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Beyond the Scale: Incorporating a Weight-Neutral Approach into Worksite Health Promotion Programs

Kylie Peterson, MPH, CHES®Diversified Insurance GroupDirector of Health and Wellbeing

Hello!

I’m Kylie PetersonI’m passionate about promoting wellbeing for all employees regardless of shape or size, and Ibelieve that inclusion and compassion are the key to helping people improve their health

Presentation Objectives

1.Gain a foundational understanding of weight research and identify the habits and behaviors that contribute to adverse health outcomes

2.Recognize weight bias in the workplace and learn how to promote an organizational culture of caring and inclusion

3.Apply a weight-neutral, evidence-based approach to the following worksite wellness program components: biometric screenings, health promotion challenges, and employee health education

Discern between behaviors and outcomes

1.The Science Behind Weight and Health

State of the (Health) Union

■ Between 2007-2008 and 2015-2016, rates of obesity rose from 33.7% to 39.6% among adults4

■ Chronic diseases are responsible for seven out of 10 deaths in the U.S.10

■ The healthcare costs associated with chronic conditions are equal to $3.5k per person14

However...

■ BMI is not a reliable predictor of morbidity and mortality6

■ Overweight and active individuals are generally healthier than their thin and sedentary counterparts12

■ 1/4 of those with a normal BMI have risk factors for chronic diseases2

■ 80-95% of dieters regain lost weight5

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Obesity is Multifactorial and Complex

Socioeconomic and Cultural

Factors

Genetic and Biological

Factors

Individual Behaviors and Environmental

Factors

Create a culture of caring and inclusion at work

2. WeightBias in the Workplace

Weight Discrimination

■ Weight bias has been associated with adverse health outcomes including anxiety, depression, low self-esteem, and increased mortality risk1

■ Those living with obesity are treated unequally at work and within the healthcare system because of their size9

How Does this Present in Corporate Culture?

■ Wellness program risk levels and associated surcharges

■ Attitudes, beliefs, and rhetoric surrounding food choices, lifestyle habits, appearance, etc.

■ Crash-dieting contests■ Focus on attaining a cosmetic ideal

Who Needs to Improve their Health?

Everybody, regardless of size or weight, can improve their health by:

◈ Getting enough sleep◈ Eating more fruits and vegetables◈ Reducing alcohol intake◈ Eliminating nicotine products◈ Moving for 30 or more minutes a day◈ Managing daily stressors and getting care for

ongoing mental health issues

Food for ThoughtEven if there were a direct, measurable link between extra weight and adverse health outcomes 100% of the time, what would be the benefit or purpose of

shaming and mistreating our fat colleagues?

Promote healthy behaviors and habits for all employees

3.Application of Weight-Neutral Approaches

From Weight to Wellbeing

■ Mental health resources and programs

■ Financial wellness■ Organizational health focus■ Social connectedness■ Community service

Biometric Screenings

■ Privacy is a priority■ Consider removing weight and/or

BMI as a screening metric○ Consider a blind weigh-in

■ Add a mental health component to your screenings

■ Focus on blood cholesterol, blood pressure, and fasting glucose

Health Promotion Challenges

■ “Biggest Loser” contests○ Replace with a walking or other activity

challenge○ Sponsor a charity walk or run

■ “Maintain, Don’t Gain” holiday challenges○ Replace with a gratitude, mindfulness,

service, or joyful living challenge○ If you still want to address physical health

or nutrition, host a healthy holiday potluck

■ “Beat Sweets” challenges○ Replace with a fruit and vegetable challenge

or a “real food” initiative○ Make environmental changes

■ Calorie tracking tools○ Can promote disordered eating, especially

among employees with a history of ED○ Promote budget and money tracking tools

instead!

Health Promotion Challenges (cont.)

Health Improvement Programs

■ Weight loss programs are not inherently bad

■ How do your insurance carriers and other vendors approach weight loss?

■ Look for programs with stamps of approval from reputable medical organizations

Employee Health Education

■ Hire onsite fitness instructors that represent a myriad of body types

■ Become familiar with your wellness vendor’s health education modules

■ Be mindful of how you communicate wellness initiatives

■ Promote non-diet approaches

In Summary

Fat ≠ Lazy, Immoral, or UnhealthyIt’s not possible to ascertain someone’s health, value, or lifestyle simply by looking at them

Become Familiar with Your Own BiasesRecognize judgemental thoughts and attitudes, and consider how the society we live in has shaped these beliefs

Kindness and Compassion are a Best PracticeAlmost no one's health improves in the face of shame, guilt, stigma, or discrimination

Create Inclusive Program MaterialsWork with your wellness vendor or wellness committee to create health promotion initiatives that include everyone and avoid singling out employees in larger bodies

Promote Mental Health and Financial Wellness ResourcesHealth is more than exercise and nutrition; apply a holistic health philosophy to your program and encourage employees to manage stress, save money, and connect with loved ones

Focus on Health, Not WeightAdopting healthy behaviors such as eating more fruits and vegetables, increasing physical activity, and cutting back on alcohol can improve biometric markers of health, regardless of whether weight loss is achieved

““The only way to solve the weight problem is to stop making weight a problem—to stop judging

ourselves and others by our size. Weight is not an effective measure of attractiveness, moral

character, or health. The real enemy is weight stigma, for it is the stigmatization and fear of fat

that causes the damage and deflects attention from true threats to our health and well-being.”

― Linda Bacon, Health at Every Size®

Thanks!

Any questions?Kylie Peterson

Diversified Insurance Group

kpeterson@diversifiedinsurance.com

References

1. Alberga, A.,S., Russell-Mayhew, S., von Ranson, K., & McLaren, L. (2016). Weight bias: A call to action doi:10.1186/s40337-016-0112-4

2. Bombak, A. (2014). Obesity, health at every size, and public health policy. American Journal of Public Health, 104(2), e60-7. doi:10.2105/AJPH.2013.301486 [doi]

3. Dollar, E., Berman, M., & Adachi-Mejia, A. M. (2017). Do no harm: Moving beyond weight loss to emphasize physical activity at every size. Preventing Chronic Disease, 14, E34. doi:10.5888/pcd14.170006 [doi]

4. Hales, C. M., Fryar, C. D., Carroll, M. D., Freedman, D. S., & Ogden, C. L. (2018). Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. Jama, 319(16), 1723-1725. doi:10.1001/jama.2018.3060 [doi]

5. Mann, T., Tomiyama, A. J., Westling, E., Lew, A. M., Samuels, B., & Chatman, J. (2007). Medicare's search for effective obesity treatments: Diets are not the answer. The American Psychologist, 62(3), 220-233. doi:2007-04834-008 [pii]

6. Nuttall, F. Q. (2015). Body mass index: Obesity, BMI, and health: A critical review. Nutrition Today, 50(3), 117-128. doi:10.1097/NT.0000000000000092 [doi]

7. Ochner, C. N., Tsai, A. G., Kushner, R. F., & Wadden, T. A. (2015). Treating obesity seriously: When recommendations for lifestyle change confront biological adaptations. The Lancet.Diabetes & Endocrinology, 3(4), 232-234. doi:10.1016/S2213-8587(15)00009-1 [doi]

8. Phillips, C. M. (2013). Metabolically healthy obesity: Definitions, determinants and clinical implications. Reviews in Endocrine & Metabolic Disorders, 14(3), 219-227. doi:10.1007/s11154-013-9252-x [doi]

References

9. Puhl, R. M., & Heuer, C. A. (2009). The stigma of obesity: A review and update. Obesity (Silver Spring, Md.), 17(5), 941-964. doi:10.1038/oby.2008.636 [doi]

10. Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the united states: A visual analytics approach. International Journal of Environmental Research and Public Health, 15(3), 431. doi: 10.3390/ijerph15030431. Print 2018 Mar. doi:431

11. Roehling, M. V., Roehling, P. V., & Pichler, S. (2007). The relationship between body weight and perceived weight-related employment discrimination: The role of sex and race. Journal of Vocational Behavior, 71(2), 300-318. doi:https://doi.org/10.1016/j.jvb.2007.04.008

12. Sui, X., LaMonte, M. J., Laditka, J. N., Hardin, J. W., Chase, N., Hooker, S. P., & Blair, S. N. (2007). Cardiorespiratory fitness and adiposity as mortality predictors in older adults. Jama, 298(21), 2507-2516. doi:298/21/2507 [pii]

13. Sutin, A. R., Stephan, Y., & Terracciano, A. (2015). Weight discrimination and risk of mortality. Psychological Science, 26(11), 1803-1811. doi:10.1177/0956797615601103 [doi]

14. Tinker, A. How to Improve Patient Outcomes for Chronic Diseases and Comorbidities. Available online: http://www.healthcatalyst.com/wp-content/uploads/2014/04/How-to-Improve-Patient-Outcomes.pdf (accessed on 30 March 2019).

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