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Cohort Analysis Assessing Medical and Nonmedical Cost Associated With Obesity in the Workplace

Kleinman, Nathan PhD; Abouzaid, Safiya PharmD, MPH; Andersen, Lenae MS; Wang, Zhixiao PhD; Powers, Annette PharmD, MBA

Journal of Occupational and Environmental Medicine: February 2014 - Volume 56 - Issue 2 - p 161–170
doi: 10.1097/JOM.0000000000000099
Original Articles

Objective: Quantify the impact of employee overweight and obesity on costs, absence days, and self-reported productivity.

Methods: Employees' retrospective body mass index (BMI) values (kg/m2) from 2003 to 2011 health appraisal data defined three cohorts: BMI < 27, 27 ≤ BMI < 30, BMI ≥ 30. Medical, pharmacy, sick leave, short-term disability, long-term disability, and workers' compensation costs and absence days, and Health Productivity Questionnaire responses were compared using regression modeling, controlling for demographics, salary, and index year.

Results: Among 39,696 (BMI < 27), 14,281 (27 ≤ BMI < 30), and 18,801 (BMI ≥ 30) eligible employees, per-employee adjusted total annual costs were $4258, $4873, and $6313, respectively. Medical, pharmacy, sick leave, workers' compensation costs and days were higher for higher-BMI cohorts (P < 0.01). Employees with BMI ≥ 30 kg/m2 had the most short-term disability costs and days and least productivity (P < 0.001).

Conclusions: Employees with higher BMI levels are associated with significantly more costs and absences and lower self-reported productivity.

From the Human Capital Management Services Group (Dr Kleinman and Ms Andersen), Cheyenne, Wyo; and Eisai Inc (Drs Abouzaid, Wang, and Powers), Woodcliff Lake, NJ.

Address correspondence to: Nathan Kleinman, PhD, 415 W 17th St, Ste 250, Cheyenne, WY 82001 (

Funding for this study was provided by Eisai Inc.

Safiya Abouzaid, Zhixiao Wang, and Annette Powers are employees of Eisai Inc. Nathan Kleinman and Lenae Andersen are employed by HCMS Group, which received funding from Eisai Inc for research and manuscript development.

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Copyright © 2014 by the American College of Occupational and Environmental Medicine