Being overweight or obese increases the risk of developing over 200 chronic diseases and conditions, as well as leading directly to premature death and disability. The good news? In most circumstances, our weight is something that is within our control. Here, Kim Allen, Director of Lifestyle Health Coaching at INTERVENT International, provides an insight into overweight and obesity and what multinationals can do to help their people avoid it.
Overweight and obesity, defined as excessive fat build up that may impair health, was once only considered a problem 
in high-income countries. But that’s no longer the case. The number of people who are overweight or obese has grown to almost pandemic proportions, even in low- and middle-income countries, and particularly in urban settings. Over four million people die as a result each year. Today more people are obese than underweight in every region of the world except parts of sub-Saharan Africa and Asia.1
Obesity as a complex, chronic disease
For many years, professional medical organisations have classified obesity as a chronic disease risk factor, similar to abnormal blood cholesterol or blood pressure. The emerging obesity pandemic and accompanying health consequences led The Obesity Society to publish a position paper in 2008, defining obesity as a noncommunicable chronic disease in itself. And, although the debate continues, over the last decade, multiple scientific organisations have argued that obesity should be treated as a chronic disease rather than simply a risk factor. In 2018 The Obesity Society published an updated position statement re-affirming the importance of defining obesity as a chronic disease.2
What are the consequences of being overweight or obese?
As well as directly contributing to premature death and disability, being overweight or obese results in a heightened risk of developing more than 200 other chronic diseases and conditions. And, the more body fat someone has, the more at risk they are. Some of the conditions include but are not limited to:2,3,4,5
heart disease and stroke
type 2 diabetes
some cancers, including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney and colon
hypertension
abnormal cholesterol
musculoskeletal disorders, especially osteoarthritis
gall bladder and gastrointestinal disease
breathing problems
sleep apnoea
stress incontinence
infertility and gynaecological problems, including gestational diabetes
erectile dysfunction
psychiatric diseases, such as anxiety, depression and eating disorders.
On the whole, either directly or indirectly, obesity is responsible for a reduced quality of life for affected individuals. And it has a substantial effect on the economy due to treatment costs and reductions in workforce participation and productivity.2
For employers, obesity can be a major health insurance cost-driver. According to a 2019 publication, across all industries, US employees with obesity were more likely to be among the top 20% in terms of healthcare costs and were more likely to be in the top 20% for medical-related absenteeism and disability costs, compared with employees without obesity.6 This is a particular problem for employers when they end up paying for medical and disability claims for these employees.
Weight loss vs weight management
Overweight and obesity, like other chronic diseases, requires long-term care and management. Losing weight can be exciting and socially rewarding, but can be hard work. Maintaining a healthy weight requires just as much, if not more, effort, but brings less gratification. And it requires a different set of skills from those needed for weight loss. Studies of people who have lost approximately 15kg or more, and have maintained that loss for at least one year, suggest that patterns associated with successful weight maintenance include the following:5
self-monitoring of weight
eating a healthy dietary pattern
daily physical activity of approximately 60 minutes or more
minimal sedentary “screen time”
eating most meals at home.
Physical activity is an integral part of weight loss, but, in general, won’t improve weight loss much over six months compared to a reduced calorie diet. Most weight loss occurs because of eating fewer calories, whereas regular physical activity is most helpful in keeping weight off once it is lost. But it’s important to note that being physically active does have the added benefit of improving fitness and reducing the risk of developing cardiovascular disease, type 2 diabetes and many other chronic conditions. Also, studies suggest that the decline in a person’s resting metabolic rate which often occurs with weight loss can be offset by regular exercise, partly because it helps preserve muscle.3
As well as exercising and eating a low-calorie diet, some overweight and obese people may be candidates for weight loss medication and/or weight loss surgery.4,5 However, these should always be used together with a behaviour change programme. The challenge of losing weight, and keeping it off, only serves to support the importance of not becoming overweight in the first place.
What can employers do to support weight management at work?
Take steps to avoid the stigmatisation of, and discrimination against, employees who are overweight or obese. Shift perceptions away from the misinformed view that obesity is simply due to lifestyle choices or a lack of willpower and instead focus on a chronic disease model for understanding and addressing overweight and obesity in both individuals and groups.2
Make affordable, healthy food choices available – in vending machines, food trucks, onsite cafeterias, catered events, etc. You don’t have to completely eliminate less healthy items, just balance them by providing some affordable healthier choices too.
Encourage overweight and obese employees to participate in a comprehensive lifestyle management and behaviour change programme for at least six months.3
Encourage individuals who have lost weight to participate in a long-term (one year or longer) comprehensive weight management programme.3
Invite employees to contribute healthy recipes to a company cookbook. Feature fresh, locally grown foods, foods low in saturated fat, added sugar and sodium, and recipes that reflect cultures and ethnic groups represented in the workforce and community.
Make sure there are safe places for employees to walk and promote taking the stairs, if possible.
Encourage employees to cycle or walk to work (possibly combined with public transport), if feasible and safe.
Organise walking groups that meet daily for short, 10-minute bouts of brisk walking. The recommended goal is a minimum of 30 minutes of moderate-intensity aerobic exercise over the course of the day on at least five days per week.
Overweight and obesity, as well as the related noncommunicable diseases, is largely preventable. Supportive environments and communities are important for tackling the problem. Eating healthier foods and taking part in regular physical activity needs to be the easiest choice (the choice that is the most accessible, available and affordable) for all.1
Thanks for sharing, Kim!
Want to know more about how you can support your people with weight management? Complete the form below to download an attachment on assessing body fat, visit INTERVENT’s page on our website, or contact your MAXIS GBN representative.
1World Health Organization. Obesity and overweight, June 9, 2021.
2Jastreboff, AM et al. Obesity as a Disease: The Obesity Society 2018 Position Statement. Obesity 2019;27:7-9.
3INTERVENT International. Understanding Overweight, 2022.
4Hamdy, O et al. Obesity Guidelines, updated March 4, 2022. Accessed at https://emedicine.medscape.com.
5Schutz, DD et al. European Practical and Patient-centred Guidelines for Adult Obesity Management in Primary Care. Obesity Facts - The European Journal of Obesity 2019;12:40-66.
6https://journals.lww.com/joem/fulltext/2019/11000/direct_and_indirect_cost_of_obesity_among_the.3.aspx