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Colorado School of Public Health


If Obesity is a "disease," what does that mean for the workplace?

August 30, 2013

​Earlier this year, the American Medical Association (AMA) House of Delegates passed a resolution recognizing obesity as a “disease state,” an announcement that has prompted a great deal of chat in media and blogosphere.  Today I’m going to speculate a little on what that disease designation might mean for the workplace.

What do we already know?

Work-related health effects associated with obesity. There are many work-related health effects that are associated with obesity, including cardiovascular disease, musculoskeletal disorders, liver disease, asthma, vibration injuries, and others. As such, obesity can be a significant contributing risk factor for work-related injury and illness, worker’s compensation claims and cost of claims, delayed recovery, absenteeism, ability to return to work, and need for accommodation to perform job duties.

How work can cause or aggravate obesity. In addition, obesity has been associated with occupational hazards, including sedentary work, jobs with low ‘control’, shift work, job stress, and certain chemicals (e.g. pesticides).  As such, we have to think seriously about how the workplace is a significant contributor to obesity in workers and in the societal epidemic.

Take, for example, the paper by Lowden and coworkers entitled “Eating and shift work – effects on habits, metabolism, and performance” published in Scandinavian J of Work, Environment and Health (2010;v.36:pp.150-162). While the literature on this subject is complex and inconsistent, one strong recommendation emerges: “It is strongly recommended that employers take steps to develop a nutrition management strategy at the workplace.”

The authors’ recommendation becomes more of an imperative if we now consider obesity to be a disease, as the AMA has announced.

Consider the following questions, if obesity is a considered a disease:

1. Will workers with obesity be considered a “protected class” of workers, leading to even more consideration of a worker’s weight and risk of weight discrimination in employment decisions, such as hiring, promotions, firing?      

2. Is there a need to be more proactive in modifying the conditions of work so that the workplace makes “reasonable accommodation” for obese workers?

3. Should employers be taking more aggressive (even mandatory) steps to address the workplace conditions that contribute to obesity risk, much like we already do to mitigate other hazardous conditions in the workplace?

4. How should we be integrating personal health risk with occupational risk factors to best protect the individual worker and optimize workplace productivity? For example, should managers and safety professionals be addressing the interaction of a worker’s weight and the ergonomics of a person’s job tasks?

5. Should participation in wellness programs that address health risk factors become a requirement of employment, and even be built into a worker’s annual evaluation?


These are just a few of the questions we will need to be considering. Each question raises significant clinical, ethical, legal, and societal issues. In the field of occupational health and safety, we need to be part of that dialogue.

 To read the whole AMA Resolution click here: OBESITY AMA ama-resolution-obesity.pdfOBESITY AMA ama-resolution-obesity.pdf






























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