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Expose of Corporate Weight-Shaming Programs Among Year’s Top Articles

surviving cover with no promotion

We published “Employers Should Disband Corporate Weight Control Programs,” in the peer-reviewed American Journal of Managed Care, in February.  We recently learned that it is trending close to #1 for the year among articles in this and related journals.  Its findings have never been challenged, with no critical comments or letters to the editor by wellness vendors or consultants.

If you struggle with weight, you are probably wondering why your employer appears to be discriminating against you by weight-shaming you.   The answer is that while a company would certainly want to facilitate employees’ desires to become healthier on their own, there is no economic basis for fining employees or withholding incentives based on weight.

It’s not just that the threat of financial forfeiture (penalties or lost incentives) doesn’t help people lose weight.  Here are highlights from the rest of the article:

(1) As ShapeUp has shown when confronted with the invalidity of its data (and being fired by Highmark as a result of it), vendors’ weight-loss figures are basically fabricated. Here is an article showing how that fabrication takes place, the “Last Man Standing” fallacy.

(2) Weight generally does not affect job performance.  At the CEO level, this is generally known.  That’s why when new factories are built, they tend to go up in states with lower wages and motivated (and non-union) workforces.  Those states also have the highest obesity rates, but that doesn’t matter when major corporate decisions are made.  CEOs, voting with their own dollars, have determined that these higher obesity rates have no noticeable effect on productivity.

(3) Weight also has only a trivial effect on healthcare expenses.  Extra spending that was once attributed to weight turns out to be due to age, as people get naturally heavier over time and naturally tend to spend more on healthcare.  Those two variables correlate but the actual causality is attributable to other factors.  Among older people, some extra weight may be protective, as well.

So three things need to be true for these discriminatory programs (age discrimination and class discrimination) to justify their existence.  The programs need to get people to lose weight, and weight has to matter somehow, in productivity and/or health spending.  Instead, none of those things are true.  So why engage in an activity that isn’t going to work, that embarrasses your employees?

We’d encourage you to read the article or at least the abstract, and pass it along to decision-makers.  And send us your stories–how has corporate weight-shaming affected your job performance, or the performance of people you know?

PS  And if Aetna comes a-knockin’ with the industry’s most expensive and most dangerous anti-obesity “wellness” jihad, don’t answer the door.  Here’s what will happen if you do.

Quizzify Q in B and W

Good health is not about weight-shaming. It’s about education.

 

Employers Should Disband Employee Weight Control Programs | AJMC

Quizzify 4

What’s the most common mistake your employees make during doctor visits?

tape-403586_1280From our newly published paper in the American Journal of Managed Care:

There is no published evidence that large-scale corporate attempts to control employee body weight through financial incentives and penalties have generated savings from long-term weight loss, or a reduction in inpatient admissions associated with obesity or even long-term weight loss itself. Other evidence contradicts the hypothesis that population obesity rates meaningfully retard economic growth or manufacturing productivity.

via Employers Should Disband Employee Weight Control Programs | Page.

Wellness Corporate Solutions Gives Us a Dose of Much-Needed Criticism

Oh, when bad things happen to good bloggers…

Shame on us!   Here’s what Wellness Corporate Solutions had to say about our observations of the wellness industry:

wcs--response to skeptics

And, in all fairness, when we went to the Wellness Corporate Solutions website, we felt quite chastened.  Their website was a breath of fresh air, taking the rest of the industry to task for expecting “instant cost savings,” noting that a “focus on ROI is short-sighted.”

wcs--roi philsophy

Further, they are totally opposed to wacky crash diets, of the type that 8-week weight loss “challenges” inspire, that cause abnormally large weight swings   As most people know by now, those may be harmful and are of course ineffective at long-term weight control.  The weight is likely to be regained and then some.  Plus contestants often binge before the initial weigh-ins to maximize contest weight loss.  That’s why Wellness Corporate Solutions quite appropriately says “stop dieting,” and “avoid making unreasonable weight loss goals.”  And “banish weight-obsessive thoughts.”

We were also thrilled to see that they “respect and appreciate size diversity” because “size prejudice hurts us all.”

wcs-celebrating fat

Finally, a company that has done enough research to realize that you can’t save money instantly by getting employees to crash-diet for 8 weeks! How exciting is that – we discovered a wellness vendor with access to Google!

Unfortunately, perhaps along the way someone at Corporate Wellness Solutions must have failed to “respect and appreciate the size diversity” of a certain Kim Jung Un, because the North Koreans appear to have hacked into their website and announced:  a program that saves money instantly by getting employees to crash-diet for 8 weeks.

wcs-weight loss challenge

Quizzify 4

How many of your employees know the difference between a deductible and a copayment?

Naturally, this being a wellness vendor, the savings are made up.  If 20% of your employees achieve a “healthy” BMI (a statement which by itself is open to a great deal of debate, since recent research overwhelmingly says it’s better to be fit and fat than to lose weight and not keep it off), for a company to reduce its total cost by 20% means that the costs for each employee who lost the weight would have to fall 100%.

And naturally, being a wellness vendor, they don’t stop there.  It’s part of wellness vendor DNA to ignore US Preventive Services Task Force recommendations, while saying they abide by them.   In this case, they are doing both thyroid screens (not recommended) and PSA tests (emphatically not recommended).

wcs-screening

And, naturally, being a wellness vendor, there is no concept of learning.  They did exactly the same thing that ShapeUp, Ron “the Pretzel” Goetzel, Wellsteps and others have done, which is failing to realize that we bite back.  Actually, we don’t bite back as much as we allow these geniuses to bite themselves back.  The wellness ignorati invariably self-immolate in the attempt to criticize us.  Hence our mantra:  “In wellness you don’t need to challenge the data to invalidate it.  You merely need to read the data.  It will invalidate itself.”

However, there is some good news about Wellness Corporate Solutions: NASA employees don’t need to worry about their job security, because these people are not rocket scientists.

 

Dr. Aetna Will See You Now

Aetna

Short Summary of Intervention:

“Aetna is launching a pilot program to test the benefits of new FDA-approved, prescription weight-loss drugs combined with lifestyle support. – See more in this news release.

Summary of Aetna’s key points:

Self-insured employers can sign up for this program in which Aetna will outreach to obese employees and recommend use of the drugs Belviq and Qsymia

Questions for Aetna:

You are only offering this program to self-insured employers. If this is, as your title says: a “strategy to improve health status and reduce costs,” why are you denying this program to your own fully insured members, where the cost savings would accrue directly to your own shareholders while the health status improvements would benefit your own members?

ANS: Refused to answer

Does it concern you that neither drug in your pilot is approved in Europe and that JAMA Internal Medicine says the drugs have been associated with serious harms and that these well-respected JAMA physician editorialists state that these drugs should not have been approved for use in the United States?

ANS: Refused to answer

How does your description of these drugs on your sales slide as “safe and effective” square with the question above?

ANS: Refused to answer

Why, over the course of the 70-minute webinar (for which attendees were charged $300), didn’t you mention the JAMA essay or any other safety concerns?

ANS: Refused to answer

In addition to omitting mention of the potential harms in the JAMA article, none of your materials mention that the (many) known side effects include impacts on memory, attention and language. Wouldn’t those side effects be of concern to an employer who is interested in, as your materials say, increasing the productivity of the employees taking the drugs?

ANS: Refused to answer

Does it concern you that these drugs have been by and large rejected by patients and physicians, with sales for Belviq “well below even reduced Wall Street expectations” while Qsymia has been described as ”flailing” ?

ANS: Refused to answer

Does it concern you that, of any drug on the market, Belviq has the highest ratio of payments to doctors to overall sales?

ANS:  Refused to answer

Suppose an employee’s doctor won’t prescribe these drugs. Many doctors refuse to prescribe these drugs because of the side effect profiles (hence the very low sales figures). In that case, will you pressure the doctor to prescribe the drugs, get a list from the manufacturers of doctors in the area willing to prescribe the drugs and encourage the employee to switch doctors, or pressure the employer to tell the employee to drop out of this program they were just recruited into at your request? In other words, if the doctor doesn’t comply, will Aetna play doctor?

ANS: Refused to answer

Are you aware of any other health plans that will recommend name-brand drugs to members who call and say that they have obesity or any other disease?

ANS: Refused to answer

Are you aware of any other health plans that, rather than wait for members to ask for drug recommendations, outreach to members who have a disease in order to recommend proprietary name-brand drugs?

ANS: Refused to answer

Are you aware of any other health plans that outreach to members who do not have a disease, but only a high BMI, to recommend proprietary prescription drugs, especially prescription drugs that “have been associated with serious harms”?

ANS: Refused to answer

You said on your webinar that people who go off these drugs will “gradually regain weight.” In that sense, other than the $2400/year cost and “potential for serious harm,” how would this result different from any other diet, in that people who stop adhering carefully will gradually regain their weight?

ANS: Refused to answer


Any responses, apologies, retractions, changes etc. by the vendor are listed here:

June 23, 2014: Note from Ed Pezalla at Aetna, Vice President for Pharmacy Policy and Strategy:  “Thank you for reaching out and inviting additional dialogue.  We have a new article about the program that addresses many of your questions.  We expect to publish the article in the next week or so in Aetna’s Health Section.  I can send you a link once it is posted.”

August 11, 2014:  Ed Pezella sent an article that would “answer some of the questions“.    I am having trouble locating the answers in that article but perhaps that’s because I can’t find my reading glasses.

October 2015: Qsymia sales still “flailing.”   May be off the market by 2017.  Belviq struggling as well.  Aetna could have avoided this entire embarrassment in the first place if they had simply asked us if pitching obesity drugs to its customers was a good idea.  Come to think of it, they didn’t have to ask us.  They could have asked anyone with an IQ over 80.

May 2016: STATNews finds that obesity drugs — specifically these two — have been abject failures in the marketplace.

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