The obesity epidemic is costing employers money, through its effects on worker health and safety, but also due to its impact on health care costs, absenteeism and productivity.

A new guide from the American College of Occupational and Environmental Medicine (ACOEM) is aimed at helping employers control the health and economic impact of obesity in the workplace – and some of the recommendations it contains may be surprising.

Bariatric surgery

"Our findings support the use of both lifestyle modification and bariatric surgery to assist appropriate patients in losing weight," write ACOEM President and Panel Chair Charles M. Yarborough III, MD, MPH, and colleagues in the ACOEM Guidance Statement, published in the January Journal of Occupational and Environmental Medicine.

That’s right. Coverage for bariatric surgery, when indicated, could result in a cost savings.

Nearly 38 percent of US adults are obese, including about 40 percent of women and 35 percent of men. Meanwhile, surveys suggest that most employees do not have coverage for obesity treatments.

"The cost of obesity among workers is immense, and the responsibility for managing it is increasingly falling to employers," Dr. Yarborough and coauthors write.

Work may be a contributing factor to obesity, with risk factors including social stressors, psychosocial work factors, working hours, sleep and night shift work, and sedentary behavior.

The recommendations for employers and health plan designers to manage obesity among employees were developed by an ACOEM expert panel, based on 275 selected, high-quality studies of obesity in the workplace.

Treatment recommendations include:

  • implementing workplace wellness programs and behavioral counseling to aid employees in adopting healthy lifestyles
  • offering insurance coverage and access to bariatric surgery for treatment of obesity (specific criteria for eligibility are included)

The Guidance Statement also identifies key areas for further research, including studies to clarify and maximize the benefits of obesity medications and bariatric surgery. Dr. Yarborough and colleagues conclude, "As these interventions may prove cost effective in the long term, a case can be made that they be covered by insurance."

Obesity's burden on productivity

Mitchell Roslin, MD, Director of Bariatric and Metabolic Surgery at Lenox Hill Hospital, New York, is a coauthor of the new report. "Whereas the impact of obesity on life expectancy, diabetes, sleep apnea and health care costs are frequently discussed, the hidden damage and consequences of obesity on the American work force are less known and incredibly detrimental," Dr. Roslin comments. "Obesity leads to reduced performance, increased chance of disability, and greater likelihood for requiring performance waivers for certain aspects of employment. There is a direct impact on health care costs and a harder to quantify burden on productivity.

"In this much-needed and sentinel document, specialists from multiple fields related to obesity and population health management have compiled critical information from evidence-based studies and made recommendations to begin to counteract this national epidemic. It is becoming widely known that companies with healthy employees succeed and have better employee and customer satisfaction. Obesity is a key determinant of health, yet increasing at alarming rates. The importance of adding greater awareness and better programs to combat obesity to the workplace cannot be overstated."

Citation — Yarborough CM III, Brethauer S, Burton WN, et al. ACOEM Guidance Statement. Obesity in the workplace: impact, outcomes, and recommendations. J Occup Environ Med. 2018;60(1):97-107.

About ACOEM — ACOEM (, an international society of 4,500 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

About the Journal of Occupational and Environmental Medicine — The Journal of Occupational and Environmental Medicine ( is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.