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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.
- 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.
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.
Because I didn’t mention any names, I published this one on the Corporate Health and Wellness Association blog. So you’ll have to click through. SPOILER ALERT: the bad news is that there are a boatload of things — 10, to be exact — that wellness vendors don’t know about BMI.
The good news is, there some things wellness vendors do know about BMI, like how to spell it. This is a big accomplishment, because spelling is right up there — along with arithmetic, integrity, behavior change, and of course wellness itself — on the list of things that most befuddle wellness vendors. We’ve chronicled many examples, such as Wellsteps’ Steve Aldana calling award-winning journalist Sharon Begley a “lier.”
If we were real journalists here, we’d have killed a lot of trees in the cause of exposing the massive amount of lying and cheating by wellness vendors. However, as mere bloggers, all we do is kill millions of defenseless atoms.*
And yet we’ve sacrificed nary a single electron to the cause of exposing the massive amount of lying and cheating by the employees themselves. And massive it is. My very own extended family members are swapping fitbits around to increase their steps. Less for the money than for bragging rights about who can game the contest the best.
Indeed, these corporate “challenges” are really mental challenges, not physical ones, to see who can do the best job outsmarting the wellness vendor. Outsmarting wellness vendors, as past columns have shown, isn’t exactly a heavy lift: we have often observed that the good news about wellness is that NASA employees don’t have to worry about their job security because wellness vendors aren’t exactly rocket scientists.
To that end, the Wall Street Journal wrote an entire article about employees cheating in wellness programs. Apparently, employees are enlisting puppies, hamsters, even power tools and a ceiling fan in their quest to undermine their company’s wellness program. One enterprising employee posted a youtube showing how to cheat on these programs. A Midwestern cadre of truly dedicated employees took cheating a bit farther than most, and got themselves indicted for defrauding Kansas City out of $300,000 by lying on wellness programs.
30-second shameless plug time
Of course, there is one surefire way to avoid the downside of cheating: design cheating into the program. And that’s exactly what Quizzify does. The way to cheat on Quizzify is to look up the answers and learn about health literacy — which is exactly what we want employees to do!
How to cheat in a crash-dieting contest
Employees especially like to cheat in crash-dieting contests, enough so that countermeasures are needed. For instance, a vendor named Healthywages is bragging about how it ferrets out “fraudulent participants.” I figured I’d see what the internet has to offer on corporate biggest loser program cheating, because, after all, these days almost every search generates tons of hits. I say “almost” because if you search on “honest wellness vendors” and “Wellsteps,” there is only one hit: my observation that the latter could never be confused with the former.
In particular, the search found a group called www.healthstatus.com, which has given this topic altogether too much thought, thankfully. In all fairness to the HealthStatus folks (who do seem very well-intentioned and on the level), before they list their recommendations, they provide a cigarette-type warning label, as these programs richly deserve:
It’s getting to be New Year’s resolution time and many companies will try and “encourage” weight loss with a “Biggest Loser” type contest. Frankly, this is really a bad idea, as it can create all kinds of bad habits and damaging activities by the participants, as they starve, dehydrate and supplement themselves in an effort to win.
Having gotten the grownup stuff out of the way, here are their “recommendations” for employees whose employers, like Schlumberger, somehow got the impression these contests are a good idea, perhaps because their mothers didn’t listen to enough Mozart when they were in the womb. A few recommendations are fairly harmless, like drink a lot of water starting 3 days early and don’t pee (or do number twosies) before your weigh-in. And, of course, wear heavy clothes, carry lots of change in your pockets etc. You know, your typical garden-variety dishonesty that is probably woven into the culture of any employer that sponsors these contests. (These employers think they are “creating a culture of wellness” when in reality they are creating a culture of deceit.)
By contrast, some of these other recommendations boggle our minds, and, having written exposes on the wellness industry for two years now, our minds are not easily boggled:
The day before the weigh-in, ideally about 17 hours or less before your weigh-in time, you want to get yourself a good salty snack. A bag of chips, you know the ones that if you eat too many your lips hurt from all the salt and a nice tray of cheese and crackers.
For your dinner meal you want to load up on the proteins and a big glass of whole milk, also, this is a day you want to skip the fiber. This is one day of eating like this, we don’t encourage it, but a binge day also sets up your metabolism to know that is not starving, and can help in when we start burning fat after the weigh-in.
The day of the weigh-in, minimize your activity, another big glass of whole milk with your breakfast that contains some salty options will help you retain more water.
“At this point,” they observe, “you should be a big bloated sloshing mess that needs to go to the bathroom really bad. This is the perfect time to get weighed and measured.” They also remind you to accentuate poor posture, since the long-since discredited Body Mass Index measure still preferred by most of these vendors is a height/weight ratio. (HealthStatus also offers hints for contests that use waist circumference.)
In other words, do all the wrong things — eat badly, slouch, and don’t exercise. Be as unhealthy as possible. So you’re already obsessing with your weight and abusing your body horrendously in the name of wellness…and the contest hasn’t even started yet!
I hate to leave everyone hanging but HealthStatus hasn’t published the rest of its recommendations yet, meaning advice on how to cheat during the contests themselves.
And a good thing because I don’t know how much more wellness a fellow can take.
Since self-abuse is actually a very serious topic, I would like to step out of character here and offer a few serious notes. First, no wonder Optum and HERO and other Wellness Ignorati are stonewalling the Employee Health Program Code of Conduct. Nothing violates it more than their cherished corporate crash-dieting contests. And a particular call-out of the biggest-loser worst offenders: Virgin Pulse (nee ShapeUp), Wellness Corporate Solutions and HealthyWages. You ought to be ashamed of yourselves, even relative to other wellness vendors like Wellsteps, which had just recently established a new plateau for harming employees, that you people are blasting right through.
*Just for the record, we know that writing blogs does not kill or even injure atoms. And while Keas might find that being used in blog posts stresses them out, we would disagree. Quite the opposite: if they enroll in wellness programs, they can live to be 100.
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.