As a country and as a society overall, we’ve always thought about and had discussions about “weight loss” and “diets”. However, in recent times, the spotlight on obesity and its treatment has intensified. Some of that can be attributed to the fascination with Ozempic. After all, the New Yorker named 2023 the “Year of Ozempic” following the widespread interest from both Hollywood and TikTok.
However, obesity treatment is not about losing a few pounds to fit into a red carpet look–it’s far more nuanced than that. Obesity plays a profound role on health and well-being, as well as the workplace experience. Individuals with obesity have greater likelihood of cardiometabolic disease, musculoskeletal issues, and often experience more mental health challenges.
As obesity rates continue to rise–currently 40% of US adults and expected to rise to 50+% by 2030–there is still this perception that the solution is simple. Increasingly, there seem to be different “camps” forming around what the obesity epidemic means–from those who believe that we need to focus more on diet and exercise to those that believe GLP-1s will solve obesity. I believe that the answer is much more complex, as is often the case. Robust and effective obesity care needs to be personalized and multi-modal, solving for the range of medical, nutritional, and emotional elements that may contribute to obesity. Addressing social determinants, such as limited access to healthy food options, is also extremely important, especially as we consider vulnerable populations.
Many employers are deciding how to address the growing demand for obesity treatment coverage, as many are feeling challenged by both the rising cost of obesity-related conditions, like diabetes, cardiovascular, and musculoskeletal issues, and by the rapid increase in price of high-cost GLP medications.
While every company needs to determine their benefits approach, I believe that it’s important to understand the role obesity plays on overall employee well-being, as well as health inequity. By acknowledging and addressing obesity in the workplace, employers can play an important role in creating a culture that prioritizes the health and well-being of all employees, regardless of weight or health status.
Bias in the Workplace
Obesity extends far beyond health concerns; for those living with obesity, it affects daily life. That may mean an inability to buy clothes from particular stores, enjoy amusement park rides, or even use certain exercise equipment. The social stigma of obesity may also mean being treated differently and having unequal opportunities in the workplace.
The Harvard Implicit Bias test has shown significant–and growing–implicit bias against those with obesity. This bias is not only present in daily life and experience within the clinical setting, it also affects perception at work.
Individuals with obesity are more likely to be perceived as lazy, unmotivated, and unprofessional. Those considered “average weight” are more likely to be perceived as high-performing, hard-working, and motivated. This biased perception likely stems from the belief that obesity is a personal choice and controllable–addressable by moving more and eating less. Therefore, someone with obesity must not be trying to better themselves. While research has shown that the majority of people who attempt to lose weight will fail, popular perception is very different.
The bias against individuals with obesity compounds gender and racial bias. Women, in particular, bear a disproportionate burden from carrying excess weight. For women, losing 65 lbs has roughly the same impact as earning a master’s degree. This impact increases with age, as women 51 to 61 with moderate-to-severe obesity experience a 40% reduction in financial net worth compared to their normal-weight peers; the reduction widens to 60% by the time they reach 57 to 67. Maybe it’s not surprising that we see so many women looking to lose those “extra” few pounds–as The Economist once wrote, in our society a woman can never be too thin.
The impact of obesity bias also extends disproportionately to minority communities as obesity is more prevalent anywhere health inequity exists–among black and brown communities, in rural communities, and among those with lower education and income.
As with any bias, poor perceptions of individuals with obesity certainly affect talent management. Far too often, someone who is talented is overlooked and underestimated because there is a perception that their size suggests they won’t work hard. As a result, organizations may inadvertently overlook valuable talent and fail to fully capitalize on the skills and perspectives that individuals with obesity bring to the table.
As the prevalence of obesity continues to rise across the country, it’s important to note that the workplace experience may also affect employee retention. 72% of U.S. employees who have faced unfair treatment at work due to their weight report contemplating quitting their jobs.
Implications for Employers
First, consider whether someone’s size really affects their ability to perform their job–that may be the case in certain roles, such as a helicopter pilot, but is likely not to be the case in many other functions, such as an engineer. In roles where weight doesn’t directly affect performance, don’t use it as a proxy for someone’s ability to succeed and drive value for the organization.
Second, evaluate whether materials and events used to attract and engage potential employees suggest that those with larger bodies are a welcome part of the workforce. If these materials exclude individuals of a certain size, it may send the message that the company is not receptive to hiring individuals who now represent nearly half the adult population.
Finally, evaluate the support and programs being provided to address obesity. Many treatments–whether bariatric surgery or anti-obesity medications–can be high-cost, especially when considering it could apply to a significant population, so it is understandable that employers are trying to evaluate options and prioritize solutions that show a return on investment. While optimizing value is one thing, merely offering gym benefits or a weight loss app as an alternative by themselves, although a nice perk, is unlikely to truly help employees improve health, well-being, and productivity.
Elina Onitskansky is the Founder & CEO of Ilant Health, a value-based and holistic obesity management company. Ilant’s mission is to work with employers and health plans to support members in achieving health and wellness through high-quality, appropriate, and supported obesity management and cardiometabolic care.