The high cost of poor metabolic health

The high cost of weight management is a top concern for plan sponsors, especially since glucagon-like peptide 1 receptor agonists, commonly referred to as GLP-1s, gained approval as weight loss agents and demand subsequently surged. But obesity and overweight significantly affect your business, regardless of your coverage philosophy around GLP-1s and other medications used for weight loss.

Poor metabolic health is costing U.S. employers and employees billions of dollars – in large part due to high health care costs from associated conditions. The increased risk for cardiovascular disease, diabetes, high blood pressure, certain types of cancer, and other health issues is well-documented.¹

There are indirect costs, too. Like other chronic conditions, obesity and overweight contribute to absenteeism, disability, and reduced productivity, plus constraints on the labor force, which can substantially affect your bottom line. As the prevalence of obesity and overweight rises, so too will the strain these conditions put on your business.

Understanding the full business impact of poor metabolic health is critical in determining an approach to weight management that makes sense for your organization. 

Higher health care spending

Given the elevated risk for chronic conditions associated with excess weight, it’s not surprising that higher body mass index (BMI) translates to higher health care spending – for both plan sponsors and members.

A recent study compared health care spending for members enrolled in large employer-sponsored benefit plans. Members who had a diagnosis of obesity incurred costs more than double those without an obesity diagnosis.⁴

• $12.6K average annual health spending for health plan members with obesity in 2021
• $4.7K average cost for members without obesity diagnosis that same year

The same was true for member out-of-pocket costs.

• $1.5K – average OOP cost for members with obesity in 2021
• $700 – average OOP cost for members without obesity that same year

These numbers reflect overall medical costs, not just those directly tied to treatment of obesity.

Absenteeism and productivity

Obesity and overweight affect absenteeism and productivity as well. A study published in the Journal of Occupational and Environmental Medicine noted that obesity increases job absenteeism due to illness or injury by an average of 3 days per year, compared to that of workers who do not have the condition.⁵

Presenteeism, a phenomenon in which workers are less productive due to impaired physical and mental health, also is higher among workers with poor metabolic health. Considering the high rates of obesity and overweight among U.S. working adults, the overall financial effects are significant.

• 30% U.S. working adults have obesity
• $13.4B – $26.8B estimated range of productivity loss due to obesity in the United States⁶

Diminished labor force

As rates of overweight and obesity increase, the pool of candidates available to handle occupations that are physically demanding decreases. Increased rates of disability and premature mortality can take workers out of the labor force further limiting available human resources.

People who are overweight or obese are also more likely to experience stigma and discrimination related to their weight, which can contribute to poor mental health and low self-esteem.⁷ They may feel less inclined to pursue – or may be overlooked for – developmental opportunities, which can translate to limited career growth for the individual and can also constrain the potential to build depth within your organization.

Obesity prevalence and its effects on the workforce vary by industry and region, and businesses have a range of philosophies for addressing it. As your PBM partner, CVS Caremark can help evaluate how obesity is affecting your business and tailor a metabolic health strategy that suits your objectives and integrates with your benefit plan.