Obese Americans have increased the cost of health care, but the doctor's office isn't the only place where obesity ups expenses. Research released Friday by Duke University found that the cost to employers of obesity among full-time employees was $73.1 billion a year.
Using survey data from the 2006 Medical Expenditure Panel Survey and the 2008 U.S. National Health and Wellness Survey, the Duke researchers estimated the extent to which obesity-related health problems affected absenteeism, work productivity and medical costs.
While previous estimates looked mainly at the direct health care costs of obesity, lead researcher Eric Finkelstein, deputy director for health services and systems research at Duke-National University of Singapore, and his colleagues found that "presenteeism," or the lost productivity incurred when employees try to work despite health problems, cost employers a whopping $12.1 billion per year, nearly twice as much as their medical costs.
"Much work has already shown the high costs of obesity in medical expenditures and absenteeism, but our findings are the first to measure the incremental costs of presenteeism for obese individuals separately by body mass index and gender among full time employees," Finkelstein said in a press release.
Presenteeism was also the biggest cost among employees of healthy weight, but researchers found that obese workers accounted for a disproportionately larger share of overall presenteeism, absenteeism and medical expenses. What's more, severely obese individuals with a body mass index greater than 35 accounted for 61 percent of all obese employee costs, though they represent only 37 percent of the overall obese population.
Among those with a BMI higher than 40, which is roughly 100 pounds overweight, these costs worked out to $16,900 per capita for women and $15,500 for men in this weight class.
This study is "a compelling reaffirmation of what Dr. Finkelstein and others have told us before: If we don't deal with obesity effectively, there is probably little hope for us dealing with our economy effectively," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine.
And while these numbers are rough estimates of costs, "capturing data in any way we can is better than ignoring," he said. "While probably not perfectly accurate, this report certainly depicts a very accurate picture overall."
Cost of Obesity for Society, and for the Obese
According to the Centers for Disease Control and Prevention, the yearly medical costs of obesity are estimated at $147 billion, a figure that has ballooned of late, growing by more than 80 percent over a five-year period, recent studies found.
Over time, the trend has been similar, experts note: The greater the obesity in an individual, the higher the medical costs on average, and now with Duke's new research, this trend appears to extend to workplace costs as well.
"As a society, the message is clear. As important as education is to our future, so is our health. If we are not a nation of educated people, we will not lead the world in emerging high-tech areas. If our children are not fit and healthy, they will not be able to perform at their optimum level," said Dr. Mitchell Roslin, a bariatric surgeon at Lenox Hill Hospital in New York.
" No child left behind has to mean more than just reading and arithmetic, and cannot separate health, fitness and emotional maturation," he said.
While encouraging employees to maintain a healthy weight should be the ultimate goal, diet experts note that any change in the right direction is likely to improve health outcomes for employees and hence productivity, and lower medical costs for employers.
"Some weight loss is likely to be associated with some health improvement; more … with more health improvement. It's a continuous scale of weight and health and dollars," Katz said.
The researchers write that these quantifications should spur increased awareness of economic drawbacks of an overweight and ailing America, but Roslin noted that these types of statistics could also contribute to discrimination against obese employees.
"One sad result is that the study provides ammunition for the discrimination that people with severe obesity deal with," he said. "Yale once published a study that showed that people would rather hire a convicted felon, than a person with severe obesity. Now, let us add the present study and think about the impact it could have on hiring practices. If you add science to discrimination, it will be very difficult for people with morbid obesity to find a job."
Billions in lost productivity should be a wake-up call to employers to help their employees get fit and stay in good health, Roslin said, not a justification for ridding the workplace of obese workers.