Obesity inflates health care costs of employees

Losing weight benefits workers, employers

Obesity is closely related to employee health care costs, according to a recent study showing that workers with a lower body mass index (BMI) incurred lower health care costs and fewer sick days.1

Using health risk appraisals and personnel data, the researchers compared the BMI of 3,066 employees with their health care needs and associated costs. Findings indicate that health care costs rise with worker BMI and suggest an "economically optimal" BMI at which health care costs are lowest.

BMI is calculated by dividing the employee’s weight in kilograms by the square of his/her height in meters. Obesity has been defined as a BMI of 27.8 or higher for men and 27.3 or higher for women.

Health care costs were found to be lowest for workers with a BMI of 25 to 27, which is equivalent to a body weight of approximately 155 pounds for a woman 5 feet 6 inches tall, or 174 pounds for a 5-foot 10-inch tall man.

Workers with an "at-risk" BMI had a higher rate of other health risks, such as insufficient exercise, lower life satisfaction, and diabetes. They used twice as many sick days (an average of 8.5) as those with a lower BMI (an average of 3.7) over three years. Sick day costs over three years per employee were $1,500 for those with higher BMIs, compared with $700 for workers with more optimal BMIs.

Women over 45 at increased risk

Three-year health care costs were $7,000 per employee for those with a BMI of 25 or higher, compared with $4,500 for those with a BMI below 25. The difference was especially pronounced for women over age 45 with higher BMI. Their health care costs increased for nearly all major disease classifications, including mental, circulatory, digestive, respiratory, and musculoskeletal disorders.

Those results suggest that workers over 45 with an elevated BMI, particularly women, are at increased risk of complications caused by obesity and represent the most promising focus of employee weight reduction programs, the researchers state.

They add that by helping workers achieve a healthier weight, organizations are likely to reduce overall medical and short-term disability costs. (See box, p. 45.) Losing weight also benefits workers, reducing risk of disease and personal health care costs.

Workers with a BMI greater than 30 constituted only 19% of the study population, but accounted for 26% of total health care claims and 29% of total health care costs.


1. Burton WN, Chen C, Schultz AB, et al. The economic costs associated with body mass index in a workplace. J Occup Env Med 1998; 40:786-792.