In his talks, Glennon cites a Duke University study, "Obesityand Workers' Compensation," that found that obese employeesexperience more than twice the number of claims ofrecommended-weight workers. Additionally, workers' compensationclaims involving obese employees are 2.8 times more expensive thanclaims for employees of normal weight, according to statistics fromthe National Council on Compensation Insurance. As the claims age,the costs go up: At five-year maturity, "obese" claims are 5.3times more expensive than "non-obese" claims.

Numerous factors contribute to the higher medical costs, such asmedications dosed according to individual body weight. It takes 295units of the powerful antibiotic Cubicin to treat a 130-poundindividual, for a cost of $590 per treatment. However, it takes 800units ($1,600) to treat a 350-pound claimant. Equipment is anotherfactor. Durable medical equipment for bariatric patients costs 35to 45 percent more than for normal weight claimants. However,perhaps the highest cost drivers are the co-morbidities associatedwith obesity, such as diabetes, cardiovascular and arterialdisease, and orthopedic issues drive medical costs.

"Every 10 pounds of body weight increases the force on yourknees by 30 to 60 pounds with each step," Glennon said. "That wasthe statistic that finally got my attention."

Bringing It Home
Glennon felt hypocritical talking about obesity while notaddressing the extra pounds he was carrying. So when TMS' HumanResources Administrator Julie Baez suggested a company-wide"Biggest Loser" contest, he was quick to sign up. The whole companygot involved, including the financial analyst who worked out thebody mass index (BMI) loss formula.

Twenty-four employees, grouped into teams based on their BMI,lost more than 400 pounds in 12 weeks. While individuals workedtheir own weight-loss plans, success was measured by a team's totalweight loss. The "losers" weighed in and gathered for a salad barlunch once a week. The team that lost the most weight that weektook home a pedometer, water bottle or other fitness-orientedprize.

Unexpected Gain
The BMI-centric team assignments brought together people whosepaths did not normally cross at their jobs at TMS. "People who hadseen each other at work but never really talked to each other endedup on the same team," said Baez. "Teams united entry-level stafferswith senior managers. We all gained new insight into the variousjobs we do and a greater appreciation for each other. It wound upbeing a great team-building exercise."

TMS colleagues started working out and grocery shoppingtogether. Weight loss tips and information on foods that rev themetabolism began flying across the e-mail system.

The program was so successful that the company started a second12-week program in May. This time, points were assigned to eachhalf-hour of exercise logged by a team member. The team with thehighest number of exercise points deducts a pound off their weeklyweight loss, enabling people who are close to their goal weight tostill contribute to their team's progress.

"Our 'Biggest Loser' program is a total winner," said Glennon."Our employees are leaner and have become a much tightergroup."

Glennon, who has lost more than 65 pounds since the beginning ofthe year, noted that the program heightened awareness of obesity inmanaging claims. "Weight is such a huge factor in selectingrehabilitation and other medical-related equipment. Most equipmentis designed to support only 250 pounds. After that, you need tolook at specialty equipment to safely accommodate patients' needs,"he said.

In addition, obese surgical patients are at higher risk forblood clot formation and may not have the stamina to participatefully in a recovery program to return to work or even functionalindependence. Diabetes, a common co-morbidity, interferes withwound healing. "A wound in the lower extremity of a normal-weightindividual will usually heal nicely in a matter of weeks and theemployee can return to work fairly quickly," said Glennon. "Asimilar wound in an obese person can turn south and become complexand expensive. It's not uncommon for these claims to drag on forfive or six months, even longer." Additionally, with obeseclaimants, payers need to set higher reserves to accommodate longerrecovery times and the increased expenses.

Employers who need an extra incentive to launch wellnessprograms should consider the impact of obesity on workers'compensation claims. Frequency, duration and costs are at leasttwice as high as for recommended-weight employees. Remember, a fitemployee gets hurt less often than an obese person and recoverstwice as quickly.

Cara Barde is president of Total Medical Solutions.www.newtms.com.