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The Effect of Weight Loss on Health, Productivity, and Medical Expenditures Among Overweight Employees

Bilger, Marcel PhD*; Finkelstein, Eric A. PhD*; Kruger, Eliza MHEcon*; Tate, Deborah F. PhD; Linnan, Laura A. ScD

doi: 10.1097/MLR.0b013e318286e437
Original Articles

Objectives: To test whether overweight or obese employees who achieve clinically significant weight loss of ≥5% have reduced medical expenditures, absenteeism, presenteeism, and/or improved Health-Related Quality Of Life (HRQOL).

Methods: The sample analyzed combines data from full-time overweight or obese employees who took part in one of the WAY to Health weight loss studies: 1 that took place in 17 community colleges (935 employees) and another in 12 universities (933), all in North Carolina. The estimations are performed using nonlinear difference-in-difference models where groups are identified by whether the employee achieved a ≥5% weight loss (treated) or not (control) and the treatment variable indicates preweight and postweight loss intervention. The outcomes analyzed are the average quarterly (90 d) amount of medical claims paid by the health insurer, number of days missed at work during the past month, Stanford Presenteeism Scale SPS-6, and the EQ-5D-3L measure of HRQOL.

Results: We find statistical evidence supporting that ≥5% weight loss prevents deterioration in EQ-5D-3L scores by 0.026 points (P-value=0.03) and reduces both absenteeism by 0.258 d/mo (P-value=0.093) and the likelihood of showing low presenteeism (Stanford SPS-6 score between 7 and 9) by 2.9 percentage points (P-value=0.083). No reduction in medical expenditures was observed.

Conclusions: Clinically significant weight loss among overweight or obese employees prevents short-term deterioration in HRQOL and there is some evidence that employee productivity is increased. We find no evidence of a quick return on investment from reduced medical expenditures, although this may occur over longer periods.

Supplemental Digital Content is available in the text.

*Health Services and Systems Research Program, Duke-NUS Graduate Medical School, Singapore

School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC

Supplemental Digital Content is 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 Website,

Supported by NHLBI R01-5-34396, CDC R01-DP000102.

The authors declare no conflict of interest.

Reprints: Marcel Bilger, PhD, Health Services and Systems Research Program, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.