The latest theme to hit employer-provided benefits is GLP-1 drug coverage and the costs to treat obesity while reducing other health risks. To properly respond to the obesity epidemic, employers must understand obesity, weight bias and stigma, and the effect obesity has on employee health. There are multiple actions employers may take to address the impact of the obesity epidemic on their employees.

In the International Foundation webcast, “Employers’ Critical Role in Fighting the Obesity Epidemic,” George Huntley, CEO of the Diabetes Leadership Council; Eden Miller, D.O., CEO of Diabetes and Obesity Care LLC; Rebecca Pearl, Ph.D., assistant professor of clinical health psychology at the University of Florida; and Alison Sexton Ward, Ph.D., research scientist at the Leonard D. Schaeffer Center for Health Policy & Economics answered questions employers have regarding obesity and how it is treated.

Obesity 101

What is obesity? Drs. Ward and Miller described obesity as a chronic disease where one’s body mass index (BMI) is over 30. Currently, over 40% of adults in the United States are obese, which is projected to continue increasing over time. Obesity is a complex disease—Dr. Miller described multiple factors contributing to obesity, including genetics, metabolic adaptation, dietary intake vs. metabolic need and social determinants of health (i.e., income, education and employment status).

Obesity can be associated with disability, pain, diabetes, heart disease, hypertension, cancer, stroke and more. Decreased productivity and absenteeism from obesity-related illness and injury cost employers, on average, three days of work per year. This is a reminder for employers that obesity is a serious problem that will not go away on its own.

What effect does treating obesity have on employee health?

Dr. Ward described the impact of treating obesity and its effect on chronic diseases. She estimated what would happen if there was widespread insurance coverage (including Medicare and private insurance) of weight-loss drugs—In 20 years, diabetes rates could fall by over 17% (4.4 million fewer people with the disease).

Dr. Miller described the impact of modest weight loss and its health benefits including better blood pressure and cholesterol levels as well as improvements in joint mobility. For individuals losing 10-15% of their weight, benefits may include diabetes remission and sleep apnea reduction as well as reduced cardiovascular mortality, all-cause mortality and cancer risk.

What can health plans do to help employees?

Dr. Miller emphasized that health plans must focus on whole-person well-being—a combination of healthy eating, physical activity and behavioral therapy. Employers can:

• Remind employees to move. For employees with sedentary jobs, getting up for five minutes every hour could reduce their heart disease risk by 20%.
• Offer nutritional counseling services
• Provide intensive behavioral therapy as part of a health plan or wellness program (e.g., smoking cessation programs)
• Cover anti-obesity medications when lifestyle management alone is not enough or when obesity-related complications yield adverse health consequences.

What if employers cannot afford the cost of GLP-1 drugs?

Huntley suggested employers consider the “net” cost of GLP-1 drugs. “The list price scares people, but rebates on GLP-1s are about 50% of the cost,” according to Huntley. Thus, employers may only pay about half of the list cost. Employers should also remember that even though the drugs may need to be taken for years or life, the costs associated with treating cancer, heart failure and other diseases can be quite high, too.

What actions can be taken by employers who do not provide GLP-1 drug coverage?

Employers can implement workplace wellness initiatives to promote employee well-being. When designing such initiatives, Dr. Pearl reminds employers of the following:

• Monitoring and rewarding employees for weight loss is not appropriate. Instead, reward healthy behaviors.
• Wellness initiatives should focus on reducing elevated health biomarkers (e.g., blood pressure, A1C, cholesterol).
• Include nutritious food options in workplace meetings, work-related social events, cafeterias and vending machines.
• Make stairways a safe and attractive alternative to an elevator.

Final Thoughts

When employers think about what resources to offer to employees to reduce obesity and increase whole-person well-being, Huntley reminds employers what they offer can impact recruitment and retention now more than ever.

To learn more about an employer’s role in the obesity epidemic, view the entire webcast recording, “Employers’ Critical Role in Fighting the Obesity Epidemic.”

Developed by International Foundation Information Center staff. This does not constitute legal advice. Please consult your plan professionals for legal advice.