A multi-worksite analysis of the relationships among body mass index, medical utilization, and worker productivity

UMMS Affiliation

Department of Medicine, Division of Preventive and Behavioral Medicine

Publication Date


Document Type



Absenteeism; Ambulatory Care; *Body Mass Index; Cross-Sectional Studies; *Efficiency; Health Promotion; Health Services; Humans; Obesity; United States; Workplace


Behavioral Disciplines and Activities | Behavior and Behavior Mechanisms | Community Health and Preventive Medicine | Preventive Medicine


BACKGROUND: The relationships between worker health and productivity are becoming clearer. However, few large scale studies have measured the direct and indirect cost burden of overweight and obesity among employees using actual biometric values. The objective of this study was to quantify the direct medical and indirect (absence and productivity) cost burden of overweight and obesity in workers.

MEASURES: A cross-sectional study of 10,026 employees in multiple professions and worksites across the United States was conducted. The main outcomes were five self-reported measures of workers' annual health care use and productivity: doctor visits, emergency department visits, hospitalizations, absenteeism (days absent from work), and presenteeism (percent on-the-job productivity losses). Multivariate count and continuous data models (Poisson, negative binomial, and zero-inflated Poisson) were estimated.

RESULTS: After adjusting for covariates, obese employees had 20% higher doctor visits than normal weight employees (confidence interval [CI] 16%, 24%, P < 0.01) and 26% higher emergency department visits (CI 11%, 42%, P < 0.01). Rates of doctor and emergency department visits for overweight employees were no different than those of normal weight employees. Compared to normal weight employees, presenteeism rates were 10% and 12% higher for overweight and obese employees, respectively (CI 5%, 15% and 5%, 19%, all P < 0.01). Taken together, compared to normal weight employees, obese and overweight workers were estimated to cost employers $644 and $201 more per employee per year, respectively.

CONCLUSIONS: This study provides evidence that employers face a financial burden imposed by obesity. Implementation of effective workplace programs for the prevention and management of excess weight will benefit employers and their workers.

DOI of Published Version



J Occup Environ Med. 2010 Jan;52 Suppl 1:S52-8. Link to article on publisher's site

Journal/Book/Conference Title

Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine

Related Resources

Link to Article in PubMed

PubMed ID