The Deck Is Stacked Against Your Employees but You Can Offer Effective Weight Management Solutions

January 2009 Edition



by Jennifer Lovejoy, PhD. Executive Director of Weight and Nutrition Services, Free & Clear

     Chances are that your quarterly goals don’t include foraging and hunting, activities for which humans’ bodies are adapted. The U.S. workforce is entrenched in an environment that promotes poor nutrition, sedentary lifestyles, and chronic stress; however, you can create a modern work environment that does not set up your employees for weight gain or obesity and that supports the prevention of weight gain, weight loss, and overall health improvement. The end result: employees with more energy, less illness, and increased productivity.
     Despite a $40 billion weight loss industry, it is clear that present attempts to stem the obesity epidemic aren’t working. General wellness programs have become central to the broad goal of reducing health care costs for employers. Alternately, programs specifically designed for weight management are often too narrowly focused on weight loss as the only goal rather than improvement in overall health and the reduction of cardio-metabolic risk, which leads to decreases in excess medical costs and improvements in productivity.
     Entrenched in an environment that promotes poor nutrition, sedentary lifestyles and chronic stress, America’s workforce is set up for failure and weight gain if not taught broad-based skills for improving overall health as part of a comprehensive, integrated weight management program. Here are some solutions to counter the culture and get your company and employees on track for a healthier bottom line.

We Live in an Obesigenic Culture

     Obesity rates in the United States have skyrocketed in the past 30 years, largely due to changes in our modern environment. Experts describe our environment, with its abundant, cheap, high-calorie food and limited physical activity as obesitypromoting or “obesigenic.” The obesigenic environment makes it very difficult to avoid gaining weight and, once weight is gained, diminishes the likelihood of succeeding at permanent weight loss.
Our nutritional environment in particular has changed dramatically in the last few decades. Prior to the 1950s, the majority of people ate home-cooked meals consisting primarily of unprocessed foods low in calories and high in nutrients and fiber.
     Although refined white flour and sugar were available, we ate nowhere near the quantity we do today. According to the U.S. Department of Agriculture, refined sugar intake increased 25% from 1967 to 2003, reaching an average intake of 142 pounds per person in 2003. A large portion of this increase is due to increased soft drink consumption and high-fructose corn syrup (HFCS), a kind of refined sugar. Whetherhigh intakes of HFCS play a specific role in the obesity epidemic is controversial, but the fructose in HFCS and table sugar has a number of biological effects that result in stimulation of appetite, potentially leading to overeating and weight gain.
     Intake of fat has also increased in the last 30 years. Added fats from cooking oils, butter, margarine, and processed food in the U.S. diet increased from 33 to 86 pounds of fat per person per year since 1970. Trans fats, widely introduced into our food supply with the promotion of margarine in the 1950s and subsequently incorporated into a variety of processed baked goods, turned out to have a number of harmful effects on weight and cardio-metabolic risk. These harmful fats only now are being removed slowly from our food.
     Not surprisingly, calorie intake has also increased significantly since the 1970s, in part because we’re eating more fat (the most calorie-dense nutrient), but also because of a significant increase in the number of meals eaten outside the home. Studies have shown a shift in eating patterns from mostly homecooked meals several decades ago to mostly restaurant-based meals. Much of this shift is due to increased consumption of fast food, where portion sizes are large and calorie counts are high. Research clearly associates higher frequency of fast food intake with obesity in both children and adults.

Our Biology Is Not Keeping Pace

     Finally, it is likely that environmentrelated changes in physical activity habits also contribute to weight gain. Although adults’ participation in sports and formal exercise has changed little in the past few decades, the amount of lifestyle activity we engage in (e.g. walking or biking for transportation, housework and yard work) and the amount of sitting we do has changed dramatically. A steady increase in the number of labor-saving devices available at work and at home, along with a huge increase in hours spent in our cars, watching television, and using the computer, has significantly decreased the amount of calories we burn every day. Interestingly, research has shown that the number of hours spent sitting is associated with increased risk of obesity and Type 2 diabetes independent of planned physical activity.
     When looking at our global obesity epidemic, it’s important to consider not only how dramatically the environment has changed, but the fact that our genes have not. Our biology is still adapted to the lifestyle of our hunter-gatherer ancestors of 10-15,000 years ago. Our Paleolithic ancestors ate a nutritious diet consisting mostly of plants with occasional low-fat game meats and were on the move much of the time foraging and hunting (like the animals they ate). Our bodies are well-adapted to survive situations of feast and famine, and we have multiple biological systems that promote fat storage and conservation whenever food is not available. As a result, when we follow deprivation diets or skip meals, our bodies kick into “starvation mode” to prevent us from losing too much fat. Our ancient ancestors also developed a sophisticated system to handle acute stress, the “fight or flight” response, which does not serve us well in today’s environment where chronic mental/emotional stress, rather than shortterm physical stress, is the norm. Our biological response to this chronic stress tends to further exacerbate overeating and weight gain, specifically causing increased abdominal fat which is associated with higher cardio-metabolic risk.

The Modern Environment and Our Workplace

     The combination of our biology and environment seems a disastrous pairing, but there are ways that employers can help employees fight back against unhealthy influences. Chances are that your quarterly goals don’t include foraging and hunting, but providing an environment that promotes and supports healthy behaviors is one of the best things you can do to increase energy and productivity among your employees. Here are some ideas to ensure that your employees’ physiological needs are being met at work:

1. Forming a wellness committee or an employee advisory board will help you to evaluate your current worksite environment and determine which changes should be implemented.
2. Knowing that your staff will be unlikely to bring nutritious, home-cooked meals for lunch and may be tempted to eat out, you can offer nutritious alternatives at a reasonable price. Evaluate what is currently offered in your vending machines and cafeteria and determine whether you should renegotiate with your vendor or draft new healthy food policies. Consider guidelines for catered events and company meetings, and compile a list of vendors that offer healthy choices.
   
3. Encourage your staff to take 10-minute breaks to stretch their legs and get a bit of exercise. Devote resources to making your worksite “walkable” or your stairwell and parking lot safe and appealing to encourage physical activity during work hours.
   

1. Most are diet plans based on a “deprivation” model involving strict calorie restriction. While this approach will result in short-term weight loss, it isn’t sustainable in the long run both because of the biological mechanisms which work against starvation, as well as psychological resistance to rigid and demanding diets.
2. Most weight loss plans recommend simple behavioral changes for weight loss, without emphasizing the biological and behavioral science behind the recommendations.
   
3. Most weight loss plans do not address underlying cognitive issues—the unhelpful, habitual thought patterns that can sabotage even the best plans for behavior change.
   

1. An approach to nutrition in ways other than simply cutting calories. For instance, the nutritional approach in Free & Clear’s Mind & Body Program is based on the extensively studied DASH eating plan, which emphasizes whole foods (fruits, vegetables, whole grains), reduced total and saturated fat, and increased calcium intake from non-fat and low-fat dairy products. Research has shown that the DASH plan not only lowers blood pressure, but reduces body weight, blood lipids, stroke, and diabetes risk factors.
2. While it is important for everyone to work toward a minimum of 180 minutes per week of planned exercise (as recommended in the recently released U.S. Guidelines for Physical Activity), it is also important for people to increase lifestyle activity and reduce sedentary behavior. Studies show that obese people sit on average 2 hours per day more than people who have a healthy weight. Furthermore, by increasing “spontaneous physical activity” (including fidgeting), an individual can burn an extra 300-500 calories each day, which would add up to a 30-pound weight loss in a year.
3. Body image and binge-eating concerns are significant for many overweight individuals and need to be addressed in a comprehensive program.
   
4. Lifelong motivation for maintaining a healthy lifestyle occurs only when someone is aware of their core values and beliefs and has identified those behaviors that are inconsistent with their core values so they can change. For example, someone may say they want to lose 30 pounds, but what they really want is to have less knee pain and shortness of breath so they can play with their grandchildren. The real motivator is “playing with grandchildren,” and while losing 30 pounds may be the means to that end, it is often easier to turn down an extra helping by thinking about your grandchild’s smiling face than a number on the scale.
   
5. Regular practice of stress management strategies to control stress-related and emotional overeating is also essential to lifelong weight management efforts.
   
6. Recent studies suggest that getting a good night’s sleep (at least 7 hours) reduces  hormones that activate one’s appetite and lowers risk for weight gain. Learning to set appropriate goals, identify priorities, and develop time management skills will decrease stress and make it more likely that behavior change will be sustained in the long run.