1. Obesity is a hidden driver of benefit costs
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So the hidden driver of benefit plan costs and I truly believe obesity is the hidden driver and I'll tell you why
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it's not in the data. So, I talked about integrating data last year. This is an actually a slide from last year. So, I've worked with lots of clients on looking at their data, so pulling in their extended health, their drug data, their disability data, and looking at where the health risks are in their population and how to drive Wellness programming.
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Pretty much, and I've been doing this for years, it's always these four conditions that are in the top 4. The odd time I see digestive disorders in here, but it's typically always depression, cardiovascular, diabetes and chronic pain, inflammation. You don't ever see obesity
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in this data, uh, disability data hardly ever do we get a disability claim in the door for short term. That is for obesity unless somebody has gastric bypass surgery. But yet if you dig into that claim and recovery is prolonged, usually obesity is a factor.
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So it'll be interesting to see when the carriers decide what they're going to do with Wagovan. We know Greenshields covering it. We know I is going to cover it starting mid November. Manulife, Sun Life are kind of still out in Canada life. But once that gets approved and if you as employers add it to your plan, if we start to see a category come up for obesity
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and in turn if we start to see some of these other areas come down, we know from the research that obesity increases your risk factor for these four conditions. And I'm going to show you why these four conditions are in there and why you really again I believe that obesity is that hidden cost driver.
2. Obesity is a complex chronic disease that requires a holistic treatment approach
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So just to set the stage on what obesity is. So, if you look on obesity can is site or on the website. So, obesity is a chronic complex disease defined by excessive fat deposits that can impair your health. OK, so BMI is still the measure for obesity. People argue it's not the best measure. Clinicians, doctors will also look at waist circumference. So, 35 for women, 35 inches, 40 inches for men across the waist increases your risk factor
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for obesity significantly and other health conditions.
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Uh, but we still use BMI, so 30 to 39.9.
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What it's not, is it's not a lifestyle condition. And that's kind of what I, I want to hit home here. It's not a lifestyle condition.
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What causes obesity. So, 40 to 70% of it is genetics. We have just this is very high level. So, we have hormones in our body that from our gut to our mind that tell us when to eat when we're full. We have hormones that regulate our sugar. So, Gremlin, which I think of her like the stomach growls when you're hungry, tell you when to eat. Lectin tells your mind to stop eating, that you're full Insulin, take sugar out of your blood, puts it into the cells for energy. So, these all need to be in
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homeostasis to manage your weight. So, from a genetic standpoint, a lot of people with obesity have lowered leptin levels so their body, their mind is not telling them when to stop eating. So that's one of the primary causes in terms of genetics.
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And another thing I heard from a speaker was a doctor that specializes in obesity is that overeating doesn't cause obesity. Obesity causes overeating. And that gets back to the hormone imbalance.
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Yes, there's other causes of obesity and there's some listed here. So, trauma, childhood trauma, bullying, medications, something call out for women here, Women's Health, you know, when we're young, we're on the pill that causes weight gain. When you're older, you're on HRT and that causes weight gain. We can't. What other medications, mental health medications, A lot of those will increase weight gain and eating.
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I would also say lifestyle.
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Lifestyle is a factor.
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We don't move enough, we don't get enough sleep,
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we're too stressed. Um, we drink too much, and we eat
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crappy processed foods. So, if you look at our food, it's full of fats, it's full of unhealthy oils, it's full of high fructose corn syrup. So, lots of unhealthy foods. So that's another factor here.
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I should have my glasses on. I can't read down there.
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Ah, socioeconomic status is a big one, right? So, people who are unemployed or have lower incomes are not choosing the healthier foods. I mean, in here we have incomes or employed and look at the grocery stores and how much it cost to eat healthy, right? So, I've been in the dollar store before and seen people buying their food in the dollar store because that's all they can afford. It's do I pay for my rent, or do I eat healthy, right? So those are the choices people are dealing with today.
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So lots of different. Is there another one on there that I missed
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medications, which I think I'm good there. OK. So basically, a lot of factors that go into obesity. It is a complex condition, lots of factors involved in your risk factor for it.
3. The impact of obesity on your benefits plan
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What is the impact of obesity on your benefit plan? So again, I'll go back to that slide I showed in terms of your costs, when you're sitting with your consultants and you're looking at your renewals and you're looking at your drug utilization, pretty much always you're going to see these conditions coming up, right? Diabetes, depression, asthma is on here, inflammatory conditions, musculoskeletal conditions, cardiovascular disease.
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I'm going to do a call out for the mental health there. You'll see a stack. 20 to 50% of those with depression also have mental illness. And so, it's kind of a chicken and the egg. It's cyclical, right? You, you have obesity, and you're depressed about your weight. You can't participate in things that you want to be able to participate in. And the converse is true. So, you're struggling with mental illness and then you've got the medications, you don't have the energy to exercise or be part of things. You're not sleeping properly. All these are risk factors and that
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leads to weight gain and obesity,
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lost productivity costs. So, there was a question there from Terry about presenteeism. So, in fact, presenteeism they researched is about one to two times the cost of absenteeism. So, if you look at your absenteeism costs and double that, that's probably what you're spending on people being at work and only being 50%. And so, there are some stats there around obesity and you'll see days miss, you'll see the light blue is absenteeism and the darker blue is presenteeism. When you go from a normal weight to a
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obesity Class 1, which is 30 to 34.9 on the BMI, you're 18.3 days for presenteeism, right? When you look at cost, they're looking at about 11.8 billion to employers and cost of lost productivity due to disability and obesity. And then we do know the costs around Type 2 diabetes because we're measuring that, and you'll see that it's around $412.00 in reduce productivity and 1042
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for Type 2 diabetes, which we know obesity is a driving risk factor.
4. Employers can support employees living with obesity
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So holistic support. Obesity, as I said, is a complex condition, lots of different health impacts to it as well. A lot of people have multiple chronic conditions. Sleep, I said, is a big piece of it. So, having sleep hygiene programs, especially if you're in an organization that has shift workers, right? So, sleep hygiene programs, nutrition and dietitians through your extended healthcare, your paramedical program, making sure that that's adequate enough to support employees who want that health coaching
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with a nutritionist,
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exercise programs, definitely that is still part, we all should be exercising regardless of what conditions we have to reduce chronic conditions. So, some employers I know have apps like Virgin Pulse app is a really great one where you are incented for doing, for moving, for eating healthy, for getting your sleep. And so, employers that incent employees and they can put in their healthcare spending account or their personal spending account, that's a great option.
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Innocent Centre subsidies, if you have capacity on site and you have employees coming in having a weight room or somewhere, some people can go on their lunch to have a bit of a workout, even if it's just stretching or resistance bands.
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Clinician support. So again, that health coaching, but giving employees access to health coaches and support in that area. And the last one on this slide is really around that lifestyle exclusions. So, when I talk about benefit plans and this collaborative effort, one thing I would say is to go back and look and make sure you don't have weight loss medications noted to be a lifestyle exclusion in your drug plan. I think most don't anymore, but just double check
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that you don't have that as an exclusion
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awareness and anti stigma. So, the video I showed you is great for promoting, you know, at the start of a meeting or something like that, whereas raising that awareness about what obesity actually is and that it's not a lifestyle condition. It's not because somebody is just choosing to be lazy and not eat healthy. It's a chronic disease like anything else should be treated that way. Making sure because there's a, there is a big link between obesity and type 2 diabetes that you're
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diabetes coverage is sufficient hunger benefit plan knowing your numbers. So biometric screening with people coming into the office, I've actually had a lot of clients asking me for vendors who can come in and do that biometric screening
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for me. One of my employers in the past did biometric screening. I found out my numbers and they weren't good, and it was pretty shocking for me to see those numbers on a piece of paper. And that is what
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got the fire lit under myself to make changes in my own lifestyle at the time.
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Again, healthy eating options. So, if employees are in, do you have a cafeteria? Do you have healthy eating options? Do you have vending machines that support some healthy options in them? If you have a cafeteria, the, the healthy food front and centre rather than the, the French fries and the pizza. So, making sure that's there and obesity toolkit. So unfortunately, it's not a website I can direct you to, but the consultants in here, it's all been pushed out to them. So, you can ask for it to be pushed out. Its posters, its stories, it's
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some excellent videos of people that have gone through their weight loss journey and how important it is to have a doctor that believes in you and an employer and supports around you. So, I, I would encourage you to reach out and ask about that.
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And then I'll just finish with this quote. Michelle Obama. Obesity is not a choice as a result of a lack of options. So, I'd encourage you as employers, when you're looking at how to support your employees through your DIB strategies and your benefit plan strategies to make sure that you're looking at employee health holistically. You're considering all your employees. One piece I forgot to mention on there is accommodations, right? So, some people
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with obesity, they don't want to come forward and ask for an accommodation because again, they're feeling embarrassed, but making sure that they have proper desk set up, do they have a proper chair that's supported? Maybe they need to be closer from a parking perspective. So just consider those things as well when you're looking at employees. And I would encourage you to really think about adding weight loss medications to your plan. Explore with your consultant if that's right for you or not.