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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.

Victims of Wellness Programs Tell Their Stories of Shame and Harm

This begins 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. 


Jane

I am a corporate executive in a Fortune 500 company.  My employer operates a wellness program.  Every year, as part of that program, we are required either to have blood drawn and have our weight, height, blood pressure and other things measured or contribute more toward our health insurance.  This testing is done on site at the workplace.

I have anorexia.  I have been in treatment for four years.  Over the years I have built a relationship with my dietician, my therapist, my psychiatrist, and my medical doctor.  Their familiarity with my needs, including what helps and what triggers the symptoms of my disability, is critical to ensuring that I receive effective treatment.

In contrast, the wellness program at my workplace is operated by people who have no familiarity with my particular needs and no knowledge of how to address them.  Among other things, the program requires employees to undergo weight-related screenings administered in a manner that undermined the treatment regimen carefully designed by my treating professionals and resulted in my relapse and admission to an intensive outpatient treatment program.


I would never have participated in this wellness program of my own accord, but due to the large financial incentives to participate, I felt like I had no choice but to do so.  When I found out that the wellness program required me to be weighed, I told my dietician, who was extremely concerned.  She wrote a letter indicating that I was receiving intensive nutrition therapy with her and that I should not be weighed or have my body mass index measured by the program, as that would be detrimental to the progress that I had made under her care.

The wellness program nurse read the letter but proceeded to weigh me and, despite my stepping on the scale backward so I would not see my weight, she announced how much I weighed and what my body mass index was.  She remarked that “it wouldn’t hurt you to enroll in our healthy eating program.”  This is precisely the type of trigger that my treatment – and the treatment of people with similar eating disorders – is designed to avoid.  She was telling me I was fat—exactly what I needed to hear to stop eating again.

After this incident, I stopped eating for two weeks and ultimately ended up in an intensive outpatient treatment program.  My dietitian was furious about the damage caused by the wellness program.

I am dreading participating in the wellness program again this year.  I am uncomfortable about having to tell my employer about my eating disorder – a very personal matter—and I do not want to repeat the experience of questions and screening that are counterproductive to my treatment.  If I don’t participate, however, I will have to pay an additional $750.00 for my health insurance, so I cannot afford to avoid it.

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