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State-Level Estimates of Obesity-Attributable Costs of Absenteeism

Andreyeva, Tatiana PhD; Luedicke, Joerg MS; Wang, Y. Claire PhD

Journal of Occupational and Environmental Medicine: November 2014 - Volume 56 - Issue 11 - p 1120–1127
doi: 10.1097/JOM.0000000000000298
Original Articles

Objective: To provide state-level estimates of obesity-attributable costs of absenteeism among working adults in the United States.

Methods: Nationally representative data from the National Health and Nutrition Examination Survey for 1998 to 2008 and from the Behavioral Risk Factor Surveillance System for 2012 are examined. The outcome is obesity-attributable workdays missed in the previous year because of health and their costs to states.

Results: Obesity, but not overweight, is associated with a significant increase in workdays absent, from 1.1 to 1.7 extra days missed annually compared with normal-weight employees. Obesity-attributable absenteeism among American workers costs the nation an estimated $8.65 billion per year.

Conclusions: Obesity imposes a considerable financial burden on states, accounting for 6.5% to 12.6% of total absenteeism costs in the workplace. State legislatures and employers should seek effective ways to reduce these costs.

Supplemental Digital Content is Available in the Text.

From the Rudd Center for Food Policy and Obesity (Dr Andreyeva and Mr Luedicke), Yale University, New Haven, Conn; and Department of Health Policy and Management (Dr Wang), Mailman School of Public Health, Columbia University, New York, NY. Mr Luedicke is currently with StataCorp.

Address correspondence to: Tatiana Andreyeva, PhD, Rudd Center for Food Policy and Obesity, Yale University, 309 Edwards St, New Haven, CT 06520 (

The study was funded by a grant from the National Cancer Institute (Grant No. 1R01CA172814-01A1).

The views expressed in this article are those of the authors and do not necessarily represent the official views of the NCI or the NIH.

Authors Andreyeva, Luedicke, and Wang have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

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