How to Create a Skinny Operation

You’re not helping employees eat better if staff lunches, cafeterias and vending machines tempt them with unhealthful choices.

By Adrienne Fox October 1, 2010

October coverThe very tools that can help your company be more efficient and profitable may also be helping to expand your employees’ waistlines. Technology, computers and complex machinery have led to more efficient yet sedentary employees. Relatively cheap gasoline lowers manufacturers’ costs but makes it economical to drive short distances rather than walk. Dual-income households result in a larger labor pool but less time to shop for groceries. And longer hours at the office leave less time for preparing and eating nutritious home-cooked meals.

Inactivity, eating on the go and stress threaten employee health—and long-term corporate health. In the United States, where about two-thirds of the population is obese or overweight, the annual economic cost of obesity—which includes the costs of insurance, paid sick leave and workplace injuries—is $12.7 billion, according to a 2005 study on food at work by the International Labour Organization of the United Nations.

In particular, the Health Enhancement Research Organization in Birmingham, Ala., found that obese employees—those with body mass indices greater than 29—spend 77 percent more on medications than non-obese employees do. Furthermore, 72 percent of those medications—for conditions such as Type 2 diabetes, high blood pressure and high cholesterol—could be eliminated if the employees would lose weight, exercise more and eat better.

And, a 2008 study published in the Journal of Occupational and Environmental Medicine found that moderately obese employees with body mass indices of 30 or higher experienced a 4.2 percent loss in productivity because of weight-related health problems. That equals $506 in lost productivity per worker per year.

The International Labour Organization study concludes that better nutrition in the workplace can raise productivity, reduce sick days and cut the number of accidents.

To find out what obese workers cost your company, see the online version of this article at for a link to the Centers for Disease Control and Prevention’s Obesity Cost Calculator.

"Employers have figured out that the underlying cost of unhealthy employees is significantly interfering with their ability to run their businesses," says Elisa Mendel, national vice president, HealthWorks and Product Innovation at Kaiser Permanente in San Francisco. "There is a huge movement afoot to change this, and the attention is shifting to food choices."

That shift is happening in break rooms, conference rooms, cafeterias and vending machines. "Employees are at work 2,000 hours a year, and we as health care providers see them only two to three hours per year," Mendel notes. "In terms of really influencing behavior, companies have a much better shot at it than we do."

Susan Albers, a psychologist at the Cleveland Clinic who specializes in weight issues, agrees: "You spend most of your day at work. And it’s the place where you’re most susceptible to mindless eating and stress eating."

Healthful Eating’s Hurdle: The Workplace

In 1998, the concept of eating to cope with stress sparked Chris Mittelstaedt of San Francisco to come up with the idea for The Fruit Guys, a company designed to provide healthful food options to programmers subsisting on candy bars and soft drinks. The Fruit Guys now delivers fresh fruit to thousands of worksites across the country from three facilities.

Mittelstaedt sees a growing desire among leaders at larger companies with existing wellness programs to help employees eat better at work. One client, Virgin America airline, has 1,300 flight crew members and other employees who struggle to find healthful fare amid airports’ fast food and sticky buns. In February, The Fruit Guys started delivering fresh fruit to 10 employee lounges in airports and to airline headquarters in San Francisco.

Executives "are realizing that they need to inspire change in employee behavior through accessible means," Mittelstaedt explains. If a leader plans ahead and makes healthful food accessible, employees will choose to eat better, he says.

Overweight vs. Obese

There are no accepted, universal definitions of "obese" and "overweight." The federal Centers for Disease Control and Prevention in Atlanta states that a body mass index of 30 or higher means the person is "obese"; 25 to 29 means "overweight." Other organizations, such as the International Labour Organization, categorize 25 to 29 as "mildly obese."

Psychology, culture and the work environment all play roles in eating well at work. For wellness initiatives to achieve positive return on investment, they need to take into account all three, says Garry Lindsay, senior program officer at Partnership for Prevention, a nonpartisan group based in Washington, D.C., advancing disease prevention and health promotion policies.

Lindsay says wellness initiatives usually include health risk assessments, nutritional seminars, on-site weight loss programs and discounts for gym memberships. But those programs can be undermined by commonplace food policies that underwrite ice-cream socials, doughnut breakfasts, and pizza-and-soda events for employees.

Paul Terry, president and chief executive officer of StayWell Health Management, a wellness consulting firm in St. Paul, Minn., is a health coach who hears complaints from clients about the people who pay for his services—employers. One client said her employer is the biggest barrier to weight loss. "I thought ‘how strange’ since it’s the employer who funded this program," he recalls.

"She explained that the company is constantly rewarding employees’ performance with food—junk food. It made it impossible for her to stay on target with her weight loss goals."

Terry concludes: "To provide a health coach and have a wellness initiative or a Weight Watchers at Work program, only to sabotage your employees’ progress with company-sponsored junk food, is not great policy."

Saying Yes to Yogurt

Getting the wellness initiative and the food policy on the same track was Sumit Sethi’s goal when he joined Radian Group Inc. last December. Radian is a Philadelphia-based mortgage insurer with self-insured employee health coverage. Leaders in the C-suite wanted to make the availability of healthful food options at work one of the HR department’s top strategic objectives for 2010.

But when Sethi, the wellness and engagement manager, lobbied executives to replace the usual Philadelphia soft pretzels and water ice—a frozen dessert—with baskets of fruit for the wellness launch event, he met some resistance. Once he reminded leaders that better eating was a top priority and that the event gave them the opportunity to introduce healthful options to employees, they were on board.

The morning of the launch, fruit baskets were delivered to each floor. The gesture was well-received. "The next corporate event was the Fourth of July, and we usually provide water ice and ice-cream sundaes. But this year, we did fruit and yogurt parfaits," he explains. Again, employees voiced pleasure with the treats.

Sethi makes sure all corporate events reflect the message of healthful eating. A Radian team participates in the Philadelphia Dragon Boat Festival each year and sponsors a cookout afterward. This year, granola bars, fruit and yogurt replaced breakfast sandwiches for racers, and mayonnaise-based salads were exchanged for green salads alongside grilled meats.

Sethi also added a category for healthful baked goods to the annual Radian bake sale competition and charity fundraiser. Next on the agenda: He is working with a community-supported agriculture co-operative to set up an on-site farmers’ market.

Radian no longer pays for soft drinks at corporate events or meetings; instead, the company provides water and 100 percent fruit juices. "In HR staff meetings, we used to order pizza," Sethi says. "We moved first to whole wheat pizzas with vegetable toppings and now order salads and healthier sandwiches."

He doesn’t require managers to order only healthful food for catered meetings, but he does educate them on where to find it. "We struggle to find fun, healthy treats, so I know how hard it is for managers, too," Sethi says. "I can understand companies that give up and go with what’s always been done because it is a struggle to find a variety of healthy options."

Steering Employee Choice

Because fresh food is perishable and costlier to transport, it is more expensive. If healthful food costs the company more, Lindsay says, one strategy is to increase the volume of sales by pricing it lower than less-nutritious food. He points to Dow Chemical Co. and Pitney Bowes as examples of companies that have raised the prices of snacks in vending machines and cafeterias and lowered the prices of healthful foods to steer employees in the right direction.

Behavioral economists call that strategy paternalistic libertarianism—and it usually works. In January, the Journal of Occupational and Environmental Medicine published a study on pricing and availability intervention in vending machines at four bus garages. The researchers found that increasing the availability of healthful items by 50 percent and reducing their prices an average of 31 percent led to sales increases of 10 percent to 42 percent.

"Greater availability and lower prices on targeted food and beverage items from vending machines was associated with greater purchases of these items over an 18-month period," the study concludes. "Efforts to promote healthful food purchases in worksite settings should incorporate these two strategies."

The Mayo Clinic’s HR professionals kept healthful options in the vending machines and cafeterias comparably priced with less-healthful items. "It would be cheaper to offer pastas and potatoes instead of fish and fruit," says Robert McGriff, HR analyst. "But employees have told us that providing the healthier food items shows Mayo cares about their health, and also that it’s expected from a health organization."

Once managers see that employees will eat the healthful food and that they are happier and more productive, managers start increasing their investment, Mittelstaedt has found. "The ratio starts with half healthy and half unhealthy, and then they realize people are eating less of the junk food," he says. Then leaders say, " ‘Let’s put all our money in the healthy food, and if employees want to bring in junk, they can at their own expense.’ "

Calling In the Food Police

Encouraging better eating is one issue; mandating it is a line few HR professionals want to cross. Deciding where to draw the line usually comes down to whether the employer or the employee pays for the food.

"When we couldn’t find a vendor who could stock our vending machines with healthy choices, we yanked [the machines] out," Terry says. "There were plenty of people who were quite annoyed—even health coaches: ‘What do you mean I can’t have easy access to junk food when I don’t have a weight problem?’ We say, ‘You can buy and bring in all the junk food you want, but I, as an employer, am not going to provide it or pay for it.’ "

As for potential backlash, Mittelstaedt takes a "bring it on" stance. "A company should take the mantle of the ‘food police’ and wear it proudly," he insists. "If the company is paying for the food or subsidizing it, then absolutely it is legitimate policy."

Many HR professionals disagree. When asked if it is HR professionals’ responsibility to regulate the food and beverages available to employees to encourage better eating at work, only 36 percent of 570 HR professionals said yes, according to a July poll by the Society for Human Resource Management.

"It takes guts for a leader to change the composition of what’s available in the food service and to challenge their colleagues to change how they reward or bond with employees," Terry says.

Lindsay advises managers to explain the reasons behind the nutrition policy and send the message that this policy is good for all employees—not just overweight ones. "Sodas and junk food affect healthy people too in mental acuity, poor sleep, lack of energy and lowered productivity," he says. "Eating healthy means you live a longer, healthier life to enjoy your retirement."

For executives who resist, explain how this policy adds shareholder value through productive, healthier employees, Lindsay adds. "Companies that make this investment understand this, and that’s why they spend the money."

Return on Nutrition

Tying healthful-food policies directly to the bottom line is difficult, however. "Studies have well-established the bottom-line effects of wellness initiatives," Terry says. In fact, in February, Harvard University researchers published a meta-analysis of 52 studies that looked at the return on investment of wellness on employee health care costs, reduced employee absenteeism or both. The study found that medical costs fall about $3.27 for every dollar spent on wellness programs, and absentee costs fall by about $2.73 for every dollar spent. Nevertheless, "It’s hard to say whether the nutritional aspect of a wellness initiative alone reduced health care costs, sick days or workplace accidents, and increased productivity," Terry reflects.

Avoided costs are also hard to measure, McGriff adds. "How do you measure someone who has avoided diabetes or a stroke because of our nutrition plan? Employees tell us in health assessments that they are experiencing illnesses at lower rates, and that evidence is enough for right now. But we want to get 10 years of data comparing the health of our employee population to that of an employee population of our size."

Assurant, a New York-based insurance and asset management firm, has data showing that employees who completed its health coaching program to lose weight each reduced their health risks an average 14 percent in one year, according to Sheila Sweeney, vice president of benefits.

Jessica Elhy, internal auditor at Assurant in Milwaukee, is one of those employees. She lost 50 pounds in seven months on the Weight Watchers at Work plan. Membership fees were subsidized at 50 percent by Assurant.

"Part of the reason I was able to lose the weight is because of the support from my employer," Elhy says. "I’ve maintained the weight loss because my employer makes it so easy to keep up a healthy lifestyle. My previous employers had wellness programs, but they weren’t as well-known or as comprehensive."

Slow Cooker

Even when employees and leaders understand that having healthful food at work benefits them and the company, progress is often slow, according to HR professionals.

The first step to making a change, Lindsay says, is to audit the number of on-site vending machines, cafeterias, and catered events and meetings, and measure the healthful options. Then, try to get the percentage of healthful options up to 60 percent in a period of time as vendor agreements come up for renewal. "You can’t do it overnight, but you don’t need to get to 100 percent healthy to make a difference," he says.

"My approach to wellness is driving the cultural change, and I believe it can only be done slowly," Sethi says. For instance, "We will move to the point where we no longer reimburse departments for ordering unhealthy food, but we’re not there yet. You have to wait for the culture to get to a point where that kind of a change isn’t a shock but what people are already doing."

McGriff advises HR professionals to look within their organizations to find people who have that knowledge and are passionate about wellness, and get their support and ideas. "Have realistic expectations," he says. "You can’t revolutionize the culture in six months. Celebrate small successes—but not with cupcakes—in the knowledge that they will convert to larger victories in the future."

Eventually, what’s deemed acceptable by society as a whole may move company policies forward. "Not that long ago, people had three-martini lunches and smoked cigarettes in the office," Mendel points out. "Today, that behavior is either frowned upon or banned. I think in the future people will feel the same way about pizza and sodas at work."

The author is a contributing editor and former managing editor of HR Magazine.

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