Rival Country Fat Australia still going backwards!

Bosses weigh up fat workforce
Tuesday, September 18, 2007
Overweight workers are costing Australia billions in lost productivity. Now employers are starting to weigh in. By Katherine Fleming.
Each day, thousands of Australians drive to the office, catch the lift to their floor and sit down at their desk. They switch on the computer and stay glued to it for most of the day, maybe getting up to sit in a meeting room or grab lunch, a soft drink or calorie-laden snack from the office vending machine.
The modern workplace is often not conducive to a trim figure. A recent Australian study confirming the link between a worker's weight and time spent sitting at a desk labelled it a "potentially hostile environment in terms of overweight and obesity". But now, the office is emerging as a key battleground in the war against Australia's ballooning waistline, as employers begin to realise the impact of poor health on their bottom-line.
The economic cost of obesity was estimated at $21bn a year, including $1.7bn in lost productivity, by Access Economics late last year. Another study, by Medibank Private, puts the cost of unhealthy workers at $7bn a year.
Professor Don Iverson, from the Health and Productivity Research Centre at the University of Wollongong, says the mounting evidence provides economic rationale for businesses to help employees manage their weight. "If you're overweight, you have significantly more days off, you have a much higher risk of having disability - lower back pain for example - and while you're at work your productivity on average tends to be around 15% to 20% less than people who aren't overweight," Iverson says. "It costs the company money, if you want to be brutal about it. But good workers are an asset and companies want to maintain them."
The statistics on Australia's battle with the bulge are staggering despite being oft-repeated: almost 63% of women and more than 72% of men are overweight or obese, putting them at higher risk of conditions like diabetes, heart disease and some cancers.
Australians have gained on average 10kg each in the 15 years to 2005, with women's waists expanding 16cm and men's 12cm. The World Health Organisation estimates that if we continue at current rates, overweight levels will reach 70% for women and almost 80% for men by 2015. In the US, one of the few countries with more overweight people than Australia, corporations take a keen interest in programs to reduce employees' weight and the subsequent risk of developing disease as they pay for health insurance. In Australia, the incentive is not as clear-cut, and business has been slower to catch on.
Boyd Swinburn, professor of population health at Deakin University, says the impact on cost and productivity has seen obesity prevention and management "get a guernsey" here. "The direct financial impact is not as great as it is in the US but, nevertheless, companies have realised a healthy workforce is very important to increased productivity," he says.
Several large companies have "wellness programs" for workers, including some banks, the Australian Taxation Office and Energy Australia, BHP Billiton and Rio Tinto. Strategies include bike racks, walking challenges and subsidising exercise programs.
Weight Watchers runs a workplace program, with clients including Commonwealth Bank, Star City Casino and Zurich Financial Services. "Employers realise [health] influences the positiveness of their employees, as well their bottom line," says program director Belinda Dimovski.
In a major report released late last month, PricewaterhouseCoopers concluded there were "quantifiable benefits from using wellness programs to attract and retain talented healthy employees ... The economic case for prevention is overwhelming."
But Queensland cardiologist Dr Geoff Holt, medical director of Wesley Corporate Health, which provides health services, including weight management, to businesses, says many organisations still refuse to treat workplace health in a strategic way.
"I have been personally surprised that some major companies [in Australia] don't have a serious, significant and strategic interest in employee health," Holt says. "I've been observing these trends for 17 years. Things are better, but it depends on the leadership of the organisation. I am always astounded when companies don't champion health as a priority.
"With full employment, you need to be the best employer. Most employers know that. I don't know how to challenge them further. If boards of companies in Australia don't have wellness high on their agenda, I think they're letting their shareholders down."
But Dr John Lang, managing director of workplace health company Good Health Solutions, believes the mood is changing. Lang's clients include ANZ, Commonwealth Bank and Boral. "The big issue for us has been the move from the warm and fuzzy space. We used to talk to companies considering themselves employers of choice or considering it good corporate citizenship to assist their employees to live a healthy life," Lang says.
"There has been a massively accumulating bunch of data here in Australia and in the US linking health to productivity. Now instead of just dealing with that employer of choice, we are dealing with hard-nosed bean-counters who say, 'if we spend this much, what will we get?'
"Ten or 15 years ago, it was common for companies ... to say personal health is not the responsibility of the organisation. Now they're saying if health impacts on productivity, illness and absence and those key business outcomes, it is the responsibility of the company."
Lang's company's research shows that high body mass index (BMI), a measurement of overweight, is the best overall predictor of poor health. Results of its recent survey of more than 3000 employees from 22 organisations, released exclusively to The Bulletin, found male managers are most likely to be overweight, at a rate of 68%. It also found many workers are in denial. Only 12% believe they're overweight, but when height and weight data is collected, the actual number is 50%.
Not only are those employees at higher risk physically, the survey found they're less likely to see a career path, feel less committed to work and less satisfied in their job.
Professor Ian Caterson is a leading obesity expert and head of the newly established Institute of Obesity, Nutrition and Exercise at the University of Sydney. He says tackling the overweight problem will require a multi-pronged approach, including changing urban planning so people have places to exercise, simplifying food labelling and making fresh food more affordable.
Caterson also rates highly the introduction of financial incentives to promote good health. "One thing that is important, and treasury [departments] are realising this, is encouraging healthy workplaces, like having tax breaks for companies that put in a gym and then encourage you to use it," Caterson says. For example, companies could give workers flexible hours or some free time to use the gym and receive a tax break for putting it in if a certain number of staff use it regularly.
"Invariably, some people will need to lose a lot [of weight] but most of us need to lose that 5kg, by having either work incentives or making it easier to get public transport or walk to work or having fresh fruit available," Caterson says. "My personal [preference] would be economic incentives to put in healthy eating in workplaces but there are a whole range of practical things."
Steve Pratt, co-ordinator of nutrition and physical activity at Cancer Council WA, says while some companies have the "Rolls-Royce" of workplace health programs, including gym memberships, "there are changes that can be made that cost nothing".
A UK study published recently in the American Journal of Health Promotion showed that posting signs saying "Take the stairs" or "Seven minutes of stair-climbing protects your heart" on shopping centre stairs led to a 190% increase in people using them over six weeks. It's an example Pratt uses to show simple things can be effective.
"It is about those structural barriers and enablers, like having the stairs open. There are a range of things that an organisation can do that encourage staff to be healthier, like flexible working hours if people do want to exercise in their lunch break, or nutritional and catering policies if you're providing lunch or morning tea," he says.
Experts agree that office vending machines for soft drinks and junk foods have to go. Holt says it's akin to having one for cigarettes. "Those vending machines should supply water and nutritious foods. There should be fruit available. Nutritious lunches should be available, not this fast, fatty food you find in the majority of canteens," he says. "You only need an extra 100 calories a day - a slice of bread - to put on 5kg to 10kg in a year.
"It is what we eat that's killing us ... we are more affluent and living in this so-called 'cafe society' where everywhere you go, you have takeaway food options that are often dense in calories. We can't just continue to do the same amount of exercise that we did. We, as a nation, have to do more because I don't believe we are likely to reduce our food intake."
Swinburn says literature on current workplace health programs shows the impacts are "modest, which is disappointing". He believes changing office eating habits is more likely to be effective than trying to dramatically alter work patterns. "There may not be a lot of room to move in reality. The increasing level of inactivity in the workplace is largely to do with the mechanisation and computerisation and automation of the jobs we do.
"We're at work for a fair chunk of our lives and, if that is increasingly sedentary, that is one of the major drivers of the [overweight] epidemic. But drivers are not always solutions. There is no way in reality we are going to pull back on automation in the workplace. The more potent thing companies can do is about food policies and what they have in vending machines or in the cafeteria, or having some nutritional guidelines on the food served if they have work functions."
Lang argues the key is making healthy choices easy, saying it is harder than ever for someone to be healthy and lean. "It's only the zealots who are able to keep it going. The barriers to healthy behaviour are becoming so high that it requires a high level of motivation and commitment to maintain good health. Year by year, people fall off the perch and become one of the unhealthy ones."
In an editorial in The Medical Journal of Australia last year, International Diabetes Institute director Professor Paul Zimmet made a blunt assessment of Australia's efforts to curb obesity. "We are facing a seemingly unstoppable juggernaut of obesity and diabetes," he wrote. "This epidemic is guaranteed to continue, unless we accept that the decades-long reliance on health promotion and intense media coverage of obesity have had virtually no effect."
To continue as we are is not an option. If left unaddressed, Zimmet says, Type 2 diabetes - the fastest growing epidemic in human history - will bankrupt entire nations. The associated renal disease alone will cripple our health system, adds Ian Caterson. Already, expanding waistlines are thwarting hard-won medical advances. Recent results from the EUROASPIRE study found a substantial increase in key risk factors for heart attacks, including high blood pressure and poorly controlled diabetes, despite effective drugs.
Still, Zimmet is optimistic we're on the right track. The weight epidemic has become an important political issue in recent years. Both the government and opposition have policies to tackle it, including matching pledges last week to consider subsidising weight-loss programs. "If anything, there has been a lot of momentum," Zimmet says. "There are self-interest groups - I call them the food Taliban - who are totally obsessed with the idea of changing [junk food] advertising on TV without looking at the big picture. It is not a single issue that is causing the crisis."
Caterson says the problem is that everyone, including governments, want to know what's proven to work. "We have to say that very little has been tried but education doesn't work, so if you're telling us you're going to put out another pamphlet, that doesn't work."
Despite the enormity of the issue, Caterson is upbeat. "Yes, it's a problem. But we're better off than we were five years ago and I hope we'll be better again in another five years."