Worked-based wellness programs reduce weight

"Worksites are self-contained environments with established communication systems where interventions that modify food options and provide physical activity have the potential to reach large numbers of adults," said Diana Fernandez, M.D., M.P.H., Ph.D., an associate professor in the University of Rochester Department of Public Health Sciences and lead author of the study. "This study shows in particular that when employees are empowered to help shape wellness programs, these programs appear to result in meaningful improvements in health."

Americans spend on average a third of their lives at work. Work-related stress, the sedentary nature of many office jobs, and the temptation to dip into the bowl of candy on a co-worker's desk or raid the vending machine for a bag of chips can all contribute to weight gain.

In recent years, many companies have established wellness programs in an effort to improve productivity, decrease absenteeism, and reduce health insurance costs. Recent surveys by the Rand Corporation and the Kaiser Family Foundation estimate that as many as half of U.S. firms have wellness programs or incentivize healthy behavior. While studies have indicated that these programs can reduce employees' health risk and potentially slow the growth of health care costs, the impact of these approaches on obesity rates has not been studied in depth.

It is estimated that 68 percent of Americans are overweight or obese. Reducing obesity rates -- through changing diets and increasing physical activity -- is a key target for public health policy as it places individuals at greater risk for conditions such as diabetes and cardiovascular disease.

The researchers worked with a Rochester-based company with sites throughout the Northeastern U.S. Ten different sites were randomized into two groups and the study examined a total of 3,799 individuals. The researchers worked with management and employees in the intervention group to establish workplace programs that focused on healthy eating and increasing physical activity. The control group did not receive any intervention.

In each of the intervention sites, the researchers and the company established employee advisory boards to help them better understand the particular worksite's culture and determine which approaches would be appropriate and well-received. The authors point to employee involvement as a key factor in driving broader participation.

Dietitians met with cafeteria managers to help them modify recipes so that the same meals could be prepared with fewer calories or in smaller portions. Employees who made healthy choices at the cafeteria or the vending machine were rewarded with free meals. They also organized workshops that shared healthy recipes for the home, especially before and during the holidays.

Physical activity programs varied depending upon the worksite. Some sites marked out walking routes or organized walking clubs or other outdoor activities, such as Frisbee golf or bocce, during breaks. Locations with gym facilities were upgraded and staff held tours, promotions, and competitions to encourage usage.

To measure the effectiveness of these changes, the researchers measured the body mass index (BMI) of employees at the beginning and the end of the two-year program. BMI is a calculation that takes into account weight and height. A person with a BMI of more than 25 is considered to be overweight and a score of greater than 30 is considered obese.

At the end of the study period, the number of employees in the control site who were overweight/obese increased by about 5 percent, while the number in the intervention group had decreased by 4 percent resulting in a net difference of 9 percent.

"This study suggests that worksite environmental interventions might be promising strategies for weight control at the population level," said Fernandez. "These observations lend support to the approaches that might eventually reduce the incidence and prevalence of overweight and obesity on a larger scale."