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