WASHINGTON -- The fatter people get, the more their health insurance costs go up, a study finds.
To counter that, some employers are encouraging their workers to exercise and diet.
"Every pound you put on is important. Even one pound more," said Dee W. Edington, director of the University of Michigan's Health Management Research Center.
Edington and his colleagues found overweight and obese people have medical bills up to $1,500 greater a year than those of people of healthy weight.
The study looked at about 178,000 adults in General Motors' health care plan, which includes workers, retirees and family members. Researchers broke down the medical costs according to how much weight they carried, using federal categories ranging from underweight to greatly obese.
The federal body type categories are calculated in terms of body mass index, a computation based on a person's height and weight. For example, an adult who stands 5-foot-8 and weighs between 125 and around 164 pounds would be in the normal weight category. At 164 to around 197 pounds, this person would be overweight. Obesity begins at 197 pounds.
Medical costs rose as weight did, said the report in the January-February issue of the American Journal of Health Promotion. The average cost for those of average weight was $2,225. The lowest category of overweight was slightly more, at $2,388, but costs rose more sharply after that, reaching $3,753 for the fattest people.
The finding is in line with a report by the U.S. Surgeon General, which estimated the economic cost of obesity in 2000 at $117 billion. And it comes as the Centers for Disease Control and Prevention documents a rising level of weight gain. The worst fatness - extreme or morbid obesity - nearly tripled among adults between 1988 and 2000.
Federal statistics also show that seven out of 10 adults get too little exercise, and four of 10 get none.
Trying to keep employees from developing conditions such as diabetes or heart attacks, which are associated with overweight, employers are trying to inspire workers to change their lifestyles.
"One thing about health costs is that you look at it as a proxy for pain and suffering," said Tim McDonald, GM's manager of corporate health programs and a co-researcher in the Journal of Health Promotion report. "We are losing ground on overweight and obesity. We are able to measure it, but we are not able to make progress - yet."
GM and the United Auto Workers union jointly are trying to change the lifestyles of employees, retirees and family members through their LifeSteps education program, which is available to about 1.2 million people, said Charlie Estey, who oversees the program. The program includes diet and exercise advice.
One pilot program tries to fit the exercise to the lifestyles of the worker, Estey said. For instance, before deer hunting season in Michigan, employees could take part in a hunting preparation program that includes "how to throw a deer onto the hood of your truck without throwing your back out," he said. There are similar programs for golfers and gardeners, he said.
Besides giving workers more fun in their lives, the program can benefit GM by reducing productivity losses caused by injury and illness, Estey said.
Such efforts are worth studying as ways to work more activity into people's lives, said Dr. William H. Dietz, director of the CDC's division of nutrition and physical activity. But simply on an economic basis, it's not known yet whether such programs would pay for themselves in health care savings, he said.
GM and the UAW also are trying to encourage more community activity in places where GM's plants give it a powerful voice, such as Flint, Mich., and Lordstown, Ohio, McDonald said. The Just a Bit Gets You Fit initiative is aimed at having people do what the federal government recommends, such as getting at least 30 minutes of moderate activity, most days of the week, he said.
Others are subsidizing health club costs for their employees. At Louisiana College, a Christian liberal arts school in Pineville, La., faculty and staff get half off their health club fees if they go at least 8 times a month, said the college's president, Rory Lee.
Students' health club costs are bundled into their activities fees, and students, faculty and staff use the same facility. So students and faculty get to know each other better by seeing each other away from class, and both also can get healthier, Lee said.
The program has been under way since April 2001, he said, so it's too early to see any reduction in health care costs, but "that may be an outcome eventually."
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