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We interrupt this program…

I have several new posts ready to go — the usual suspects acting out in their usual hilarious fashion — but this is a serious post.

It is time for wellness vendors to stop harassing employees about their weight.

A new article summarizing the voluminous data on the futility and harms of weight-shaming just appeared. It doesn’t contain new data, but rather presents the existing evidence in a clear and compelling format.

This article finds fault in the physician community, but the wellness industry (the outcomes-based companies and their enablers at the Health Enhancement Research Organization (and their enabler-in-chief, Ron Goetzel) is even worse because they tie money to weight loss. They give employees a financial reason to binge before the first weigh-in and then dehydrate themselves and crash-diet before the last one.

This does nobody any good, except of course the outcomes-based wellness vendors — like Interactive Health, Wellsteps, Wellness Corporate Solutions, Staywell, Bravo, Total Wellness, Star Wellness, Health Fitness Corporation and probably a host of others.  And there is a special dishonorable mention for HealthyWage, whose entire business model is corporate crash-dieting contests.

They aren’t going to agree to stop on their own, any more than Monsanto stopped making DDT on its own volition. They need to have it made clear that this behavior won’t be tolerated any more.

Action Steps

A starting point is this linkedin post.  Like it, comment on it, share it.  Once we get to 100 likes and comments, and we’re already more than halfway, I can probably generate media attention.

 

 

https://www.linkedin.com/feed/update/urn:li:activity:6448329478551719936/

 

Should your employees get annual checkups?

Note that this blog post is my personal posting and does not necessarily represent the views of any organization with which I am affiliated, other than the one with which I am most closely associated, and of which I am one of the founders.  I am referring, as everybody knows, to the Needham Frisbee Club.  People who play Ultimate 3 times a week don’t need no stinkin’ checkups.


Why Wellness Vendors Hate Information: A New Theory

I have no clue why wellness vendors hate information so much.  Perhaps they are repressing childhood memories of being bitten by a librarian.

A far-fetched theory, perhaps, but there is simply no other explanation for half the things half these very stable geniuses insist upon doing.  In many cases, reams of information demonstrating the futility, fallacies and even harms of what they do is right there — begging to be googled — and yet no one in the wellness industry (or at least the wellness companies “profiled” on this site — there are plenty of exceptions listed at www.ethicalwellness.org) does.

Before we get into the checkups, consider some other information gaps, like the eight-glasses-of-water urban legend. Anyone with an internet connection can easily learn that you do not have to drink eight glasses of water a day, and the whole meme was completely made up. 70 years ago someone estimated that humans require that much water a day — but also that basically everyone with access to water already gets that much without having to force themselves to drink when they aren’t thirsty.

Yet try telling that to a wellness vendor (excluding the ones who have signed the Code of Conduct, of course). One vendor, Provant, even provides an infographic in case the employees they are harassing can’t count to eight:

Wellness Corporate Solutions — no stranger to these pages — has gone one step farther.  Along with their crash-dieting contests, they offer what they call “healthy competitions” to see who can drink the most water:

Water-drinking “healthy competitions” may or may not make employees “more aware of their health status,” but they certainly make employees “more aware that this meeting better end really soon.”

Maybe WCS should combine those two competitions — along with their massive overscreening campaigns — to create a competition to reward employees for doing the most stupid things to themselves.

Failure to understand that thirst is your brain’s signal that you need a drink of water is not an isolated oversight. Wellness vendors take great pride in their ignorance of wellness generally. Consider their propensity to screen the stuffing out of employees. There are clinical guidelines for optimal screening frequencies and lists of biometrics that should be screened for, that most wellness vendors (It Starts with Me, US Preventive Medicine, and Limeade being three huge exceptions) have apparently never laid eyes on. If it helps, here they are:


There are a few subtleties beyond these words. “People at risk for diabetes” (under “Diabetes test”) would include people with high blood pressure or family history (which wellness vendors can’t ask about). It would also include people who are overweight or obese. Additionally, “members of certain ethnic/racial groups may be at increased risk at a lower body mass or a younger age.” Otherwise, it’s quite clear that cardio screenings should begin at 35 for males and 45 for females, and take place “at least once every five years” after that.

Some people should get that frequency, others a higher one. But like most other things in healthcare, the answer is not the same for every employee of every age and every health status, and you do not just screen people because you make money on each screen, so the more you screen, the more you make. Otherwise you end up like Interactive Health, one of the most expensive vendors, positively hyperventilating about all the false positives they’ve found:

Finally, let’s once again review the aforementioned crash-dieting contests, a staple of many wellness programs besides Wellness Corporate Solutions. Schlumberger, for example, pays out thousands of dollars to the team which does the best job packing on the pounds in December and then taking them off in January. “Just plain fun,” is how their ironically named vendor, HealthyWages, describes it.  None of these vendors have apparently seen the CDC’s advisory memo warning that crash-dieting is futile, likely counter-productive, and possibly harmful.


What about annual checkups?

Let’s cut to the chase: there is not one shred of evidence that annual checkups are a good idea for asymptomatic working-age employees.  There are many good reasons to go to the doctor — you notice a change in some aspect of your body, you want to develop a plan to improve your health, you need help managing a chronic disease,  or even that you’re sick — but here’s what’s not among them: the earth completing a revolution of the sun.

New England Journal of Medicine says that while the major benefit is “less patient worry,” checkups “may actually be harmful.”

“Less worry” is not necessarily a good thing. An employee (name on request after an NDA — not a made-up person) had a checkup in order to collect a wellness incentive…and as a result of being told not to worry, ignored heart attack symptoms about a week later.

The Journal of the American Medical Association says offers of health checks did not reduce any kind of mortality, but “may be associated with more diagnoses and drug treatments.”

Choosing Wisely says: “Annual checkups usually don’t make you healthier,” and “tests and screenings can cause problems.”

None of this takes into account the cost of annual checkups — which often lead to more unneeded and expensive tests and prescriptions, as JAMA notes — but we have definitely observed that wellness vendors and even some HR departments don’t really care about costs. It’s not their money. Here is Reuters on the high and unneeded cost of prevention.

Here is The Incidental Economist on the same subject.

Meanwhile, I’ve yet to find a wellness program that does not either pay employees to get checkups or fine them if they don’t — or shunt them into a worse health plan unless they submit to an annual physical.

I would also note that, however useless annual checkups are to begin with, they are likely even more useless if someone is visiting the doctor because their benefits department is forcing them to do so, against their will.

Finally, there isn’t exactly a surplus of primary care doctors. Why are we paying healthy employees to take up clinician time that unhealthy employees might actually need?


What is the argument in favor of checkups?

If checkups don’t actually prevent anything, why make employees undergo them? Two reasons have been proposed. One is that employees can “build a relationship” with their PCP.  This of course assumes that neither the employee nor the PCP ever retires, moves or changes jobs. It also assumes that somehow the things that affect employees can be prevented by having a “relationship” with a PCP. However, if you look at the list of the most frequent reasons for hospitalization among the working-age population, it’s kinda hard to find anything that fits that description.

Can you think of any disease in your own life that would be cured by a relationship with a PCP? I can’t think of only one problem — chronic heartburn — that my PCP could have prevented. But she didn’t. The PCP was perfectly happy to keep me on Prevacid, which, as Quizzify teaches (right on the home page quiz!), is likely harmful in long-term use. Fortunately, I happened to run into a yogurt salesman one day, who told me about active-culture yogurt. Within days my heartburn was gone, never to return.

The second argument in favor of checkups, proposed by the CEO of Bravo Wellness, Jim Pshock, is as follows:

The hope is that the [Bravo] program will get people to proactively see their physicians to manage their health risks. Yes, this will, hopefully, mean more prescription drug utilization and office visits, but fewer heart attacks and cancers and strokes.

It isn’t his money, so he is perfectly fine with employees “hopefully” spending more on drugs and office visits.  On the other hand, there is no information supporting his claim that all this spending and all these checkups will prevent all these diseases.  Quite the contrary, 100% of available information reaches the opposite conclusion — especially JAMA, which specifically measured mortality due to heart attacks, cancers and strokes and found no improvement. You’ll fine zero information suggesting the contrary finding, no matter how hard you search.

Perhaps when he was a toddler, Mr. Pshock’s parents threw him into an entire cage of librarians.


What is the best frequency for checkups?

The literature is quite adamant: not at all.  That seems a bit extreme and I would bet the people who write these articles do occasionally get a checkup. For the most reasonable compromise I would turn to Quizzify, the leading health literacy vendor. They recommend a simple mnemonic: get two checkups in your 20s, 3 in your 30s, 4 in your 40s, 5 in your 50s, and annually after that. Quizzify’s advisory colleagues, doctors at Harvard Medical School, approved this recommendation too. As with most other questions, this one carries the HMS “shield.” (Quizzify also reports that this question is the one most likely to be removed by its customers, which is an option for all questions in their database before they get seen by employees.)


So what’s the solution?  

In three parts, it’s:

  1. Screen according to guidelines
  2. Send employees to the doctor at age-appropriate and health-appropriate intervals
  3. Pay the fines on overdue books.

Healthywage is helping Schlumberger employees crash-diet their way to better health

In the wellness industry’s epidemic of very stable geniusitis, Healthywage is Patient Einstein.

Somehow they recruited Russian trolls to convince Schlumberger that the best thing they could do to reverse their four-year stock price decline…

…would be to: encourage their employees to binge and then crash-diet.  So far Schlumberger is halfway through its 8-week crash-dieting contest. In case you’re keeping score at home following our initial posting, here are the standings:

Pound Town has lost 10% of its weight in 4 weeks. Figure — as a conservative estimate — the average participant weighed 200 pounds at weigh-in.  A 9.86% loss of body weight equates to more than 19 pounds, almost 5 pounds a week.  The Centers for Disease Control (CDC) recommends 1-2 pounds/week.

The better CDC recommendations include not crash-dieting at all, but rather improving your health and fitness, at your current weight, because rapid weight loss likely leads to rapid weight regain, and possibly even slows metabolism so that one could regain more than one loses.

However, the CDC recommendations didn’t take into account that weight regain is a big part of what makes this contest work. Employees can win the $10,000 in 2018 — and then regain the weight in order to enter again in 2019. Is this a great country or what?

Health has nothing to do with it, of course.  It’s about making Schlumberger shareholders proud again.

At Schlumberger, Today is Take-Your-Stupid-Wellness-Vendor-to-Work Day.

Once again, having been snake-charmed by HeathyWage, Schlumberger is offering a crash-dieting contest, starting today, January 22.

Once again, they are ignoring every iota of research that says crash-dieting is a complete waste of time. It may also harm you. Once again, they are offering a whopping $10,000 prize to the winning team.


The relevant language from the Wellness Code of Conduct

Here is the relevant language from the Employee Health and Wellness Program Code of Conduct.  The language that the group agreed upon — “may have negative effects on their health” — was intended to be as acceptable as possible to what has become an delightfully large Ethical Wellness group:

Research shows that the vast majority of people who participate in weight loss programs will eventually gain their weight back after the program ends. Many will also gain back more than they lose. The weight cycling that occurs with repeated participation in weight loss programs may have negative effects on their health.

It’s also slightly possible that offering a $10,000 prize (for a team of five) could exacerbate the harms of weight-cycling just a tiny bit by encouraging employees to binge, bloat, salt and constipate themselves before the first weigh-in. But no team would ever do that, right? After all, it’s not worth sacrificing your ethics or harming yourself in order to win a measly $2000/team member.

Haha, good one, Al.


The relevant language from Here’s How to Win a Corporate Biggest Loser Contest

On the weigh-in day, avoid the bathroom before weigh-in if you can, and minimize your activity, another big glass of  whole milk with your breakfast that contains some salty options will help you retain more water.  If you are also going to get your waist measured, drink about half a can of root beer.  Sounds gross, but the carbonation and salt will give you are really good belly bloat…If they are measuring your waist, wear some pants that are snug around the waist, or add a tight belt that hits below your belly button, this will create some fluid buildup in your belly area.  At this point 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.  If you are getting measured, poor posture can get you another inch and a half, so go for it.

To their credit, even the group that gives this advice has a more adult sense of responsibility than Schlumberger and HealthyWage, as they preface a few pages of advice with:

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.


The relevant language from Schlumberger’s vendor, HealthyWage

Let’s look at the marketing pitch from HealthyWage, the outfit that runs this contest and epitomizes everything that makes the wellness industry what it is today:

That equates to over 50 pounds per person, in their 12-week contests — more than 4 pounds a week.* This means one of five things:

  1. Employees are indeed binging, bloating, salting and constipating themselves before the contest to maximize their odds of winning, since losing 50 pounds in 12 weeks would be a Herculean task without a bunch of extra weight that will be as easy to take off as it was to put on, thanks in part to websites that show you how to gain weight rapidly in preparation for corporate crash-dieting contests;
  2. Healthywage is unfamiliar with the CDC guidelines that recommend steady weight loss at 1-2 pounds per week;
  3. Healthywage is betting that employers don’t know that the odds of keeping weight off are 1 in 200 for males and 1 in 100 for females;
  4. Heathywage is counting repeat contestants more than once, meaning that the same employees binge, crash-diet, regain the weight and then do it all over again;
  5. Heathywage is lying.

Of course, this being the wellness industry, it may be all five.


*How does a 50-pound weight loss compare to other companies? Pfizer won a Koop Award because its participating employees were able to lose — get ready — four ounces. Six if you measure against the two ounces gained by non-participants. In all fairness, Pfizer’s program was not exactly intensive. “Participate” was defined as “open an email with a message in it.”  The good news is that opening an email isn’t going to harm anyone.

Plus you never know what a message will contain.  Open this link to see an example.

Schlumberger’s program confirms that in wellness, harming employees is the new black.

Silly us. We thought Wellsteps’ wellness program was an outlier when it came to harming employees. But Wellsteps has nothing on Schlumberger.  Almost immediately after reading last year’s post on the harms of crash-dieting contests run by Healthywage, Schlumberger instituted  — hang on to your hats — a crash-dieting contest run by Healthywage.  They even included some decent-size prizes — $1000 per winning participant. How did they finance those prizes, with sales of their drilling equipment falling by about half from its peak? Simple. They canceled their employee gym membership subsidy.

Then, as some may remember, it turned out that Healthywage’s understanding of arithmetic rivaled their understanding of obesity. In their contest, somehow five teams lost exactly 16.59% of their body weight.  This is clearly alternative math, since the chances of that coincidence using real math are about 1 in 4 quadrillion, meaning that the odds of winning the lottery are about 1000 times better than the odds that Healthywage’s executives are not a bunch of idiots.

So Schlumberger harmed employees, wasted money, and got ripped off by alleged weight control experts who can’t read a scale. What does a company do in situations like this? Double down, of course. Literally. Yes, this year, they’re back partnering with Healthywage…with twice the prize money — $2000 apiece for the five members of the winning team.

schlumberger-contest

They gave employees a week’s advance notice, so that they could pack on some pounds that they can take off later.  Plus they could time their consumption of salt tablets, and concoct other ways to bloat up, before the contest began.  Basically they needed to figure out how to become as unhealthy as possible, before starting the unhealthy process of crash-dieting. (As an aside, several teams apparently tried to recruit pregnant women whose due dates fall during the contest period.)  And now that they contest is underway, who wouldn’t pop a few OTC diet pills to make $2000?


The difference is that this year, several concerned employees wrote to me and urged me to inform their benefits department of the indisputable facts that:

  1. Crash-dieting is a stupid idea;
  2. Offering prizes for crash-dieting is an even stupider idea.

I wrote the requested letter to Schlumberger, and explained all this to them, not that anyone with an internet connection should need an explanation of why crash dieting contests don’t work, or, more basically, why being stupid is a bad idea.

Their response?  The benefits department appears to have tried to determine who sent me the announcement, presumably in order to get them fired. It was actually multiple people since I have family in Texas in the oilfield services industry. I had anticipated this, so I un-linkedin with all of them before writing to Schlumberger. I’ve learned through experience that in wellness, you need to anticipate the most inappropriate and misanthropic reaction to any helpful offer, because that is the reaction you will get.  (For instance, rather than being concerned about Wellsteps harming their employees, the Boise School District wellness program coordinator told Wellsteps I was blowing the whistle on them for harming their employees.)


Update:  Healthywage presents alternative math, Volume 2. If the rule is (as stated) that you must sign up in teams of five, what is wrong with this picture?

schlumberger-703-people


And just as I was about to click “publish,” I noticed alternative math, Volume 3.  Apparently Healthywage thinks you can lose a high percentage of your total weight even if “you only have a little weight to lose”:

schlumberger-misunderstanding-percentages

And that brings us back to the main, decidedly unfunny, point: crash-dieting contests, especially with big prizes, are a very bad idea…and companies like Healthywage ought to be ashamed of themselves for making a business out of harming employees.

 

 

 

 

Shocking News: Employees Reveal They Cheat in Weight-Loss Contests

Recently we described how to cheat one of those worthless, hazardous corporate crash-dieting contests, like the ones run by Wellness Corporate Solutions or HealthyWages or Virgin Pulse (nee ShapeUp). But we didn’t interview any employees who actually did.

Journalist and wellness expert Pat Barone, writing in LifeZette (Laura Ingraham’s popular online magazine) managed to do just that. She found some employees who “confessed” (bragged about) the ways they snooker these vendors — and of course their own employers –every year, starting again in most cases next month.

These employers, like Schlumberger, think they are creating a culture of wellness when in reality they are creating a culture of deceit, diet pills and dyspepsia. Why would any employer sponsor one of these contests? Simple: in wellness, stupid is the new black.

I don’t want to spoil your fun reading the article by giving away all the punchlines, but the keywords are carbs, sodium, and rocks.  All the things that employees should eat, as part of a healthy diet. OK, maybe not too many vitamins but certainly lots of minerals.

charlie-brown-i-got-a-rock

snl-quarry

 

How to cheat in a corporate weight loss contest (SPOILER ALERT: This gets gross)

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.

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