Workplace Health & Wellness

Financial Incentives for Weight Loss: Results From a Workplace Wellness Program (2012) is a new study which evaluates the attrition and the degree of weight loss in wellness programs based on offering employees financial incentives in various forms. You can see the full study here. So what happens when you attach financial rewards to a Workplace Wellness and Weight Loss Program?

Unfortunately, not much. This study showed that more than two thirds (68%) of all participants dropped out before the completion of the year-long program. An end of program payment resulted in no greater weight loss than achieved by the control group that was provided no incentives. Even trying to get additional ‘buy in’ from employees by getting them to pay a deposit was relatively ineffective - resulting in a lower level of uptake from the outset, and only an extra 2 pound increase in weight loss upon completion.

This research begs the question – do financial reward incentives and a weight loss focus provide the best wellness approach for organisations seeking to improve and maintain employee health, wellbeing and performance?

Extensive research says no. Here’s why.

INCENTIVES

• Despite numerous studies there is no magic number for amount, frequency or method of financial incentives you can successfully offer employees for wellness program success.^[1]
• Recognition has a time-lag. Incentives are often paid at the end of a program, or at designated intervals. The time-lag in recognition reduces an employee’s motivation, increasing the drop off rates of your wellness program.^[2]
• Those who are receiving financial incentives by achieving positive results are more likely to stop taking part in the program once they get their reward. This shows that your employees are often ‘in it for the money’ and not to change their lifestyle.^[3]
• Employees may revert to unhealthy, even dangerous methods of weight loss before ‘weigh ins’ to gain financial incentives. There is a long history of financial incentives for weight loss unintentionally creating unhealthy behaviours in the workplace (such as taking laxatives, diuretics, heat exhaustion or over-strenuous exercise just before being weighed).^[2] This purge mentality also makes it highly likely they’ll revert back to unhealthy lifestyles, and put weight back on once the incentive is removed.^[4]

SO WHAT IS THE ANSWER?

• Spend your money on engaging your employees through internal communications and a fun and exciting wellness program – by doing so you get better uptake, and can impact long-term behaviour change – both of which are limited in a weight loss only program.
• By creating a wellness program that is built on engagement, excitement and fun, employees are intrinsically motivated, and get their recognition from behaviour and lifestyle changes. Rewarding overall increased physical activity, continuity of positive behaviour and understanding of nutrition best practice means you’re empowering employees to take charge of their health for the long term.
• Creating a community for employees to embrace and share healthy habits is very effective, by utilising the teamwork mentality. A weight loss focus alone tends to be intensely personal subject, and therefore cannot benefit from the team aspect.
• Include all employees - even those who are reasonably healthy and not overweight. Wellness program benefits should look at all facets of physical and mental wellbeing in order to achieve holistic and effective health and wellbeing improvement for all employees. Focusing on weight loss alone automatically rules these employees out.

Sources:

^[1] When and Why Incentives (Don’t) Work to Modify Behavior (2011), Gneezy et al.

^[2] Financial Incentives for Weight Loss: Results From a Workplace Wellness Program (2012), J. Cawley and J. Price.

^[3] Financial Incentive–Based Approaches for Weight Loss - A Randomized Trial (2008), Volpp et al.

^[4] The Oxford Handbook of the Social Science of Obesity (2011), Jones-Corneille et al.

The Foundation for Chronic Disease Prevention has just released some compelling research on the comparative health effects, both physical and mental, of taking less than 5,000 steps a day and taking more than 10,000 steps a day.

Embed this infographic on your site by copying the following code:

<a href="http://www.gettheworldmoving.com/blog/steps-to-a-healthy-life"><img src="http://static.gettheworldmoving.com/media/sys/downloads/steps-to-a-healthy-life.jpg" alt="Where are you on the steps to a healthy life?" width="600"  border="0" /></a><br />Via: <a href="http://www.gettheworldmoving.com">Global Corporate Challenge</a>

Well, as a recently published finding by researchers at the University of Queensland and the Baker IDI Heart and Diabetes Institute shows – it’s a lot more impactful than you may have thought.

Using existing data and the Australian Diabetes, Obesity and Lifestyle Study the researchers found that the amount of TV viewed in Australia reduced life expectancy by 1.8 years for men and 1.5 years for women.

Australia is ranked 7th in daily average TV watching hours behind the UK, US, Italy, Germany, France and Ireland with research from Nielsen showing that Americans watch around 5 hours of TV per day.

The study found that those who spend a lifetime average of 6 hr/day watching TV can expect to live 4.8 years less!

This means that on average, every single hour of TV viewed after the age of 25 reduces the viewer's life expectancy by 21.8 min.

Sitting and watching TV therefore carries the same increased risk of dying as physical inactivity and obesity! Your workforce spends one third of their day at the office, often in a chair and unfortunately when they are getting home they are spending their nights in an equally inactive state.

These findings more than ever reinforce the need for organisations to implement wellness programs that break the sedentary lifestyles of their employees.

It’s imperative that a wellness program addresses physical inactivity beyond the boundaries of the workplace to create genuine behavioural change that is meaningful, effective and sustainable.

Experts have known for years that physical activity decreases the risk of chronic diseases including cancer, heart disease and type II diabetes, but new data give estimates on the number of cases that might be prevented if people were more physically active.

Researchers reviewed more than 200 cancer studies worldwide and found convincing evidence that regular physical activity reduces the risk of breast cancer, colon cancer and endometrial cancer by 25% to 30%. There's some evidence that regular exercise also reduces the risk of lung, prostate and ovarian cancer.

The employee health and wellbeing benefits of the GCC are well documented, and this research outlines even more health benefits from being physically active. Corporate workers often sit between 7.5-9 hours of the day and it's critical to their health and wellbeing to break this cycle of sitting.

What can you do?

In just 60 seconds you can reap major health benefits by simply standing up to break this sedentary behaviour as outlined by the European Heart Journal earlier this year. Incidental exercise is at the foundation of the GCC, and these studies further support research that regular small amounts of physical activity can have a significant positive impact on your health and wellbeing.

You can watch the video below or read more on the findings at USA Today.

The Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group’s study of 9.1 million participants in 199 countries over 28 years confirms many of the fears regarding the obesity epidemic. June's Occupational Medicine details some of the key findings in recent studies on the obesity epidemic, including those associated with workplace health and wellbeing:

The increasing prevalence of obesity

• Globally, mean Body Mass Index (BMI) has increased since 1980
• Across the three decades, age-standardised obesity rates doubled
• An estimated 1.46 billion people were overweight by 2008 (BMI equal to or over 25kg/m2)

The world’s overweight nations

• The greatest rates of weight increase among men were from the UK, the USA and Australia
• The greatest rates of weight increase among women were from the USA, New Zealand and Australia

Mortality

Obesity increases the prevalence and severity Cardiovascular risk factors, including:

• Type II diabetes
• Elevated non-HDL cholesterol
• Reduced HDL cholesterol
• Both systolic and diastolic hypertension
• Certain types of cancers, including colon, oesophagus, liver, gall, pancreas and more

Financial concerns

• Obesity related health care costs are proposed to be higher than those attributed to smoking, drinking and poverty in the USA
• As employee BMI increases, so does the associated health care costs.
  Males with BMI classification ‘overweight’ +$148.
  Males with BMI of class III obesity [BMI 40+] +$1269
  Females with BMI classification ‘overweight’ +$529.
  Females with BMI of class III obesity +$2395
• Total healthcare costs are going to rise steadily with the global rise of obesity

The financial concerns extend beyond the US healthcare system as some analyses suggest that the cost of obesity-related presenteeism is greater than the direct medical care required by obese employees.

Adverse work health effects

Obesity contributes to:

- Increased absenteeism (more days out of work)
• Increased presenteeism (reduced productivity while at work)
• More sick days, longer sick leave
• Increased compensation claims

One compensation study has shown that those with class III obesity make twice as many medical claims and see roughly a 10 fold increase in loss of workdays versus those with recommended BMI.

These findings remind us that the obesity epidemic continues to rise at a significant pace. It is necessary that we not only address obesity in the workplace through wellness interventions, but preventative methods and the correct working conditions are also required. Some bodies of studies suggest that overweight and obesity are related to job stress, shift work and long work hours.

Organisations and occupational professionals face a growing issue – those at most risk of obesity and its effects are statistically the least like to undertake an organisation’s interventions. Many suggest that creativity, fun and excitement lay the path to address the obesity epidemic from within the workplace.

Source: Borak, J. 2011, 'Obesity and the workplace', Occupational Medicine, Vol 61 Issue 4

GCC website developer, Farabi Syed, shares with us how an important month on the Muslim calendar means adapting his day to ensure he is still achieving the step count goals he has set for himself.

During the month of August the Islamic faith is undertaking the fasting period of Ramadan. During this month, no food or drink is consumed between sunrise and sunset. At its core, Ramadan is about teaching followers of this faith patience, humility, and spirituality - so for Farabi it would be easy to drop his step count. However as we learnt (and see from his step entries) just a little planning means he is still powering his way through the GCC.

“During the month of Ramadan I wake up very early in the morning, put on my pedometer as usual, and prepare ‘Sehri’ (the name of the meal taken before sunrise). After Sehri, and still an hour and a half or so before sunrise, I walk to the mosque which gives me 2000 steps to start my day with. This early prayer time is called Fajr and is completed before the sun rises. After Fajr I go for a 5000 steps morning walk. By this time it is around 6:30am and therefore a lovely quiet time to reflect and exercise.

During Ramadan I am not able to drink any fluids or eat any food during daylight hours, so I will take fewer steps than usual during the day to avoid becoming dehydrated. After work, I go home for Iftaar (the evening meal that breaks the day's fasting), before walking another 2000 steps to the mosque for Magrib (the after sunset prayers).

A light dinner at home follows, before again heading back to the mosque for prayer. I incorporate a longer walk into this trip and usually add an additional 5000 steps.

With this schedule I’m able to keep my steps up while also adhering to my religious commitments during the month of Holy Ramadan.”

Farabi

Non-communicable diseases (chronic diseases) are non-infectious diseases which usually progress slowly over an extended duration. Chronic diseases include diabetes, heart disease, stroke, cancer, asthma and more. WHO’s latest report provides further evidence on the role physical inactivity plays in the increased risk of chronic disease globally.

The key findings of the report include:

Non-Communicable Diseases

• At least 2.8 million people die each year as a result of being overweight or obese. Risk of heart disease, stroke and diabetes increases steadily with increasing body mass index (BMI).
• Raised cholesterol is estimated to cause 2.6 million deaths annually; it increases the risk of heart disease and stroke.
• Raised blood pressure is estimated to cause 7.5 million deaths, about 12.8% of all deaths. It is a major risk factor of cardiovascular disease.

Physical Activity

• Insufficient physical activity is the fourth leading risk factor for mortality.
• Approximately 3.2 million deaths each year are attributable to insufficient physical activity, globally.
• Participation in 150 minutes of moderate physical activity weekly is estimated to reduce the risk of heart disease by approximately 30%, the risk of diabetes by 27% and the risk of breast and colon cancer by 21-25%. Additionally, physical activity lowers the risk of stroke, hypertension and depression.
• People who are insufficiently active have a 20-30% increased risk of all-cause mortality compared to those who engage in at least 30 minutes of moderate-intensity physical activity on most days of the week.
• Globally, 31% of adults aged 15 years or older were insufficiently active (men 28% and women 34%) in 2008. Prevalence of insufficient activity was highest in the WHO Region of the Americas (Men 40%, Women 50%).
• High-income countries had more than double the prevalence compared to low-income countries.

It has been well documented that, as the number of hours worked increases, the level of sedentary activities and low physical activity of the workplace role also increases.

As a result, the workplace environment is increasingly becoming the focus for detection and intervention programs that aim to reduce the risk of such chronic diseases. Given that the majority of adults are employed, spend a considerable amount of time at their workplace and eat at least one main meal during this time, interventions in the workplace are a successful and important way of influencing risk factors for chronic disease in the total population.

These latest statistics from WHO show that the risk of chronic disease is continually on the rise. Research literature show that workplace interventions are becoming the key focus to reduce the prevalence of these chronic diseases.

The full World Health Organisation Chronic Disease Report (3.2MB) is available for further information.

In 2011, the FCDP Research Program has commissioned Lancaster University’s Centre for Organisational Health and Wellbeing to assess the effect of GCC participation on major health risks and mental health.

The main study objectives are to further assess whether participation in GCC:

• increases low-intensity, physical activity levels in participants upon the completion of the program,
• reduces risk factors associated with Type 2 Diabetes, stroke and cardio vascular disease and improves factors relating to mental wellbeing,
• affects recognised psychological measures of health, as well as personal and business performances.

Design

• 5 UK and 1 US based businesses participating in the GCC 2011.
• Biometric and Mental Wellbeing Analysis – completed by Lancaster University.
• Mental Wellbeing Analysis (pre and post GCC) will be completed online.
• Unlimited (~1,500) participants from 6 companies in mental health online survey.
• Biometric data (Pre and Post GCC) conducted in 5 UK companies only.
• ~60-80 participants in biometric component per company – total 400 participants.

We hypothesise that:

• BMI will decrease by 5%
• Waist circumference will decrease by 3-6%
• Total cholesterol, LDL and TG will decrease 5%
• HDL will increase 2%
• % body fat will reduce by 5%
• Employee will better enjoy normal day to day activities
• Concentration levels and their overall health will improve.
• There will be significant improvement in people’s productivity levels at work.

Companies

UK

• Kraft Food
• Tesco
• Hays Recruitment
• Tyco
• Wood Group

US

• Yum Brands

Reports

Lancaster University’s Centre for Organisational Health and Wellbeing will produce

• 1 report for each participating business on the participants from their company,
• 1 report on total combined data set (6 businesses) for Mental wellbeing and Biometric Data + Executive Summary.

Kirilly Middleton, Managing Director FCDP

We hope to have these results available by the end of 2011 and will be sharing these through GCC NOW. For any of the previous research studies or more information on FCDP, you can visit the FCDP website.