Our book title Surviving Workplace Wellness was intended to be figurative, but a new study shows it should be taken literally.
In the issue of Annals of Internal Medicine published today, a study of tens of thousands of people shows that a low BMI is associated with a higher death rate than all except the highest BMIs in women. In men, the lowest quintile of BMIs is associated with the highest death rate.
The study also shows that BMI is a poor predictor of death, as compared to body fat composition. This conclusion mirrors that of another study published last month.
Once again, the wellness industry strikes out. Their obsession with reducing BMI might actually be leading to a higher death rate among their customers’ employees. We say “might” because the study was careful to say that low BMIs “were associated with” a higher death rate, not “led to” a higher death rate. Wellness vendors and consultants love to conflate correlation and causality, but we can easily resist that urge, thanks to our triple-digit IQs.
Naturally, ShapeUp is one of the worst offenders. As you can see, they automatically associate “improved health” with lowering BMI.
So is workplace wellness killing people by getting them to reduce their BMI? Unlikely. It’s not just that the link may not be causal. There is a more important reason: ironically, wellness is too ineffective to harm people. Since basically no one ends up actually keeping the weight off using the pay-for-performance methods embraced by wellness promoters, there is no meaningful long-term reduction in BMIs. So even if low BMIs caused premature death, employees have nothing to fear from these programs.
And even those poor Highmark employees subjected to ShapeUp’s get-thin-quick scheme advertised below probably have nothing to worry about: the “163 employees” mentioned above only represent about 1.5% of participants, and given that Highmark fired ShapeUp, it’s likely that most of them gained the weight back anyway.
They Said What? 
Excellent article. It is believed that the reason people with mildly elevated BMI have a mortality advantage is that they are more likely to survive a serious illness.
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I think you are right about that but we like to stay within the confines of what the data says.
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Don’t you think you have an unfair advantage in these back-and-forth discussions due to your “triple digit IQs” ?
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On the other hand, we often recommend to these wellness people that they have their material reviewed by a smart person before they publish it. However, judging from what gets published and posted, it’s fair to conclude that most vendors and consultants ignore that recommendation.
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Doy! Low BMI could easily mean little muscle, which could be related to a sedentary lifestyle and poor diet. Which once again proves how useless BMI is as a measure of anything, and how clueless and reckless most of the wellness vendors are
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In future posts it’d be good to see more mention of your point on body composition, one your compatriot Vik mentions. For example two people of the same height and weight could be per BMI, overweight. If one however has a waist circumference 1/2 or less of their height, it is likely they are actually lean and muscular. The Shape-Ups and others of the world would tell both to lose weight. Yikes……
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