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The reward for showing your wellness program works is now $3 million!

As almost everyone in the wellness industry knows, we have offered a $2 million reward to anyone who can show that conventional annual “pry, poke and prod” wellness saves money. I’m feeling very generous today, what with the holidays upon us, so let’s make the reward $3 million.

Even more importantly, let’s loosen the rules — a lot —  to encourage applicants. You’ll find the $3 million reward is not just more generous, but also far easier to claim than the previous $2 million reward.


Loosening the Rules

Except as indicated below, the rules stay the same as in the previous posting, but with the following relaxed standards. Most importantly, I’ll now accept the burden of persuasion. It is my job to convince the panel of judges, using the standard civil level of proof, that you are wrong, as opposed to you having to convince them that I am wrong.

Next, let’s expand the pool from which the judges can be drawn. It wasn’t very nice of me to allow you to choose from only the 300 people on Peter Grant’s exclusive healthcare policy listserve, since obviously no one invited into a legitimate healthcare policy listserve thinks wellness saves money.

In addition, you can also choose among the 100+ people on Dave Chase’s email list and the 70 people on the Ethical Wellness email list. (www.ethicalwellness.org)  And to make it totally objective, we will add as judges whatever two bloggers happen to be the leading dedicated lay US healthcare economic policy bloggers at the time of the application for the award, as measured by the ratio of Twitter followers-to-Twitter-following, with a minimum of 15,000 followers.

So judges are chosen as follows: two bloggers chosen by objective formula, plus we each choose six people from among the other 460, with the other party having veto rights for 5 of them. That gives a total of 4 judges, who will choose a fifth from among those roughly 500 people.

The original rules included the requirement of defending Wellsteps’ Koop Award.  After all, the best vendor should be exemplary, right? A beacon for others to follow? A benchmark to show what’s possible when the best and brightest make employees happy and healthy?

However, now you have another option. You could instead just publicly acknowledge that the Koop Award committee is either corrupt or incompetent, as you prefer, since that possibility cannot be ruled out as a logical explanation for Wellsteps winning that award. Your choice…

Next, you may bring as many experts with you to address the adjudication forum as you wish to bring.  I, on the other hand, will be limited to myself.

Further, you no longer have to defend the proposition that wellness as a whole has saved money. You can, if you prefer, simply acknowledge that most of it has failed…except you. Meaning that, if you are a vendor that has been “profiled” on this site in the last 2 years, you can limit your defense to your own specific results. You don’t have to defend the swamp.

That new loophole allows companies like Interactive Health, Fitbit, Wellness Corporate Solutions, etc. — and especially Wellsteps — to get rich…if what I have said specifically about them is wrong. I have $3 million that says it isn’t.


Special Offer for HERO

Ah, yes, the Health Enhancement Research Organization (HERO). The belly of the beast.

Let me make them a special offer. Paul Terry, the current HERO Prevaricator-in-Chief, has accused me of the following  (if you link, you’ll see they had enough sense not to use my name, likely on advice of counsel, given that I already almost sued them after they circulated their poison pen letter to the media):

I’m convinced responding to bloggers who show disdain for our field is an utter waste of time. I’ve rarely been persuaded to respond to bloggers [Editors note, in HERO-speak, “rarely” means “never” — except for that intercepted Zimmerman Telegram-like missive], and each time I did it affirmed my worry that, more than a waste, it’s counter-productive. That’s because they’ll not only incessantly recycle their original misstatements, but worse, they’ll misrepresent your response and use it as fodder for more disinformation.*

Tell ya what, Paul. let’s debate disinformation, including your letter. Aside from the standard 10% entry fee (used to pay the judges honoraria, reserve the venue, and compensate me for wasting my time with your THC-infused quixotry), all the economic burden falls on me.

The only catch: I have asked you on multiple occasions to clue me in as to what my alleged disinformation actually is, if any. That way I can publicly apologize and fix it, should I choose to do so.  Before applying for this award, you need to disclose this alleged disinformation. You can’t just go around saying my information is made up etc. without specifying what it is.

By definition, “disinformation” is deliberate misrepresentation. To my knowledge, as a member of the “integrity segment” of the wellness industry, I have never, and would never, spread disinformation.

On the other hand, if I did spread inadvertently incorrect information by mistake, it seems only fair to let me fix it — especially given that I have been totally transparent and generous with my time in explaining to you what yours is, and how to correct it. (I might have missed some. Keeping up with yours is a challenge of Whack a Mole-meets-White House press correspondent proportions.)

So perhaps it is time to man up, Mr. Terry.  You and your cronies claim to have been collecting my “disinformation” for years, without disclosing any of it. I’m offering you a public forum and $3-million to present it.

Otherwise, perhaps you should, in the immortal word(s) of the great philosopher Moe Howard, shaddap.


A couple other mid-course corrections to the previous award offer.  Someone wondered if this offer is legally binding, so if your attorney’s knowledge of contract law matches your knowledge of wellness economics, they can voice their likely spurious objection. I will publish the objection and address it if need be, to make the reward a binding offer.

Another commenter whined that maybe I just won’t pay the reward. I’m sure that’s the reason no one has applied. (Not.) So put 10% of the entry fee down, and I’ll attach a lien.


And as mentioned, to close the original thread, Happy Holidays to one and all.


*As a side note, Mr. Terry writes: “We’re fortunate to work in an industry with a scant number of vociferous critics.” This “scant” number appears to include the entire medialeft-wing, right-wing, centrist, and health policyApparently also most employees, according to Towers Watson. The good news about “pry, poke and prod” is that it truly bridges the partisan divide in that everyone hates it.

 

 

 

 

Aaron Carroll’s new book asks: Can “bad food” be good for you?

When I was a kid, there was a seasoning called Accent. Both its TV commercials and its canisters featured a little horn with the slogan: “Wake up the flavor.” We poured that stuff on everything (except for our Captain Crunch), often accompanying our culinary adventures by making little horn sounds.

It turns out Accent was pure MSG. Who knew? And yet we lived to tell the tale. Neither me nor my siblings ever got headaches as kids. Or ever get headaches as adults. Indeed, we seem to have acquired some headache immunity from using this stuff. (Correlation, not causation, a good researcher would say.)

The reason, as you’ll learn in The Bad Food Bible, is that MSG isn’t bad for you, even apparently in the quantities we devoured.  (Yes, we know – you get a headache when you go to a Chinese restaurant. That could be your imagination, or you may be one of the few people with a sensitivity to it, just like a few people have sensitivities to other foods.)

MSG isn’t the only maligned food. Is butter good for you or bad? Milk? Artificial sweeteners? Organic foods? Sugar? Meat? Red meat? Tuna? Coffee? Wine? Eggs? Salt?

Oh, and don’t forget gluten. Turns out, virtually every one of these foods has been studied in depth…and here the studies in both directions are summarized and sourced.


How does this apply to wellness vendors?

Wellness vendors – and I’m looking at you, Interactive Health – want to micromanage our diet in so many ways that most employees just tune their advice out.  This book reveals that tuning vendor wellness advice out is probably the right response in most cases. Not all, but most.

We’ve shown repeatedly that wellness vendors, once they move beyond eat-more-broccoli-olive oil-nuts-and-fruit, are usually peddling very controversial or decidedly incorrect unsolicited dietary advice. Not that they care, because they show huge savings no matter what they do. One study – so seminal that it became part of Kate Baicker’s infamous “Harvard study” meta-analysis – found massive short-term savings by advising diabetics to swap out fats in favor of carbs. Not surprisingly, that study qualified the author for a coveted spot on the Koop Award Committee. Apparently bad advice is part of the Koop Award’s DNA.

What that study did and what Interactive Health does should not be called “dietary micromanagement.” Rather, it should be termed “dietary micromismanagement.”  Interactive Health’s advice to non-hypertensive diabetics and people at risk for diabetes is exactly that: swap out the whole milk for skim milk and cut way back on the salt. As a previous column noted, that turns out to be exactly the opposite of what they should do.


So what should we eat…and what shouldn’t we?

The great philosopher Dan Quayle once uttered the immortal words:  “The role of the Vice President can be summed up in one word: to be prepared.” Likewise, with the exception of sugar and soon-to-be-extinct artificial trans fats, the book can be summed up one word: chill out.

Author Aaron Carroll, part of The Incidental Economist (the country’s leading health economics blog), lays out the case for OK-in-moderation for most controversial foods. This guy doesn’t have an ax to grind – except when it comes to skewering people who have an ax to grind. He goes after faddists, extremists, and people who ignore research with a zeal approaching ours in exposing dishonest wellness vendors (and I’m looking at you, Interactive Health…and Wellsteps and Fitbit and about 50 others).

Since The Incidental Economist’s positioning is that of arbiter, not advocate – the go-to place for evidence-based answers no matter what the evidence shows – their answers on these topics are highly credible and carefully sourced. (Hence their smackdowns of the Koop Award Committee and wellness vendors are even more credible than mine.)

The answers boil down to: stop knocking yourselves out trying to be perfect. You are probably stressing more over your diet than you are gaining from fine-tuning your diet. Yes, there are a few things to avoid, like added sugars (but you knew that, or if not you would as soon as you play a round of Quizzify). Or, if you have a predisposition to hypertension due to history or ethnicity, you might want to go easy on the salt. (Most people needn’t – there is a reason your taste buds welcome the flavor).

So live a little, let your employees live a little, and know there are really only a few things that all the evidence says you truly need to avoid: trans fats, added sugars, and Koop Award-winning wellness vendors.

 

Should Interactive Health’s wellness advice carry a warning label?

This is the third in our series exposing the hilarious antics of Interactive Health. 


Hilarious, that is, unless you are one of those unfortunate souls who are:

  1. paying their bills;
  2. believing their outcomes; or
  3. taking their advice.

The first and third are closely related in the sense that one would think with their fees –which rank among the wellness industry’s highest due to their industry-leading embrace of hyperdiagnosis — they could afford to train their employees in wellness.

However, since they apparently forgot to check that box, I’ll do it for them. I owe them this favor, having recently made unflattering observations regarding their botched cover-up of their invalid outcomes reporting.


First the good news

No one can accuse Interactive Health of wasting money on excessively silly, excessively gimmicky, excessively readable user interfaces. Here is the advice they give to employees, all 1350 words of it, starting with Page 1.

But wait…there’s more. Page 2

And for all those employees who simply have too much free time on their hands at work, Page 3.

More good news. They do tell this employee, after informing her that she has metabolic syndrome, to “avoid sugar.”  Credit the law of averages with that — if you write 1350 words, it is likely that 2 of them —  0.14% — will be correct. These two words are in the middle of the second page, so I’m sure she saw them. Who wouldn’t?


Next, the bad news

To prevent that metabolic syndrome from progressing to diabetes, the letter also recommends “lowfat or nonfat dairy” in the diet. However, according to the the journal Circulation, people with the most dairy fat in their diets had a 50% lower risk of diabetes. Likewise, a study of 18,000 women showed lower obesity among those who consumed full-fat dairy.  Journal articles are likely beyond Interactive Health’s grade level, so here are two lay summaries and two lay books:

  1. The Skim Milk Scam: Words of Wisdom from a Doctor Dairy Farmer
  2. Lowfat Dairy: Zombie Guidance
  3. The Big Fat Surprise
  4. The Bad Food Bible

It’s not just dairy fat, where the science, though perhaps not definitive, is settled enough that even the dumbest wellness vendor should know not to tell diabetics to switch to skim milk. It’s also saturated fat in general, where the change in scientific understanding over the last 10 years has caught many wellness vendors by surprise, and they haven’t had time to react.

If consumed in large quantities, perhaps saturated fat may be a heart disease risk factor nonetheless.  Who are we to say? However, if it were a culprit of any significance — like trans fats or cigarettes or family history — that conclusion would be definitive by now, given the massive amount of research that’s been thrown at this question.  Even if saturated fat were a minor risk factor, there is still one overriding reason Interactive Health shouldn’t be telling people with metabolic syndrome to eat less fat: what the he** do they think people will eat instead? There is a whole body of literature on how telling people to eat less fat helped create the obesity epidemic.

In all fairness to Interactive Health, they recommend eating only less dairy and other saturated fat, not less total fat. However, that is a subtlety that can get lost in those 1350 words brimming with all sorts of random advice. For instance, on the subject of abnormal thyroid function, the letter says:  “Talk with your healthcare provider about possible treatment options for this condition.” Sound advice indeed — if in fact the person in question had abnormal thyroid function, but according to this report (bottom of Page 2), her “thyroid was normal.”


More bad news

Even though this person does not have high blood pressure, the letter also recommends eating less salt. For people without high blood pressure and especially people like her who have other diabetes and cardiac risk factors, avoiding salt is likely a bad idea.

Other than the answer being different for different people and different ethnicities (subtleties overlooked by almost all wellness vendors, which prefer to give blanket advice), the science is unsettled. It does, however, increasingly point to the importance of salt — something humans have been consuming in large quantities ever since way before the Roman Empire paid its soldiers in salt — in the diet. This is especially the case for people with, or at risk for, diabetes or heart disease (which this person is). In particular, for people without hypertension, reducing salt intake to a level much below the US average:

Among other limitations,  most of these studies are correlative, not causative, and rely on self-reporting rather than controlled environments.  So we can’t conclude with certainty that avoiding salt is a bad idea. Nonetheless, my suspicion is that companies paying Interactive Health millions of dollars — and basically forcing their employees to choose between submitting to them or losing money — have assumed that the advice they are giving employees is settled and likely correct, rather than controversial and likely incorrect.

Other studies, generally older ones, recommend low-salt diets to prevent high blood pressure, so it is still at least arguably fair to say salt science is conflicted. But the overriding reason for Interactive Health stop telling employees at risk for diabetes to eat less salt and less saturated fat is, what the he** do you think they are going to eat instead? Since most proteins come with saturated fat (and salt), there is only one thing left to eat: carbohydrates.

The bottom line is that anyone who actually takes Interactive Health’s advice on how to avoid diabetes is likely to increase their odds of getting diabetes.

Fortunately, most employees will have the good sense to ignore their advice, if for no other reason than it is quite a Herculean task to plow through it all. How do I know this? By definition, any employee reading this blog is more health-conscious than average. And yet the particular employee who, after reading my blog post on them, sent me this letter originally sent me only the first and third page. She hadn’t even realized there was a second page, since Interactive Health printed it on the back of the first page.

Ironically, that was the page where it said “avoid sugar.”


The “coaching” call

In addition to the letter, this employee did receive a coaching call, described as follows:

When they called to offer me advice they simply said, “ Do you know you have high cholesterol?” I said, “yes.”  Then she proceeded to ask me what I was going to do about it .  I said : “I thought you would tell me what to do.”  She had nothing to say.  Then I received another call a few weeks later as a follow up and I wanted nothing to do with them as they had already discredited themselves with the first call.  

 


In yet another installment (which will have to wait until 2018 since December is devoted to highlighting the best-in-shows of the wellness industry and of course the Deplorables Awards) we’ll explain how Interactive Health translates ignorance of clinical guidelines, bad dietary advice and massive hyperdiagnosis into quite literally the most inflated savings in the wellness industry this side of Wellsteps.

 

Final installment: 3 more stories of wellness shame and harms

Included in this concluding batch is yet another wellness program debacle regarding eating disorders. The irony is, this one takes place at an addiction facility.  I’m always maintained that, along with facts, integrity, math, data, employees and me, the wellness industry has no appreciation of irony. Examples:

This final set of case studies concludes with a statement from an actual named LCSW who specializes in the treatment of eating disorders.

Links to previous installments:

  • Part 1: Recovering executive with anorexia nervosa begs not to be weighed…DENIED
  • Part 2: Recovering technologist with bulimia told to “fit into his skinny jeans”
  • Part 3: Recovering employee with anorexia nervosa told “nothing tastes as good as skinny feels” and advised to eat only half her lunch.
  • Part 4: Recovering employee with bulimia and a severe grain allergy penalized for eating too many natural fats, as correctly prescribed by her dietitian…and begins purging again.

Joan

The school where I work recently instituted a wellness program.  In order for our insurance premiums to not increase, we had to go through a series of tests:  total cholesterol, blood pressure, BMI, LDL cholesterol and fasting glucose.  If we did not “pass” 4 out of 5 of these biometric screenings, we had to go through six weeks of phone therapy and then have the screenings done again after that time.

If, after the six weeks of phone therapy, the results did not change, our insurance would go up about $50.00/month.

The whole experience was a nightmare.  They conducted the screenings in the music room at school, with different tables and stations set up.  About 10 or 12 teachers and staff members were in the room at one time, so there was little privacy.

We moved from one station to the next as each of our results was written down and passed to the next person.

When we got to the end, a wellness “counselor” went over our results.  The lady saw my triglycerides number and immediately asked, “Does diabetes run in your family?”  “Is obesity an issue in your family?”  I asked why.  She said that a high level of triglycerides means that the body has “too many fat cells” and that I am at an “increased risk.”

To someone who has struggled with an eating disorder, as I have, this was tantamount to saying “Because of your high triglycerides, you are fat.  You are obese.”

Being weighed is always a humiliating and shameful experience for me, as it is for many people with eating disorders, and it can trigger exacerbations of my disorder (treating professionals familiar with eating disorders are well aware of this phenomenon and structure treatment accordingly).  To have to be weighed in front of my peers made that experience even worse.

This biometric screening triggered my disorder.  I was in tears by the time I got to the last “counselor” and had a very hard time controlling my feelings.  Right after this, I needed to get into my classroom and be with my kids.  I had to “suck it up,” until the end of the day.

It was horrible and it makes me wonder what is in our future in regard to all of this.


Katie

My workplace, an addiction treatment facility, has an employee “wellness” program.

If employees want to obtain the insurance “wellness rate” (the lower of two rates available to employees), we are required to start every year in January with a “health fair” and a “know your numbers screen” where they check weight, blood pressure, glucose levels and cholesterol.  Then we are “advised” by a registered nurse to exercise more and eat less (as if that had never occurred to anyone previously).

This year, the medical assistant drawing my blood engaged in numerous behaviors that would trigger most people with an eating disorder.  She informed me she “used to be as big as” I am until she “got bypass surgery.”  Despite mentioning several times that I see a nutritionist who recommends that I not weigh myself or know my weight, I was asked to guess my weight before I stepped on the scale.  I turned around when I stepped on the scale to avoid seeing my weight, but the assistant nonetheless chattered on about my weight.

I was reminded of embarrassing weigh-ins with school nurses and weight loss programs before I was exposed to eating disorder recovery.

This year we are also assigned to a “wellness team” where everyone is supposed to wear pedometers every day and log their steps weekly on a website.  Everyone can see everyone else’s steps on the site and a competitive spirit is encouraged.

I am especially saddened and concerned that we have this potentially damaging environment that encourages obsession with weight and numbers in a facility that treats addiction, where one would hope we would be steered away from, rather than toward, the process of addiction to disordered eating.


Rhonda Lee Benner, LCSW

I have worked with hundreds of patients over the 13 years during which I have worked with people with eating disorders.   In the past two years, I have seen a number of patients who were quite negatively impacted by the wellness programs at their place of work.

In one instance, a patient with binge eating disorder reported that she would be financially penalized if she didn’t set weight loss as a goal and make progress toward this goal. However, this was in direct conflict with her treatment goals to stabilize eating and set any goals for weight loss aside.  This patient could see how focusing on weight loss increased her binge eating; however, she felt shame and anxiety as a result of these pressures put on her by her employer.  She did not feel that as a larger-sized person she could speak up about this injustice.

In another instance, a patient reported that her employer required her to complete a health screening or be charged $600.00, and when she didn’t meet the health targets she was given an opportunity to still get the monetary “rewards” by meeting with a dietician three times.  She was also informed that she could get a “Healthy Weight Improvement Reward” by losing five pounds since her last health screening. Again, this is a patient with binge eating disorder whose condition is destabilized by focusing on weight loss. She too felt that as a larger-sized person she could not speak up about how this program could cause her harm.


What now?

Next week, and with the help of others, we will ask, what does this all mean? What can be done to prevent or discourage wellness vendors from harming employees?

And once again, kudos to the good guys, the vendors who are not implicated in this series at all, and indeed would never do such things to people:

American Institute of Preventive Medicine, Health Advocate, HealthCheck360, It Starts with Me, Limeade, Redbrick, SelfHelpWorks, Sterling, Sonic Boom, Sustainable Health Index, US Health Centers, US Preventive Medicine

Wellness vendor penalizes employee with severe grain allergy for eating too much fat. (Part 4)

Imagine if you were a recovering alcoholic. You hadn’t taken a drink in quite some time, attended AA meetings conscientiously, and were getting on with your life. Then your employer had a drinking contest and told you that you weren’t drinking enough. Further, if you failed to drink more, you would be fined.

Preposterous? Yes — but that is exactly what people with eating disorders are forced to endure in many wellness programs. They are told to eat less to become thinner, docked points or money if they don’t, and are made to feel inadequate by vendors who have no idea what they’re talking about.



This is the fourth in the series of major wellness harms perpetrated on employees by wellness vendors and indifferent employers. These narratives have been painstakingly compiled, edited only lightly, and with no detail omitted other than the victim’s name and employer. I won’t tell you who the perps are yet, other than to say that the vendors I have consistently noted to be the best — American Institute of Preventive Medicine, Health Advocate, HealthCheck360, It Starts with Me, Limeade, Redbrick, SelfHelpWorks, Sterling, Sonic Boom, Sustainable Health Index, US Health Centers, US Preventive Medicine — are not among them. 

See:

  • Part 1: Recovering executive with anorexia nervosa begs not to be weighed…DENIED
  • Part 2: Recovering technologist with bulimia told to “fit into his skinny jeans”
  • Part 3: Recovering employee with anorexia nervosa told “nothing tastes as good as skinny feels” and advised to eat only half her lunch.

Sue

I struggle with bulimia. My employer instituted a wellness program that requires employees to undergo yearly medical screenings of cholesterol, blood sugar, blood pressure, and body mass index.  We also have to fill out an annual health questionnaire.  Employees who undergo the screenings and complete the questionnaire receive a reduction in their health insurance premiums, whereas employees who decline to do either of these things cannot receive this reduction.  If an employee’s spouse is covered under his or her insurance, the spouse must undergo the screening as well in order for the employee to receive the premium reduction.

The program recommends that you join coaching and weight management classes if the screening identifies your body mass index as “too high.”  It suggests that being thin means being healthy, and being heavier means being less healthy, even though this is far from true for many people.  For individuals who have struggled with eating disorders, it is particularly troubling to be labelled as having a weight problem or a problem with body mass index despite having worked closely with treating professionals to manage the disorder.  Telling such individuals that they have a weight problem is precisely the type of response that professionals who treat eating disorders know to avoid. When nurses with no knowledge of our treatment history or progress, and no knowledge of eating disorders generally, respond this way, it undermines our treatment and progress.  It is even worse when that undermining happens at one’s place of work.

Like the screenings, the health questionnaire inappropriately suggests that thinner is always better.  Based on my answers, the wellness program assumes that I have unhealthy eating habits, but it does not account for the fact that my diet is carefully prescribed by my treating doctor in response to a multitude of food allergies.  I am allergic to all grains, and as a consequence, in 2013 I switched to a natural fat, unprocessed, grain-free diet.  My health markers began to improve at that time.  The wellness program, however, identified my eating as unhealthy because of the fats included in my diet.  As a result, I was docked “health points” and was given recommendations such as “eat less,” “unsupersize your meals,” and “go Mediterranean to transform your health and your weight,” and attend Weight Watchers.  After receiving these messages that suggested I was overweight and eating poorly, I began experiencing greater symptoms of my eating disorder and began purging.  While the wellness program did not start my eating disorder, it has certainly made it worse.

 

Victims of Wellness Programs Tell Their Stories of Shame and Harm — Part 3

This is the third in the series of major wellness harms perpetrated on employees by wellness vendors and indifferent employers. These narratives have been painstakingly compiled, edited only lightly, and with no detail omitted other than the victim’s name and employer. I won’t tell you who the perps are yet, other than to say that the vendors I have consistently noted to be the best — American Institute of Preventive Medicine, Health Advocate, HealthCheck360, It Starts with Me, Limeade, Redbrick, SelfHelpWorks, Sterling, Sonic Boom, Sustainable Health Index, US Health Centers, US Preventive Medicine — are not among them. 

See:


Mary

I used to work for a county health program that established a workplace wellness program. One cold January morning, I returned to work for the first time in nearly eight weeks. I had taken a leave of absence after a suicide attempt and inpatient treatment for chronic depression and anorexia. I had gained a few pounds and my depression had stabilized, and I was looking forward to returning to work I found meaningful.

But when I walked in the door, I was inundated with signs about our workplace weight loss contest—a “Biggest Loser”-style competition. For someone who was struggling desperately to gain weight, this was nothing less than an affront. Signs told me that “Nothing tastes as good as skinny feels.” Besides being the same slogans plastered all over the anorexia-enabling websites I used to visit, I had spent the past decade feeling exactly how skinny could make you feel—miserable enough to complete a near-lethal overdose.

I pulled my chin up, set my things down at my desk and walked into the break room for a hot cup of coffee. There, on a big sheet of blue posterboard, was a tally of how much weight everyone had lost. Veronica in accounts receivable had already lost 3.4 pounds. Then, flooding in my inbox were the emails encouraging us to only eat half our lunch, and to try to sneak in an extra workout during our lunch break. Never mind that these behaviors were exactly what had landed me in the hospital. Now, I had a prescribed diet developed in consultation with my dietitian.

For several months, I tried to grin and bear it, but eventually, the madness was just too much. I couldn’t bear the meetings about how good steamed broccoli was. I couldn’t stand working in an external environment that was, quite possibly, more toxic than the internal chatter I endured all day. The poster listing everyone’s weight loss statistics was removed upon my request, but the fact remained that the workplace wellness program had created an environment that was anything but healthy.  I had to quit my job.

Perhaps my experience is an unavoidable side effect of a war against obesity that some have determined should be won at all costs (and regardless of strong evidence that existing wellness programs don’t work).

But when you consider that around one in 20 Americans will struggle with an eating disorder at some point in his or her lifetime, that’s a lot of collateral damage.

Victims of Wellness Programs Tell Their Stories of Shame and Harm — Part 2

This is the second in a series of first-person narratives of harms caused by wellness vendors. These narratives have been painstakingly compiled, unretouched except for formatting, and with no detail omitted other than the victim’s name and employer. I won’t tell you who the perps are yet, other than to say that the vendors I have consistently noted to be the best — American Institute of Preventive Medicine, Health Advocate, HealthCheck360, It Starts with Me, Limeade, Redbrick, SelfHelpWorks, Sterling, Sonic Boom, Sustainable Health Index, US Preventive Medicine — are not among them. 


John

I’m 37 and have put a lot of work into recovering from bulimia.  I have been in treatment for bulimia for 12 years.  I see a therapist, a doctor specializing in eating disorders, and a psychiatrist.

For the last five years, I’ve worked at a technology company.  I’ve noticed that every year, their “wellness program” has become more and more triggering, as it has become increasingly tied to health biometrics and “rewards” on my paycheck.  The “rewards” for taking answering the health risk assessment, taking various biometric tests, and meeting certain health outcomes are so significant that I felt I had to participate.  These rewards now come to a total of $2470 per year for taking the tests and meeting all of the health targets.  With a family and a child in day care, I cannot afford to forego such a large amount of money.

A couple of years ago, the wellness program started to require that employees’ weight, triglycerides, and blood pressure be checked. These biometric screenings happen every year, and I dread it. If my body mass index does not fall into what the program considers “normal,” then I don’t get a “reward” on my paycheck—or, to put it another way, I get penalized.  If I forego even one part of the biometric screens, such as the weight check, I lose the reward for all of the screenings.   In addition, the program’s instructions for employees, including to keep their meal portions “as small as possible” (to “fit into your skinny jeans”) are inconsistent with and undermine all the work that I have done to overcome my disability.

The wellness program allows employees to have their own physicians perform the screenings.  When my doctor heard about the screenings, he was incredulous.  He indicated that, out of concern for my health, he did not want me to participate in these tests.  But I felt compelled to do so given the large sum at stake.  My doctor wrote a letter explaining that having me step on a scale and having my weight read out loud would be extremely damaging.  After three months of requests and negotiations, I was ultimately able to get the program to permit me to apply for the incentive without my doctor filling out the screening form (a special “manual process” was used), but this process was extraordinarily stressful and I have no assurance that I will be permitted to do this in the future.  I was the first person who was able to forego the screening without losing the incentive—and to my knowledge, the only person.  And guess what? It’s time to do the entire thing again for this year’s screening!


Part 1 can be found here.

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