New Study Shows Morbidly Obese Workforce Has Higher Prevalence Of 100+ Diseases And Conditions

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Public Health
Article Date: 30 Apr 2009 - 2:00 PDT

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Workers with morbid obesity have a significantly higher prevalence of more than 100 diseases and conditions than other employees, and those that had bariatric surgery reduced the prevalence of one-quarter of the diseases studied, according to a study of large employers in the February edition of the Journal of Occupational and Environmental Medicine, a peer-reviewed journal on employee health issues.

The study found that employees with morbid obesity had about five times the rate of osteoarthritis and esophageal disorders, four times the rate of Type 2 diabetes, anemia and hypertension and three times the rate of high cholesterol and asthma, compared to employees who did not have morbid obesity. Researchers analyzed the Human Capital Management Services Research Reference Database, a database of more than 700,000 employees from large employers throughout the U.S.

"The impact of morbid obesity in the workplace is significant and perhaps connected to more concurrent health conditions than anyone thought," said study lead author, Nathan L. Kleinman, PhD, Director of Research Services, Human Capital Management Services, Inc. "Morbid obesity appears to be a common link between a wide variety of conditions. This study suggests employers who implement effective prevention and treatment strategies for morbid obesity itself could have a major impact on the overall health of their employees."

According to the National Institutes of Health (NIH), obesity or being overweight in America costs the health care system an estimated $117 billion and results in about $3.9 billion in lost productivity each year.(1)

Researchers believe this is the first study to evaluate obesity's association with all diseases and conditions as defined by the Agency for Healthcare Research and Quality (AHRQ), the leading government agency for research on health care quality, costs, outcomes and patient safety. The evaluation included the AHRQ's list of 17 major disease categories and 261 specific disease states and conditions.

The study also found that those who had bariatric surgery had a significant decrease in prevalence in 26 of 106 AHRQ specific diseases and conditions - about one-fourth. The prevalence of Type 2 diabetes, high cholesterol or hyperlipidemia, osteoarthritis and intervertebral disc disorders dropped by about half, hypertension dropped by about one-third and asthma dropped by almost three-quarters within two to four months after surgery. Employees were generally able to maintain or further decrease prevalence for up to two years. Patients experienced an increase in prevalence in conditions generally associated with bariatric surgery, including anemia, surgical/medical care complications, nutritional deficiencies and nausea and vomiting.

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), about 220,000 people had some form of bariatric surgery in 2008 and more than 15 million people in the U.S. are morbidly obese.(2) Guidelines from the National Institutes of Health (NIH) state that a person must have a body mass index (BMI) of 40 or more, or a BMI of 35 or more with an obesity-related disease to be a candidate for bariatric surgery.(3)

Study Results

The study found that employees with morbid obesity had significantly higher annual prevalence rates in all 17 major diagnostic categories (MDC) except pregnancy and perinatal conditions and a higher prevalence in 102 out of 131 specific diagnostic categories, as classified by the AHRQ. The annual prevalence of diseases and conditions in employees with morbid obesity and employees who did not have morbid obesity compared as follows:

-- Hypertension (42% vs. 12%)

-- Hyperlipidemia (32% vs. 13%)

-- Diabetes with or without complications (29% vs. 7%)

-- Intervertebral disc disorders (27% vs. 14%)

-- Osteoarthritis (13% vs. 2.5%)

-- Asthma (11% vs. 4%)

Those who had bariatric surgery in the group of employees who had morbid obesity saw significant drops in 26 out of 106 AHRQ specific diseases within two to four months after surgery as compared to the two to four month period before surgery. Prevalence of conditions before and after surgery included:

-- Hypertension (20% vs. 13%)

-- Hyperlipidemia (12% vs. 6%)

-- Diabetes with or without complications (17% vs. 9%)

-- Intervertebral disc disorders (12% vs. 6%)

-- Osteoarthritis (8% vs. 4%)

-- Asthma (7% vs. 2%)

Two to four months after surgery, bariatric surgery patients had higher prevalence rates of 10 AHRQ specific diseases and conditions normally associated with surgery as compared to the two to four month period before surgery, including:

-- Surgical/medical care complications (1% vs. 12%)

-- Nutritional deficiencies (0.1% vs. 10%)

-- Anemia (2% vs. 7%)

-- Nausea and vomiting (1% vs. 5%)

Study Methodology

This retrospective study was conducted by Human Capital Management Services, Inc. on the Human Capital Management Services Research Reference Database, the group's proprietary database of employee health insurance, absence, payroll and productivity data from 2001 to 2008. For the study, each employee was required to have at least 12 months of health plan enrollment. The database contained 1,651 employees with morbid obesity and 33,020 matched employees who did not have morbid obesity. The entire database contains information from many large employers with workforces of 5,000 to 100,000 and employees in all 50 states. Employees in the morbid obesity and control groups were matched by age, tenure, gender, marital status, race, exempt status, employment status, salary and geographic region. Workers were largely full-time (96%), female (71%), white (56%) and on average, 40-years-old.

All AHRQ categories of diseases and conditions were evaluated, but to eliminate rare categories, only those affecting at least 0.5% of the total population were included in the results. This method resulted in comparisons of 131 of the original 261 condition categories when comparing morbidly obese employees to controls and comparisons of 106 categories when comparing prevalence of conditions before and after bariatric surgery.

The authors of the study acknowledge in the article published in Journal of Occupational and Environmental Medicine that Ethicon Endo-Surgery, Inc. (EES) "sponsored this research and assisted with the design of the analytical plan, analysis, interpretation of the data, and review of the manuscript." EES is a manufacturer of advanced medical devices for minimally invasive and open surgical procedures, including general and bariatric surgery.

About Human Capital Management Services Group

The Human Capital Management Services Group consists of three related companies that reduce healthcare costs, empower personal ownership of health decisions, measurably grow productivity and business performance, and inform public policy. The HCMS Group partners with governments, national employers and health organizations to demonstrate the Health as Human Capital approach -- where investments in people come first.

References

(1). Statistics Related to Overweight and Obesity. National Institutes of Health. Weight-control Information Network.

(2). Metabolic & Bariatric Surgery Fact Sheet. American Society for Metabolic & Bariatric Surgery.

(3). Bariatric Surgery for Severe Obesity. National Institutes of Health, Weight-control Information Network

Source: Human Capital Management Services Group