Wellness is Free Stuff

How so? Here are just a few figures on what it costs to be “unwell.”

• Overweight and obesity costs total $117 billion in the United States each year.
• Annual medical expenses for employees ranges from $114 for normal-weight individuals to $573 for overweight individuals to $620 for the obese.
• A Cornell University study (Dec. 2007) recently reported that obesity-related sick days cost employers $4.3 billion a year in 2004 dollars.
• Type 2 diabetes costs related to overweight and obesity: $98 billion per year.
• Osteoarthritis costs related to overweight and obesity: $21.2 billion per year.
• Hypertension (high blood pressure) costs related to overweight and obesity: $4.1 billion per year.
• Lost productivity costs related to obesity (BMI > 30) among Americans ages 17-64: $3.9 billion per year.

OK. But, what does it cost to walk around the block?

What does it cost to make better nutritional choices?

What does it cost to change behavior in modest but meaningful ways?

That’s why we say “wellness is free stuff.” And that’s not all.

• Physically active people save an average of $500 a year in health care costs.
• Adults gain two hours of life expectancy for each hour of regular physical activity.
• Substitute water for one 20-oz bottle of regular soda each day and save enough calories to lose 26 pounds in a year.
• Take the stairs. For a total of 2 minutes, five days a week, you’ll get the same calorie-burning results as a 20 minute walk. It burns 100 to 140 calories.
• Sit up straight to eat—and you’ll eat about 10 percent less.
• The average person makes about 200 food choices each day. When making those choices, pay attention to plate size, package size, and the people around you. By using smaller plates and bowls, you will eat up to 60 percent less (if you don’t go back for seconds).

It’s a start. Walk the dog, play with the kids, think before you eat. Free is good. Free wellness is really good.

Dear CBS News,

We know breakfast is important.

But now you report that we have a “Big Breakfast” Diet, where we’re encouraged to eat a 600 calorie breakfast rich in carbohydrates. And, that this big breakfast will result in greater weight loss. Well, we can sort of see where all that food would keep you from getting hungry before lunch. That’s a good thing, but we know that people don’t always eat just because they’re hungry, and that many of us tend to snack our way through the day—and that in too many cases—the more you eat—the more you tend to want to eat.

In the big breakfast study, daily calories were limited to 1,240, with 610 of those calories consumed at breakfast. We know a controlled study is a whole lot different from real life, and we know too, that most of us won’t eat half of our daily calories at breakfast.

Rather than one more gimmick diet plan, LoneStart offers a real solution. For the past three years hospitals in Texas and the Midwest have participated in the LoneStart Wellness Challenge. We have partnered with the Texas Organization of Rural and Community Hospitals, Pioneer Health Network, and the National Cooperative of Health Networks to make our Caring for the Caregivers wellness strategy available to their members.

Examples: Permian Regional Medical Center in Andrews, Texas took the LoneStart Wellness Challenge in February 2008. The Midland Reporter-Telegram reported in a recent story that about 54 percent of the hospital’s employees lost a total of 500.5 pounds in three months.

Peterson Regional Medical Center in Kerrville, Texas has not only offered its employees several LoneStart Challenges in 2007 and 2008, but has taken it out into their community as well.

These are real results, in real communities, with real people dealing with real day-in-day-out choices. These are people taking personal responsibility for their own wellness decisions.

Maybe not as catchy as the Big Breakfast Diet—but effective, low cost, easy to implement and making a difference. If that’s not news, what is?

Wellness—Of Course We’re Biased

So, after the three previous posts, we still know what we already knew—that bigger is not better when it comes to the human race. What can a workplace employee wellness program accomplish? What can an individual accomplish?

Success or failure. The road to wellness, becoming more physically active and yes, losing weight, begins with taking control—control of the decisions you make every day that determine your lifestyle and the quality of your life, both now and in the future. We know that just because information is available, those who need it most tend not to act on it. Motivation, support, incentive and the desire to meet a challenge are key to the success of the LoneStart Team Esteem Challenge. But that’s just one solution.

Healthy weight is a combination and balance of watching what you eat and becoming more physically active. The American Heart Association suggests:

• Adjusting total calories to reach and maintain a healthy weight
• Limiting saturated fat to 7 to 10% or less of your total calories
• Limiting polyunsaturated fat to 10% of your total calories
• Adjusting your monounsaturated fat to 15% of your total calories
• Adjusting your total fat intake to no more than 30% of total calories if you are overweight
• Limiting your cholesterol intake to less than 300 milligrams per day
• Limiting your sodium intake to less than 2,300 milligrams per day (the equivalent of about one teaspoon of salt)

We say, take it a step further and find ways to put your body in motion during the day. Take the stairs. Park further away and walk, walk around the block, or the parking lot, or the office, (just not to the vending machine).

Bigger, But Not Better—Part III, The Skinny on Obesity

Finally, let’s look at some of the really staggering figures associated with our growing society.

• Since 1991, the number of Americans considered morbidly obese has increased more than 74 percent.
• The Social Security Administration pays more than $77 million per month to those who meet obesity requirements for disability.
• Obesity and inactivity are closing in on tobacco use as the leading preventable causes of death in the U.S.
• Obesity is now more costly to U.S. companies than smoking or alcoholism.
• Obesity is associated with 53 health conditions and has roughly the same association with chronic health conditions as 20 years of aging. It contributes to heart disease, diabetes, arthritis and some types of cancer.
• As many as 47 million Americans may exhibit a cluster of medical conditions (metabolic syndrome, or Syndrome X), characterized by insulin resistance and the presences of obesity, excessive abdominal fat, high blood sugar and triglycerides, high blood pressure (hypertension) and high cholesterol.
• It is likely that the increase in the prevalence of diabetes in the last 20 years in the United States is due to the marked increase in the prevalence of obesity. Body mass index, abdominal fat distribution, and weight gain are important risk factors for type 2 diabetes. (American Obesity Association)
• From 1997 through 2004, the number of new cases of diagnosed diabetes increased by 54%.
• Data from the 14-year Nurses’ Health Study demonstrated that normal weight women who gain only 11 to 17.6 pounds were nearly twice as likely to develop diabetes during the study. Women who gained 24 to 44 pounds were more than five times as likely to develop diabetes.
• The medical consequences of obesity in the US—diabetes, high blood pressure, even orthopedic problems—costs an estimated $100 billion a year.

The costs are high, no doubt, but the ultimate cost to Americans is measured in chronic disease, disability and early death. If these are indeed costs we can begin to control, there’s never been a better time to start doing so.

Bigger, But Not Better—Part II

A number of our workplace wellness clients are hospitals—organizations that have been forced to accommodate the needs of ever-larger patients (some of whom weigh hundreds of pounds) with “expanded” products and services.

Some of these specialty items include: Larger, sturdier hospital beds and stretchers, special imaging equipment, bigger blood pressure cuffs, recliners that can hold 350 pounds—or more, super-sized clamps, air-powered transfer devices, and longer needles. Even wall-mounted toilets are only designed to accommodate 350 pounds.

Surgery too is trickier. In a normal weight patient the abdominal wall may only be an inch or two thick, but in a morbidly obese patient, the abdominal wall may be 12 inches or more. And, respiratory depression, respiratory failure and breathing issues can be catastrophic in a morbidly obese patient.

Yes, hospitals want to and must treat all patients and family members with dignity and respect and provide the best patient care possible. In some cases this means obesity-friendly equipment. Because this is where we are.

But, these changes cost money, changes that are factored into budgets, and who ultimately picks up the tab? Consumers and taxpayers who fund insurance and Medicare. Medically, obesity is viewed as a disease, but it is a preventable disease.

And, that’s the point here. If it’s preventable, why don’t we prevent it?

Bigger, But Not Better—Part I

Guess what? Most of us (more than 65 percent) are outgrowing more than our clothes. No big surprise, but as we Americans grow bigger, so does all of our stuff. Do you go to the movies? The standard width of a movie theatre seat used to be 19 inches. Today, it’s 23 inches. Church pews? From 18 inches per worshipper to 21 inches. Office furniture companies advertise chairs made for larger workers with optional slide-out arms for those that need still more room.

Looking for a new car? Some SUVs offer 40-inch wide driver seats. There are seatbelt extenders, and telescoping steering wheels. But, not only do the majority of us need bigger seats, we need more room to maneuver when we get out of our bigger seats. Revolving doors have grown from an average of 6 feet in width to about 8 feet. Supermarket aisles have expanded from about 5 feet to 7.5 feet. Shopping carts too are larger, to accommodate the greater quantities of food we buy.

Even our children aren’t immune. The Journal of Pediatrics reported in 2006, that about 1 percent of all American children (more than 283,000) are too large to fit safely in a car seat.

And, you know what else? All these adjustments make it easier to live bigger—and this makes it that much harder to motivate ourselves to do the healthy thing and lose weight, make better nutritional choices and become more (rather than less) physically active.

The Leg-bone's Connected to the Foot-bone

Walking: A gentle, low-impact activity that can ease you into a higher level of fitness, health and long-term wellness. According to the U.S. Surgeon General, more than 60 percent of adults in the United States do not engage in the recommended amount of physical activity, and approximately 25 percent of American adults are not active at all. Physical inactivity can lead to chronic diseases and conditions like heart disease, stroke, colon cancer, diabetes, obesity, arthritis and osteoporosis. Healthcare costs related to these conditions total more than $600 billion nationally.

Reduce your risk of a heart attack. Walking keeps your heart healthy by lowering low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) and raising high-density lipoprotein (HDL) cholesterol (the "good" cholesterol).

Manage your blood pressure. If you already have high blood pressure, walking may reduce it.

Reduce your risk of developing type 2 diabetes. Regular physical activity reduces your risk of developing type 2 diabetes. If you're a woman, overweight and at a high risk of diabetes, walking can improve your body's ability to process sugar (glucose tolerance).

Manage your diabetes. If you already have type 2 diabetes, taking part in a regular walking program can improve your body's ability to process sugar, lower your blood sugar, reduce your risk of heart disease and may help decrease the amount of insulin or other medications needed to control your condition

Manage your weight. Walking burns calories, which can help you manage your weight. Middle-aged women who walk more than 10,000 steps a day have lower levels of body fat than do women who are less active. Walking burns approximately the same amount of calories per mile as does running. Walking briskly for one mile in 15 minutes burns about the same number of calories as jogging an equal distance in 8.5 minutes.

Manage stress and boost your spirits. Going for a brisk walk is a great way to reduce stress. Regular walking also can reduce feelings of depression and anxiety.

Stay strong and active. Walking is the only exercise in which the rate of participation does not decline in the middle and later years. In a national survey, the highest percentage of regular walkers for any group (39.4%) was found among men 65 years of age and older. (President’s Council on Physical Fitness and Sports)

So, like we say, let’s “move to improve.” With each step you take, you’ll be making an investment in wellness—and your future health and happiness.

The Knee-bone's Connected to the Leg-bone

And getting those leg bones in motion means a lot. Did you know that adults gain two hours of life expectancy for each hour of regular exercise. (American Heart Association)

Or that—taking the stairs for a total of 2 minutes, five days a week gives you the same calorie-burning results as a 20 minute walk. It burns 100 to 140 calories.

As for the knee bone: Researchers reporting in the journal Arthritis & Rheumatism found that for every pound of weight lost there is a four-pound reduction in the load placed on the knee joint with each step. The accumulated reduction in knee load for a one-pound loss in weight would be more than 4,800 pounds per mile walked. Lose 10 pounds and your knees would be subjected to 48,000 less pounds of pressure per mile.

Less weight, less pressure, less knee pain.

Wellness and Fun? Yes!

It’s not an oxymoron. You can make wellness fun and create an environment of wellness at the same time. Organized wellness teams (The LoneStart Team Esteem Challenge) can compete to achieve defined wellness goals, such as pounds lost, steps taken, or BMI reduction.

Proactively managing health (rather than waiting for people to get sick) reduces health costs for all of us and helps employers retain employees. According to the Centers for Disease Control and Prevention, about 70 percent of health costs in this country are preventable. So what if you can continue to provide excellent insurance benefits while reducing your costs through a focus on prevention and wellness. And if you make it fun?

Following are some actual quotes from LoneStart Workplace Wellness and Team Esteem Challenge participants at Peterson Regional Medical Center (this is our blog, so we can really promote ourselves here).

• “Uplifting for staff at ACC – lots were motivated and made it fun for all. Made me think twice before eating something—better choices all in all.”
• “I really liked the quotes in the journal. Even though good “lifestyle habits” are very serious subjects, fun laughter and stress reduction make living so much more manageable . . . LoneStart is a good start for PRMC.”

There’s this, also from Peterson Regional Medical Center, and we think it’s pretty significant. After two successful LoneStart Wellness 63-day challenges, PRMC participants lost a total of 921 pounds and 40 participants reduced their average BMI by approximately 2.7 points.

“Admissions for six months of the year were down by 25 percent, with length of stay (LOS) per admission down 3 percent for the same period. Reduced utilization, fewer claims and reduced incident rate can take the credit for the reduction,” says Pat Murray, Hospital Administrator.

And the hospital saw its insurance premiums decrease approximately 9.1 percent.

That’s no laughing matter.

Heavy Costs

Employers are increasingly concerned about obesity in the workplace and its associated price tag. According to The Conference Board a nonprofit business membership and research organization, obese employees cost U.S. private companies an estimated $45 billion annually in medical expenditures and work loss. What are obese employees costing your organization?

What’s more, between 1997 and 2004, obese workers filed twice the number of workers’ compensation claims, had seven times the medical costs and lost 13 times the days of work from work injury or illness compared to other employees. The average medical claims costs per 100 employees amounted to $51,019 for the obese, compared with $7,503 for normal weight employees. (Duke University Medical Center study published in the Archives of Internal Medicine, 2007)

We know what overweight and obesity costs the employer—but what does it cost the employee? The question here is: As an employee, is your weight holding back your career?

“This is not something on the margins,” says Mark Roehling, Michigan State University associate professor of human resources management. “At the obesity level and higher, we have every reason to believe (discrimination) is having a very significant impact on people.”

Weight-based discrimination consistently affects every aspect of employment, from hiring to firing, promotions, pay allocation, career counseling and discipline, according to Roehling’s work.

It’s during the hiring process that the bias appears to be most prominent, when an employer knows a potential employee the least, and therefore is most likely to be influenced by stereotypes, says Cort Rudolph, a Wayne State University researcher.

The bulk of research has also shown that the bias tends to be felt most by overweight white women who are battling both the glass ceiling and the stigma of being heavy. A 2004 study by Cornell University Associate Professor John Cawley found that when the average white woman puts on an additional 64 pounds, her wages drop 9 percent. And in 2004, Charles Baum, of Middle Tennessee State University, also reported in the journal Health Economics that obesity could lower a woman’s annual earnings by as much as 6.2 percent and a man’s by as much as 2.3 percent.

We have to believe (and being in the wellness business, we do believe) that workplace wellness works on more than one level. And, a successful employee wellness program benefits not only the employer and the organization, but based on the above statistics, provides financial benefits even beyond individual long term health and wellness for employees as well.