Obesity Prevention Source

Worksite Obesity Prevention Recommendations: Complete List

Obesity Prevention On the Job

Work is a reality of life for the vast majority of people across the globe, and little apart from sleep consumes as much time in people’s days. As with school in youth, the workplace is very much a microcosm of the adult world-filled with elements that promote health as well as elements that diminish it. This makes the workplace an ideal, focused, and efficient avenue for improving health and tackling many of the key contributors to the obesity epidemic.

Obesity, with its links to many chronic conditions, is a huge drain on individual as well as corporate health. It can sap productivity, worsen mobility and morale, and increase healthcare claims, sick days, and occupational injuries. (1,2) Programs that focus on workplace obesity prevention have been shown to reverse these trends.

Effective programs take a multidisciplinary approach that focuses on providing workers with the knowledge, skills, and support to eat a healthier diet and be more active. This can include nutrition classes, onsite exercise facilities and changing rooms, access to nutritionists and other counselors, and worksite or company-wide policies that provide healthier food options and reimburse exercise-related expenses.Obesity, with its links to many chronic conditions, is a huge drain on individual as well as corporate health. It can sap productivity, worsen mobility and morale, and increase healthcare claims, sick days, and occupational injuries. (1,2) Programs that focus on workplace obesity prevention have been shown to reverse these trends.

Less apparent policy changes can also be helpful. While most workplace obesity prevention programs focus on helping to create and sustain behavior change in individuals, growing evidence points to some characteristics of the workplace itself as initiators of weight gain and obesity. Things like job stress, overbooked schedules, few breaks, and nighttime work shifts can promote poor eating and little exercise. (1,2) In most companies, job-related hazards such as these are the domain of occupational health, disconnected from worksite health promotion efforts. (3) Programs, policies, and practices that help mitigate these types of working conditions could further boost obesity prevention activities, as could taking a more integrated, holistic approach to workplace health-one the U.S. Centers for Disease Control and Prevention calls “Total Worker Health.” (3,4) The goal is to create a “culture of health,” one that recognizes thatworkerhealth andworkplacehealth are intertwined, rather than viewing obesity, job stress, and other personal or work-related health concerns in isolation. (3)

Businesses are always striving to push productivity and curb costs, and many companies-small and large-are realizing that obesity prevention and workplace health promotion programs can have an excellent return on investment. A healthier and happier workforce is also one that helps keep healthcare spending low and productivity high. It’s a win-win that we can’t overlook.

This section of The Obesity Prevention Source summarizes obesity prevention recommendations for worksites, based on a review of expert guidance from the Centers for Disease Control and Prevention, the World Health Organization, the Wellness Council of America, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list on each page, as well as the links to useful toolkits and other resources.

Adding Food and Fitness to Worksite Wellness

Apple and computer keyboard (apple_and_computer_keyboard.jpg)

Worksite wellness programs that address food and fitness can help employees lose weight. Comprehensive and structured programs seem to have a bigger impact on weight than narrow or unstructured programs. Worksite wellness programs should take a total view of worker health, coordinating health promotion efforts with occupational health.

Here is a summary of obesity prevention recommendations for worksite wellness programs, based on a review of expert guidance from the Centers for Disease Control and Prevention, the World Health Organization, the Wellness Council of America, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Incorporate nutrition/healthy eating and physical activity into worksite wellness and health promotion programs (1,2,3,4,5,6,7,8)

  • Focus on nutrition behaviors, physical activity behaviors, or both (8)
  • Use educational, behavioral counseling, or environmental change strategies, or a combination of the three (8)
  • Use multi-component, more intensive, or more structured programs for greater impact (8)

Offer weight management programs or incorporate weight management into worksite wellness and health promotion programs (1,3,4,5,9)

Offer health screenings, such as BMI screenings or health risk assessments (1,9)

Design effective worksite wellness programs by

  • Taking an integrated approach to worker health that addresses occupational health and safety as well as health promotion (1,10,11)
  • Obtaining senior management support (5,7)
  • Obtaining support from middle managers and supervisors (11)
  • Tailoring programs based on employees’ needs and preferences (1,7)
  • Monitoring and evaluating programs’ success (1,5,7)
  • Addressing needs of all employees, regardless of gender, age, culture, ethnicity, socioeconomic status, job type, or physical or intellectual capacity (1,5)
  • Collaborating with multiple stakeholders (academia, nonprofits, government, professional organizations, employees, insurance providers, food distributors) (4,7,9)

Worksite Wellness Programs-Source List

1. Carnethon M, Whitsel LP, Franklin BA, et al. Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association. Circulation. 2009;120:1725-41.

2. Task Force on Community Preventive Services. A recommendation to improve employee weight status through worksite health promotion programs targeting nutrition, physical activity, or both. Am J Prev Med. 2009;37:358-9.

3. Levi J, Vinter S, St. Laurent R, Segal LM. F as in Fat: How Obesity Policies are Failing in America2008: Trust for America’s Health; 2008.

4. U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.

5. Wellness Council of America. WELCOA’s 7 Benchmarks of Success: Developing Results-Oriented Wellness Programs One Company At a Time.Absolute Advantage: The Workplace Wellness Magazine. 2006.

6. World Health Organization. The Challenge of Obesity in the WHO European Region and the Strategies for Response: World Health Organization; 2007.

7. World Health Organization WEF. Preventing Noncommunicable Diseases in the Workplace through Diet and Physical Activity: WHO/World Economic Forum Report of a Joint Event; 2008.

8. Anderson LM, Quinn TA, Glanz K, et al. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: a systematic review. Am J Prev Med. 2009;37:340-57.

9. National Governors Association. Creating Healthy States: Actions for Governors. 2005. Accessed February 2, 2012.

10. Centers for Disease Control and Prevention. The National Institute for Occupational Safety and Health (NIOSH). Total Worker Health. Accessed April 5, 2012.

11. Harvard School of Public Health Center for Work, Health and Well-Being. SafeWell Practice Guidelines: An Integrated Approach to Worker Health. Version 1.0. February, 2012.

Giving Incentives for Healthy Behavior

Single carrot (single_carrot.jpg)

Employers can use a variety of “carrots” to promote healthy behaviors. Some keys to success: Tie rewards to behavior change-not to weight. And don’t penalize or stigmatize employees who don’t reach a healthy weight.

Here is a summary of recommendations for worksite obesity prevention incentives, based on a review of expert guidance from the World Health Organization, the American Medical Association, The Obesity Society, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Offer incentives to promote healthy behaviors, such as participation in physical activity. Types of incentives include (1,2,3)

  • Financial
  • Days off
  • Employee recognition
  • Medical plan enhancements, such as coverage for weight loss programs and lower co-pays and premiums

Offer incentives for using preventive services, such as BMI screenings or health risk assessments (4,5)

Offer free or reduced price access to exercise clubs or gyms (2,5,6,7)

Do not use weight status as the basis for incentives or penalties (2)

Avoid stigmatizing overweight or obese employees (2,8)

Worksite Incentives-Source List

1. American Medical Association. National Summit on Obesity: Building a Plan to Reduce Obesity in America. Executive Summary and Key Recommendations.; 2004.

2. The Obesity Society. The Obesity Society Position on Employer Incentive and Penalties Related to BMI and Weight Loss 2011. Accessed February 2, 2012.

3. World Health Organization, World Economic Forum. Preventing Noncommunicable Diseases in the Workplace through Diet and Physical Activity: WHO/World Economic Forum Report of a Joint Event; 2008.

4. National Governors Association. Creating Healthy States: Actions for Governors. 2005. Accessed February 2, 2012.

5. Levi J, Vinter S, St. Laurent R, Segal LM. F as in Fat: How Obesity Policies are Failing in America2008: Trust for America’s Health; 2008.

6. Carnethon M, Whitsel LP, Franklin BA, et al. Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association. Circulation. 2009;120:1725-41.

7. Lee V, Mikkelsen, L, Srikantharajah, J, Cohen, L. Promising Strategies for Creating Healthy Eating and Active Living Environments. Oakland: Prevention Institute; 2008.

8. World Health Organization. The Challenge of Obesity in the WHO European Region and the Strategies for Response: World Health Organization; 2007.

Creating a Healthy Worksite Food Environment

Plastic bottles with soda (plastic_bottles_with_soda.jpg)

Offering better-for-you options in the cafeteria, limiting access to sugary beverages, and establishing healthy food policies are some of the ways that worksites can make it easier for employees to eat well during the work day.

Here is a summary of worksite food environment recommendations for obesity prevention, based on a review of expert guidance from the Centers for Disease Control and Prevention, the Institute of Medicine, the World Health Organization, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source listand the links to other resources.

Create a worksite environment that promotes healthy eating (1,2,3,4,5,6,7)

  • Provide healthy food and beverages in cafeterias, vending machines, and elsewhere in the worksite (1,2,4,8,9,10,11)
  • Ensure access to clean drinking water (3,12)
  • Limit access to sugar–sweetened beverages (12)

Implement formal worksite policies to promote healthy food and beverages or reduce less–healthy foods and beverages, such as (2,3,7,12)

  • Healthy cafeteria policies (2,3)
  • Healthy vending machine policies (2,3)
  • Healthy food policies for meetings (2,4)
  • Healthy beverage policies (12)

Use marketing strategies to encourage healthier food and beverage choices or discourage unhealthy choices at the workplace

  • Reduce the price of healthy foods and beverages (3,7,12)
  • Replace unhealthy items with healthy items in high traffic areas, such as cafeteria checkout lanes, and at eye-level in vending machines (2)

Promote breastfeeding or pumping, such as by setting up lactation rooms and giving female employees time to breastfeed or pump (3,4,5,13,14)

Worksite Food Environment-Source List

1. Carnethon M, Whitsel LP, Franklin BA, et al. Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association. Circulation. 2009;120:1725-41.

2. Centers for Disease Control and Prevention. The CDC Guide to Strategies for Reducing the Consumption of Energy Dense Foods. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention 2010. Accessed February 2, 2012.

3. Institute of Medicine. Local government actions to prevent childhood obesity. Washington, D.C.: National Academy of Sciences Press; 2009.

4. Lee V, Mikkelsen, L, Srikantharajah, J, Cohen, L. Promising Strategies for Creating Healthy Eating and Active Living Environments. Oakland: Prevention Institute; 2008.

5. U.S. Department of Health and Human Services. The Surgeon General’s Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.

6. Wellness Council of America. WELCOA’s 7 Benchmarks of Success: Developing Results-Oriented Wellness Programs One Company At a Time.Absolute Advantage: The Workplace Wellness Magazine. 2006.

7. World Health Organization. The Challenge of Obesity in the WHO European Region and the Strategies for Response: World Health Organization; 2007.

8. National Governors Association. Creating Healthy States: Actions for Governors. 2005. Accessed February 2, 2012.

9. The Obesity Society. The Obesity Society Position on Employer Incentive and Penalties Related to BMI and Weight Loss 2011. Accessed February 2, 2012.

10. World Health Organization WEF. Preventing Noncommunicable Diseases in the Workplace through Diet and Physical Activity: WHO/World Economic Forum Report of a Joint Event; 2008.

11. American Medical Association. National Summit on Obesity: Building a Plan to Reduce Obesity in America. Executive Summary and Key Recommendations.; 2004.

12. Centers for Disease Control and Prevention. The CDC Guide to Strategies for Reducing the Consumption of Sugar–Sweetened Beverages. 2010. Accessed February 2, 2012.

13. Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. MMWR Recomm Rep. 2009;58:1-26.

14. Levi J, Vinter S, St. Laurent R, Segal LM. F as in Fat: How Obesity Policies are Failing in America2008: Trust for America’s Health; 2008.

Promoting Physical Activity at Work

black bike (black_bike.jpg)

Adults need at least 30 minutes of moderate physical activity most days of the week for good health, and may need an hour a day or more to control weight. Worksites can help employees meet those goals by creating an environment that weaves activity into the workday—and into the daily commute.

Here is a summary of recommendations for increasing physical activity at worksites, based on a review of expert guidance from the Centers for Disease Control and Prevention, the Institute of Medicine, the World Health Organization, the American Heart Association, the National Governors’ Association, and others. For more detailed guidance on these recommendations and ideas for putting them into practice, explore the source list and the links to other resources.

Create a worksite environment that promotes physical activity (1,2,3,4)

  • Provide on-site gyms or other physical activity facilities, such as walking paths (1,2,3,4,5)
  • Allow flexible work time or breaks for participation in physical activity (3,4,6,7,8,9)
  • Promote the use of stairs, such as by using signs or by making stairwells safe and attractive (1,2,5,8)
  • Promote “active transport” (bicycling or walking to work), such as by offering bicycle storage (3,9)
  • Provide showers and/or changing facilities (1,3,4)

Implement formal policies that promote physical activity in the workplace, such as policies for exercise breaks or bicycle parking (7,9)

Promoting Physical Activity at Work-Source List

1. World Health Organization WEF. Preventing Noncommunicable Diseases in the Workplace through Diet and Physical Activity: WHO/World Economic Forum Report of a Joint Event; 2008.

2. Carnethon M, Whitsel LP, Franklin BA, et al. Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association. Circulation. 2009;120:1725-41.

3. Lee V, Mikkelsen, L, Srikantharajah, J, Cohen, L. Promising Strategies for Creating Healthy Eating and Active Living Environments. Oakland: Prevention Institute; 2008.

4. National Governors Association. Creating Healthy States: Actions for Governors. 2005. Accessed February 2, 2012.

5. U.S. Department of Health and Human Services.The Surgeon General’s Vision for a Healthy and Fit Nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2010.

6. American Medical Association. National Summit on Obesity: Building a Plan to Reduce Obesity in America. Executive Summary and Key Recommendations; 2004.

7. Institute of Medicine. Local government actions to prevent childhood obesity. Washington, D.C.: National Academy of Sciences Press; 2009.

8. Levi J, Vinter S, St. Laurent R, Segal LM. F as in Fat: How Obesity Policies are Failing in America2008: Trust for America’s Health; 2008.

9. World Health Organization. The Challenge of Obesity in the WHO European Region and the Strategies for Response: World Health Organization; 2007.