take part in races, document other exercise or reach their goal weight.

"We have a lot of interest from employers who say (incentive) is the missing piece of the puzzle," said Dr. Sam Ho, PacifiCare's chief medical officer.

Still, plenty of businesses are doing no more than handing out educational leaflets. So far, there's little evidence that costly obesity-related services -- other than gastric bypass -- work long-term for most people, said Dr. Alan Spiro, head of health care management at human resource consultants Towers Perrin.

"I'm seeing more talk than action," he said.

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Encouraging weight loss in the workplace

U.S. corporations are trying a range of programs to help overweight employees slim down. These programs claim an average weight loss of 6 to 12 pounds, plus benefits such as lower cholesterol levels. Here's a sampling:

Pharmaceutical company Hoffmann-La Roche subsidizes Weight Watchers and offers coupons toward a free lunch when employees buy a low-fat "Choosing Health" meal in its cafeteria. It also awards gift certificates for healthy behavior such as regular exercise, provides counseling by fitness consultants and psychologists, and hosts aerobics, yoga and kickboxing classes. Employees also can get its diet pill, Xenical, for free.

Appliance maker Whirlpool Corp. sponsors 10-week "Dump Your Plump" competitions; teams from its 23,000 employees in North America earn points by losing pounds and exercising. It offers a $75 annual fitness rebate toward aerobics classes or membership in a gym or Weight Watchers.

Health-care giant Johnson & Johnson has fitness centers at most facilities. Its "Live for Life" program has twice-weekly running and walking clubs and individualized nutrition and fitness counseling, offering prizes for healthy choices.

At diversified manufacturer Parker Hannifin Corp., one-third of its 26,000 employees participate in Healthtrac. They get quarterly phone calls from a health educator about weight control or other health problems. The program claims to cut doctor visits and health costs more than 20 percent in a year.

Insurer CIGNA Corp. and computer maker/consultant IBM use a "Think Light!" program that pushes low-fat, high-fiber diets through counseling, telephone support, discussion groups and educational materials.

Third-party billing company Alliance Data Systems has a fitness center and uses a program called "Learn" (Lifestyles, Exercise, Attitudes, Relationships and Nutrition); it includes a food diary and 16 weekly lessons on setting realistic weight-loss goals, staying motivated and preventing or coping with relapses.

-- AP