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A New Metric for Wellness: Percent Body Weight Lost and Kept Off Through One Year
September 14th, 2012
Prior to the FTC Guidelines change in 2009, the generally accepted practice of the weight loss industry was to share the results of an individual client with the disclaimer, “Results Not Typical.” Since the FTC came out with the new guidelines at the end of 2009, the weight loss industry has had to provide a measure of average performance that a customer can expect to experience within joining that weight loss program. This change was a huge step in the right direction to move from a lack of measurement to a metric that allows potential customers to understand what they can expect average results to look like. Unfortunately, the key metric selected then, which is used dominantly in market today, has significant limitations.
The key metric for communicating program efficacy selected by the weight loss industry to comply with FTC standards was the average pounds lost per week on any given weight loss program. This choice is consistent with the way most customers feel about weight loss, but, ultimately, does not serve their best interests. In fact, this metric is a concise illustration of how the commercial weight loss industry is at odds with the collective best interest of our society in reducing the obesity epidemic. The best customer for the commercial weight loss industry is one who loses weight rapidly, gains weight rapidly, and returns to the program to repeat the cycle. This cycle explains why revenue growth in weight loss has not been correlated with turning the tide on the obesity crisis, as the weight lost is quickly recycled into weight gain.
A new metric we propose is not going to fix these problems, but it can at least focus the conversation on programs that can truly make a difference for individuals and our society over the long term. Our key metric for wellness is: percent of body weight lost at the end of one year.
Why? A week in weight loss is simply not significant. Even a few weeks in weight loss is not very significant in understanding if any given customer has truly taken on a new behavior. Once you measure success using months, patterns become clearer. For anyone who has tried to lose weight, the typical pattern is pretty strong weight loss in the first few weeks up to 3 months, followed by slower weight loss (if a client is still engaged in the program) in the next 3-6 months, followed by the most challenging 6-12 month period where weight maintenance or gain are the general pattern.
In addition to being too short term a metric, using pounds as the way to quantify weight loss, while commonplace, is misleading because it does not take into account the starting point for any given individual. A 400-pound person who begins a weight loss program losing four pounds a week is not doing twice as well as a 200-pound person losing two pounds. Looking at percentage of weight lost is a starting point for addressing these differences.
Combining percentage of weight loss with long-time horizons improves the measure further. We see patterns also differ by gender, with men in general losing weight more quickly. So it is quite possible that a 300-pound man losing three pounds a week and a 160-pound woman losing just a half a pound a week may be on an equally successful track; it is their sustained weight loss over time that will tell the full story.
Finally, a focus on percent of weight also has the additional benefit of putting our daily thoughts around weight loss in the same language as the critical 10% weight loss goal, which studies have shown creates a medically significant improvement in health. For many people, this level of weight loss is far more modest than their desired goal, but achieving it and maintaining it will likely improve their health and quality of life significantly. This achievement has an extensive effect not only for the personal benefits, but also for professional benefits of lowering health care costs.
While the weight loss industry reported profits this year of a staggering $20 billion, obesity numbers haven’t budged. Two-thirds of America’s population is still overweight, and costly related health conditions, including cardiovascular disease, diabetes mellitus, osteoarthritis, and some cancers are soaring. These high numbers put an average company at risk for higher healthcare costs, with 66% of employees shown to be either overweight, obese or struggling with associated conditions.
According to a Duke University study, not only are employers and government finding it increasingly difficult to finance the high costs of obesity-related medical treatments, but additional costs in terms of absenteeism and reduced productive on the job (“presenteeism”) are further adversely affecting firm profitability. Authors Eric A. Finkelstein, Kiersten L. Strombotne, and Barry M. Popkin combined the per capita estimates with obesity prevalence data from full-time employees to generate the aggregate costs of having employees above the healthy weight range. The combined estimated value of medical expenditures, absenteeism, and presenteeism resulting from excess weight among full-time employees, which represents roughly 65% of the civilian labor force, were estimated to be $73.1 billion per year; 82% of this expense was roughly equally split between medical expenditures and presenteeism, and 18% resulted from increased absenteeism.
Breaking down those numbers and assuming a gender balanced work force of 100 employees with equal amounts of healthy weight, overweight and obese employees, yields an average added $1,492 in cost per year for employees above the healthy weight range. The study shows that such obese employees require 700% higher healthcare costs and are 13 times more likely to miss work. These individuals file twice the number of worker’s compensation claims and are 200% less productive at work.
These costs are preventable. Corporations need to combat these statistics by offering holistic programs focused on health results in order to impact the bottom-line cost per employee. The new key metric not only drives the daily monitoring of each client as he or she stays on the glide path towards achieving this goal, but also serves the weight loss program’s cost structure. In the Retrofit Weight Loss business model, the company pays for an additional year of services if clients have not hit their goal and also directly incentivizes each client’s wellness expert team based on whether the client meets his or her year-end goal.
The truth is, the primary motivator for our own firm’s employees counseling clients is the daily relationship with their clients, but the financial structure gives our wellness teams a clear incentive to help clients reach their individually set goals. In a survey of what our staff found most appealing about working for Retrofit, 71.4% said the ability to make a positive impact. Potential bonus compensation ranked lower at 37.1%. The motive in this case is not to simply increase the bottom line, but to positively impact the lives of each client and make daily work truly meaningful in the big picture – for employees as well as clients, who interact frequently.
As clients learn that small changes add up, individual progress aggregates in corporate clients as well. Accounts with just 3-5 clients in a single location begin to build a buzz, as wireless trackers become a focal point for conversation. In a Chicago law firm with 15 staff using our service, they now have a daily "walk the stairs" break at 3:00pm, when most employees are reaching for a snack.
As financial metrics are aligned, this type of cultural sea change will drive down healthcare costs for individuals and employers. Such industry measures to insure client success are working to move the conversation towards long-term weight loss with positive social implications. It’s still early to fully understand the impact this standard for measurement can have, but initial results are promising. More than 90% of individuals can lose weight, with 61% feeling more energy and 51% feeling more confident. Overall, weight losers also report sleeping better, being happier and having an overall better sense of well-being. Now that is the bedrock of a truly sustainable business.
To calculate the impact overweight employees have on your company’s bottom line, click here.