Super-size me

Weight is both a topical and sensitive issue, with the UK leading the world with the fastest growth in the numbers of overweight and obese people. It is because obesity is so common, and likely to become more so, that it is a key issue for HR professionals and OH practitioners.

More than 22% of men and women in the UK are obese compared to just 6% 25 years ago. From a public health perspective the epidemic of obesity is having a huge impact on the number of people with chronic health conditions and the associated costs to society as a whole.

Obesity results from an imbalance between the calories taken in and calories burnt off through activity. But despite media coverage suggesting that excessive eating is the main cause of the obesity epidemic, the real reason is a general reduction in physical activity.

And far from being considered to be simply a matter of over-eating and lack of willpower, obesity is now recognised as a disease with a major genetic component that needs treatment like any other chronic condition.

It is important to remember that weight gain can be very slow as it only takes an excess of about 130 calories per day – the equivalent of a bag of reduced fat crisps – for an individual to put on 14 pounds in a year. Make that every year and it becomes clear how excessive weight gain occurs in so many people.

Obesity is an unusual condition in one respect, as society blames the individual for the disease and makes assumptions about obese people being lazy and less competent. One researcher in the US concluded that “overall the evidence of consistent, significant discrimination against overweight employees is sobering”.

The research, Weight-based Discrimination in Employment: Psychological and Legal Aspects, found that overweight people were subject to discrimination in employment decisions based on body weight, they were stereotyped as emotionally impaired, socially handicapped and as possessing negative personality traits.

But it is the medical complications of obesity that make the condition so important for employers. The risk of developing diabetes, hypertension, heart disease and certain cancers is greatly increased in overweight and obese people.

As an example, women with a body mass index (BMI) greater than 25 are five times more likely than those with a lower BMI of developing diabetes. Those with a BMI greater than 35 are 95 times more likely to be diagnosed as diabetic.

The less dramatic consequences of excess weight include impaired mobility, reduced stamina, breathlessness and sleep apnoea – a sleeping disorder characterised by loud snoring but associated with high blood pressure.

Employers have an essential role to play in preventing obesity, as work may actually contribute to the development of the condition. Sedentary jobs are now common and in many ways work is designed to avoid physical activity.

High-calorie, high-fat food is provided in canteens and vending facilities dispense high sugar drinks. Buffet lunches are commonplace and are often a source of enormous calorie intake both because of the food and the style of eating or ‘grazing’.

Workplaces contain individuals who may not ordinarily come into contact with their GP. But even in the absence of professional healthcare staff, a lot can be done at little or no cost to make people less likely to become overweight (see below).

There has never been such a prevalent condition where there is such prejudice or such a disabling condition with such little sympathy. Employers and HR professionals can do much to overcome the prejudice and stigma and to actively improve the working lives of their staff and the efficiency of their business.

What employers can do:

  • Reflect on the impact of obesity on your business and on its relationship with its customers (many of whom will also be overweight and obese).

  • Identify what resources/facilities/schemes are available locally to encourage activity and how they can be accessed.
  • Review the food available at work – are there healthy choices in restaurants, snack bars, vending machines, buffet lunches? Subsidise healthy options.
  • Encourage exercise by putting in place bike racks and providing loans to buy bikes. Contact national chains of health clubs and arrange reduced membership rates.
  • Provide information to encourage and support staff in their efforts to lose weight.
  • Provide free fruit, one piece a day, for each member of staff.
  • Provide individual weight maintenance and loss advice either at the site or through external organisations.

Dr Nerys Williams is a consultant occupational physician/honorary consultant in weight management, Birmingham Heartlands and Solihull NHS Trust.

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