In This Article Expand or collapse the "in this article" section Weight Management in US Occupational Settings

  • Introduction
  • Environmental Measures
  • Environmental Interventions

Public Health Weight Management in US Occupational Settings
Mark Wilson, Heather Padilla
  • LAST REVIEWED: 23 August 2017
  • LAST MODIFIED: 23 August 2017
  • DOI: 10.1093/obo/9780199756797-0109


Workplaces offer a unique opportunity to promote health behavior change and the adoption of healthier lifestyles. Workplace programs can benefit from characteristics of the environment. The population is relatively stable, workers interact with each other in close proximity on a regular basis, and some policies can be more easily implemented in worksite settings than in community settings. Additionally, the burden of illness is shared by employers and employees, providing an impetus for both policy and behavior change. Couple this with studies showing that two-thirds of the employees in the United States are overweight or obese, costing US business $73 billion annually, and it is understandable that work organizations have become interested in offering weight management programs for their employees. In the Guide to Community Preventive Services, the US Task Force for Community Preventive Services recommends worksite programs that improve diet and physical activity behaviors. This article provides an overview of weight management efforts in occupational settings. It provides evidence of the magnitude of the problem in employed populations, documentation of the cost to organizations, and efforts by private and public organizations to support worksite programs, as well as a summary of the effectiveness of various strategies. Although modification of eating behaviors and physical activity form the foundation for most weight management efforts, this bibliography focuses on those sources that are predominately directed at weight management as the primary outcome.

Obesity’s Prevalence and Impact on Workplaces

A number of studies document the prevalence of overweight and obesity in worksite populations, demonstrate the impact of obesity on health and organizational outcomes, and document the extent of obesity-related worksite health promotion programs being offered in organizations. Gu, et al. 2014 and Laukhaupt, et al. 2014 document the prevalence of obesity by occupation and industry and the association with specific work-related factors. Gable, et al. 2009 demonstrates the levels of interest that obesity programs are generating for both employers and employees. Schulte, et al. 2006 examines the impact of obesity on traditional health and safety outcomes, while Pollack, et al. 2007 links obesity to increased rates of traumatic injury on the job. The idea of an integrative perspective that integrates multiple departments in worksites, particularly worksite health promotion and occupational safety and health, fits nicely with obesity, as it impacts both safety and health promotion outcomes. Chapman 2004 and Heinen and Darling 2009 highlight initiatives that organizations have undertaken, including individual programs, environmental changes, and health benefit plan modifications. And finally, Carnethon, et al. 2009 provides the policy statement from the American Heart Association on worksite wellness programs for cardiovascular disease (CVD) prevention. These papers emphasize the impact of obesity on workplaces and possible solutions being tried by workplaces.

  • Carnethon, M., L. P. Whitsel, B. A. Franklin, et al. 2009. Worksite wellness programs for cardiovascular disease prevention: A policy statement from the American Heart Association. Circulation 120:1725–1741.

    DOI: 10.1161/CIRCULATIONAHA.109.192653

    Although not specific to weight management, the policy statement from the American Heart Association on worksite wellness programs for CVD prevention is very relevant, as healthy eating and physical activity are cornerstones of CVD prevention. The statement also has specific suggestions for interventions that include individual behavior change, environmental strategies, policies, and incentives that are relevant to all behaviors.

  • Chapman, L. S. 2004. Reducing obesity in work organizations. American Journal of Health Promotion 19.Suppl. 1: S1–S8.

    DOI: 10.4278/0890-1171-19.1.TAHP-1

    Chapman provides an overview of the obesity problem in the workplace. He discusses legal and human resource issues such as employment, wages and benefits, Equal Employment Opportunity Commission (EEOC) and Americans with Disabilities Act (ADA). Most importantly, he includes an extensive list of options for responding to the obesity problem, ranging from creating a supportive culture for healthy body weight to individual behavior change strategies.

  • Gable, J. R., H. Whitmore, J. Pickreign, et al. 2009. Obesity in the workplace: Current programs and attitudes among employers and employees. Health Affairs 28:46–56.

    DOI: 10.1377/hlthaff.28.1.46

    Gable and colleagues use a national survey to paint a picture of the prevalence of obesity programs and services that are offered by work organizations and examine worker attitudes about offering programs and services as part of the organization’s health insurance coverage. This is particularly relevant information during the current health-care reform discussions.

  • Gu, J. K., L. E. Charles, K. M. Bang, et al. 2014. Prevalence of obesity by occupation among US workers. Journal of Occupational and Environmental Medicine 56.5: 516–528.

    DOI: 10.1097/JOM.0000000000000133

    This study provides a detailed examination of the prevalence of obesity by occupation and examines these changes over time. This clearly documents the increase in obesity levels of US workers over time and the higher prevalence in certain, mostly blue-collar, occupations, although the prevalence significantly increased during this time in white-collar occupations but not blue-collar occupations.

  • Heinen, L., and H. Darling. 2009. Addressing obesity in the workplace: The role of employers. Milbank Quarterly 87.1: 101–122.

    DOI: 10.1111/j.1468-0009.2009.00549.x

    Heinen and Darling discuss obesity in the workplace from the employer’s perspective. They highlight current initiatives that worksites have undertaken to limit the impact of obesity, including health benefit design and environmental, cultural, and community approaches. They conclude with case studies from four organizations that demonstrate these approaches.

  • Laukhaupt, S. E., M. A. Cohen, J. Li, and G. M. Calvert. 2014. Prevalence of obesity in U.S. workers and associations with occupational factors. American Journal of Preventive Medicine 46.3: 237–248.

    DOI: 10.1016/j.amepre.2013.11.002

    This paper uses data from the 2010 National Health Interview Survey to document the prevalence of obesity in US workers by industry classification. It further documents obesity levels by workweek length, work schedule, work arrangement, presence of hostile work environment, and perception of job insecurity and work-family balance. This study establishes the relationship between various work-related factors and obesity, which provides an argument for organizational-level interventions targeting the work environment.

  • Pollack, K. M., G. S. Sorock, M. D. Slade, et al. 2007. Association between body mass index and acute traumatic workplace injury in hourly manufacturing employees. American Journal of Epidemiology 166.2: 204–211.

    DOI: 10.1093/aje/kwm058

    This study documents an increase in traumatic workplace injury in obese manufacturing workers. This provides evidence to employers that obese workers are up to twice as likely to be injured as non-obese workers. Obesity is one issue that cuts across traditional organizational departments (i.e., safety and health, medical, human resources, Workplace Health Promotion [WHP]).

  • Schulte, P. A., G. R. Wagner, A. Ostry, et al. 2006. Work, obesity, and occupational safety and health. American Journal of Public Health 97.3: 428–436.

    DOI: 10.2105/AJPH.2006.086900

    This manuscript provides an excellent overview of the impact of obesity on occupational safety and health. Authors discuss the impact of obesity on vibration-induced injury, work-related asthma, chemical immunomodulation, musculoskeletal disorders, neurotoxicity, cancer, and stress-induced responses. They provide models for explaining the interrelated nature of obesity and work, and discuss legal, social, and ethical issues surrounding safety initiatives organizations may undertake.

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