Obesity, Depression, and Costs

As we have seen, the opinion is widely held that research done so far on the relationship between employment and associated physical and mental disorders is insufficient. In some jobs and with some people, there may be a tendency to escape work whenever possible, on the thinnest of excuses. From the bosses’ side, there may be a tendency to take advantage of people who need jobs by making them do dangerous tasks and then blaming them if injury occurs. It would come as no surprise to learn of lawsuits and strikes related to these issues.

The history of labor has encompassed very complicated and conflict-prone areas. Hard-fought decisions have been made about who is entitled to compensation for being absent from work; as well as who is allowed to show up and underperform (presenteeism), which in the long run costs the company even more.

Obesity is one of the conditions that can influence worker productivity. If our kids are overweight or obese, it is likely they will grow up to be obese adults, and this relationship to work will be just one of the many problems they will be challenged to deal with.

Wider information, please

Archived studies on the subject have been recognized as excellent, but too narrow in scope. One example (published in 2020) focused on almost 3,000 Japanese office workers, of whom 70% were male. According to the researchers,

Ten health risk factors for presenteeism have been identified, including health-related behaviours such as smoking, lack of physical activity, high blood pressure, perception of health and stress. Studies have reported that workers with arthritis, allergies, fatigue, depressive symptoms, hypoglycaemia, overweight and obesity were at higher risk of presenteeism.

In the same paper, mention was made of such impactful organizational policies as sick pay, attendance management, and permanency of employment.

What about profit and loss?

Recently, Investopedia.com looked back at a 2016 study from Social Psychiatry and Psychiatric Epidemiology, which showed that…

[…] presenteeism associated with depression costs $5,524 per person annually in the U.S., five to 10 times higher on average than costs associated with absenteeism.

And of course, there is an extensive connection between depression and obesity. A 2015 article said,

Human obesity has serious consequences on health, including increased risks for depression, noninsulin-dependent diabetes mellitus, cancer, rheumatoid and osteoarthritis, hypertension, and heart disease. In addition, obesity has been found to reduce the quality of life for both men and women and markedly reduces life expectancy…

Those facts are quite depressing. Depression has been called the enemy of motivation, and one thing from which it can definitely demotivate a person is the desire to wake up, get spiffed up, and travel to a hated job.

And another thing…

It is possible that depression is being promoted for profit. This will not be gone into here, but the following quotation is worrisome in its implications, given all the ways through which obesity’s overall expense to society is likely to increase:

[M]any people who once called themselves alcoholics and drug addicts now say they are “dually diagnosed” with “major depressive disorder” and “bipolar disorder.”[…] Today, when alcoholics and drug addicts leave rehab, they are lifelong Pharma customers… For this lifelong, chronic and lucrative condition — resting on the now disproved chemical imbalance theory — they can remain on drugs like SSRIs for decades.

Whatever degree of legitimacy is represented there, it is bound to involve obesity in a large number of cases, and to be inimical to good employment relationships. Closer to home is a 2020 report from Sweden titled “Childhood obesity linked to higher risk of anxiety, depression and premature death.” Among other statements, we find:

Children with obesity have a three times higher risk of mortality in early adulthood compared with children in the general population and are more likely to suffer from anxiety and depression.

When these children grow up and become employed, their tendencies toward impaired physical health and depression are certain to impact their effectiveness at work, which in turn raises the employers’ costs to a greater or lesser extent in every business and in government jobs too, with the result that all these costs are passed on to customers and also eventually to every other facet of society.

Your responses and feedback are welcome!

Source: “Presenteeism among workers: health-related factors, work-related factors and health literacy,” Occupational Medicine, November 2020
Source: “Presenteeism: What It Is and How It Works,” Investopedia.com, 01/06/25
Source: “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity,” Academia.edu, 2015
Source: “Drugmakers Continue to Profiteer on ‘Free’ Mental Health Programs,” Academia.edu, 11/04/24
Source: “Childhood obesity linked to higher risk of anxiety, depression and premature death,” News.ki.se, 03/18/20
Image by KarlToon/Pixabay

Obesity, Pain, and Presenteeism

Pain is an obesity issue, because “musculoskeletal or joint-related pain in the feet, knees, ankles, and back” can make certain maneuvers difficult or impossible. Obese people often cannot move very well because of arthritis, and, of course, the relative lack of mobility leads to increased obesity. Carpal tunnel syndrome also shows up more often among heavier workers.

It might seem that a very obese person would be more difficult to knock over, but other factors are involved. The authors suggest that, in heavy individuals, balance and coordination are compromised. Obesity is also connected with sleep apnea and heart disease, both of which cause shortness of breath and general weakness, two definite drawbacks in a work situation.

According to an Australian study of long-term health conditions and obesity released in 2020, the mechanisms of the phenomenon are still obscure to the point where “little is known.” That paper’s conclusion “implies that interventions to improve workers’ health and well-being will reduce the risk of presenteeism at work,” an observation that one reviewer with an attitude dryly states “does not actually qualify as helpful.”

A 2018 study, using data compiled around 10 years earlier, compared various occupations in terms of how, and how much, productivity is affected by weight. Not surprisingly, obesity had the most profound impact in the physically demanding field of construction. Arts and hospitality was the next most affected category, which seems like an odd pairing since the arts can include extremely strenuous physical activity like performative dance, while hospitality could encompass standing behind a counter giving out room keys in a hotel.

Perhaps in this context, hospitality only includes the personnel who clean the premises, change the bedsheets, and so forth. A surprising number of jobs might turn out to include repetitive motions, awkward body positioning, and other challenging requirements.

At any rate, the conclusion there was that “Obesity differentially impacted productivity and costs, depending upon occupation,” which could not have come as much of a surprise to anyone. Between 2004 and 2011, all American industries saw weight increases in their average workers. This much was definitely stated:

When examined by occupational group, the highest age-standardized obesity prevalence was found for US adults working in the Motor Vehicle Operator occupational category (39.2%), with the lowest prevalence for those working in the Health Diagnosing and Treating Practitioner (15.4%) category.

These facts should also not be startling, because the drivers of trucks and buses are perpetually seated, while employees in the health field have a relatively high awareness level of the dangers of obesity. An interesting insight emerged from a large study in the Netherlands, which…

[…] reported that obesity was predictive of developing musculoskeletal symptoms, especially among workers whose jobs had low (vs high) physical workloads… Yet, the researchers acknowledged that their findings could alternatively be explained by individuals with musculoskeletal symptoms tending to self-select into occupations with fewer physical job demands.

In the field of manufacturing, when physically demanding tasks are involved, excess weight definitely impairs productivity, especially in terms of needing “additional time to complete physically demanding tasks.” In the realm of office workers, management and professional occupations tended to see higher costs “attributable to obesity-related absenteeism across a number of primarily office-based positions.”

Impairments in productivity and higher medical expenditures tend to characterize obese individuals with cardiometabolic risk factors like hyperlipidemia, diabetes, and hypertension. During the time period encompassed by that study, it was found that almost two-thirds of the expenses incurred by businesses were attributable to morbidly obese employees.

The authors noted that such studies tend to focus on only one or perhaps a few occupations, so…

[T]here exists a dearth of empirical research investigating the impact of obesity across varying occupational groups. Such research is critical, as excess weight may be associated with differing degrees of burden depending on profession and job responsibilities.

Your responses and feedback are welcome!

Source: “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity,” Academia.edu, 2008
Source: “A longitudinal exploration of the relationship between obesity, and long term health condition with presenteeism in Australian workplaces, 2006-2018,” PLOS.org, 08/26/20
Source: “Impact of Obesity on Work Productivity in Different US Occupations: Analysis of the National Health and Wellness Survey 2014 to 2015,” NIH.gov, 2018
Image by RosZie/Pixabay

UNICEF Warns Childhood Obesity Has Surpassed Underweight Worldwide

Obesity has now overtaken underweight as the more common form of malnutrition among children, according to a new UNICEF report. The study, “Feeding Profit: How Food Environments are Failing Children,” reveals that 1 in 10 school-aged children and adolescents — about 188 million — are living with obesity, putting them at risk of serious, life-threatening diseases.

Pratik Pawar wrote for Yahoo:

Obesity in children isn’t just about size; it raises risks for Type 2 diabetes, high blood pressure, cardiovascular disease, and even certain cancers later in life. Starting so young makes the costs even higher. By 2035, being overweight and obesity are expected to drain more than $4 trillion a year globally — about 3 percent of the world’s GDP.

The report draws on data from more than 190 countries. Since 2000, underweight prevalence among children ages 5-19 has dropped from nearly 13% to 9.2%. At the same time, obesity has more than tripled, from 3% to 9.4%, and now exceeds underweight in every region except sub-Saharan Africa and South Asia.

Alarming trends across regions

The findings highlight especially high rates of childhood obesity in several Pacific Island nations. In Niue, 38% of 5-19-year-olds live with obesity; in the Cook Islands, 37%; and in Nauru, 33%. These figures have more than doubled since 2000, largely due to a shift away from traditional diets toward cheap, energy-dense imported foods.

Wealthier nations are not immune. For instance, 27% of children and adolescents in Chile are obese, along with 21% in the United States and 21% in the United Arab Emirates.

UNICEF Executive Director Catherine Russell commented:

When we talk about malnutrition, we are no longer just talking about underweight children… Obesity is a growing concern that can impact the health and development of children. Ultra-processed food is increasingly replacing fruits, vegetables and protein at a time when nutrition plays a critical role in children’s growth, cognitive development and mental health.

The health and economic costs

While undernutrition such as wasting and stunting remains a problem for children under five in many low- and middle-income countries, the prevalence of obesity among older children is rising quickly. Globally, 391 million children and adolescents, which is 1 in 5, are now overweight, with a significant proportion classified as obese.

The report stresses that this crisis is not about individual choices but about environments saturated with unhealthy foods. Ultra-processed products (high in sugar, salt, refined starches, and unhealthy fats) are dominating children’s diets. Schools and shops are filled with them, while digital marketing gives food companies unparalleled access to young audiences.

A UNICEF U-Report poll of 64,000 young people aged 13-24 across 170 countries showed just how pervasive this influence is. Seventy-five percent of respondents recalled seeing ads for sugary drinks, snacks, or fast foods in the previous week, and 60% said the ads made them want the products more. Even in conflict zones, 68% of young people reported exposure to such marketing.

The long-term costs are staggering. In Peru alone, obesity-related health impacts could cost more than US$210 billion. By 2035, the global economic toll of overweight and obesity is projected to exceed US$4 trillion annually.

Policies that make a difference

Despite the bleak outlook, there are success stories. Mexico, where ultra-processed foods and sugary drinks make up 40% of children’s daily calories, has banned the sale and distribution of these items in public schools. This policy shift has improved food environments for more than 34 million children.

UNICEF is urging governments, civil society, and global partners to act quickly by:

• Enforcing strong policies such as food labeling, marketing restrictions, and taxes or subsidies to shift demand toward healthier foods.
• Supporting social and behavior change programs that empower families to demand better food options.
• Banning junk food sales and sponsorship in schools.
• Safeguarding policy-making processes from food industry interference.
• Strengthening social protection measures so vulnerable families can afford nutritious diets.

Russell emphasized:

In many countries we are seeing the double burden of malnutrition — the existence of stunting and obesity. This requires targeted interventions… Nutritious and affordable food must be available to every child to support their growth and development. We urgently need policies that support parents and caretakers to access nutritious and healthy foods for their children.

Your responses and feedback are welcome!

Source: “Obesity exceeds underweight for the first time among school-age children and adolescents globally — UNICEF,” UNICEF, 9/9/25
Source: “Child obesity level surpasses underweight cases worldwide for the first time, UNICEF warns,” UN.org, 9/9/25
Source: “For the first time, more kids are obese than underweight,” Yahoo.com, 9/15/25
Image by Porapak Apichodilok/Pexels

More About Absenteeism, Presenteeism, and Obesity

The authors of a 2008 meta-study described the obesity-related costs (that take such a toll on society as a whole) as “astounding.” “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity” found that “the annual presenteeism cost for moderately or extremely obese workers was $1783.81, which is $506 higher than the cost for other workers.”

The study’s subject groups categorized as moderately and extremely obese experienced the highest absenteeism, averaging 91.08 absentee hours “for personal health reasons.” Financially, presenteeism is dreaded because…

[…] absences do not necessarily cost the employer the full value of the worker’s time to the extent that these are unpaid absences and that other workers are able to cover the missing shifts. Meanwhile, presenteeism is always a cost to employers because the worker is receiving a full paycheck despite reductions in productivity.

All in all, this accounts for a sizable chunk of the annual $900 billion that American employers pay for medical expenditures.

As numerous other studies have confirmed, the price paid by businesses for employee obesity is up there in the mega-bucks range. Unfortunately, much more work is needed on the minutiae of “Why?” When the cost derives from absenteeism and/or medical services rendered, this is easily understood.

What seems elusive is the exact process by which, when obese employees are involved, presenteeism (showing up for work but underperforming) is so wasteful. Is it just that they move more slowly when picking up a phone or straightening a stack of papers? Do they take longer lunch breaks, or spend more on-duty time moving back and forth to the snack machines? Do they fall asleep at their desks? What, exactly, is the issue?

Employees are on the job, but not functioning effectively because of medical or psychological conditions. But how does this manifest? We are told that the moderately and extremely obese workers experience the most limitations, as measured by the time needed to complete some tasks, and sheer inability to perform others.

In a broad sense, that tracks. If employed as a ballet dancer, a person with a BMI of over 35 would obviously fail. But how does the extra poundage inhibit or prohibit, for instance, a journalist? Presumably, the fingers on the keyboard would still be just as fast and accurate.

The particular questionnaire utilized in this study comprised 25 items falling into four categories:

The time scale addresses difficulties with meeting job expectations and scheduling demands. The physical scale focuses on workers’ ability to perform their normal job tasks as influenced by bodily strength, movement, endurance, coordination, and flexibility. The mental-interpersonal scale examines cognitive tasks, sensory input, and interactions with others. The output scale focuses on the quantity, quality, and timeliness of meeting job demands.

But the details involved in particular office tasks are not described. We know what the workers in a warehouse do. They move heavy physical objects from one location to another, which presumably requires an energy expenditure that helps prevent them from putting on weight. (Although, don’t count on it.) Still, a job in a plant or warehouse environment usually implies the ability to bend, stretch, squat, push, and walk.

But in an office setting, how heavy is a pencil or a file folder? Someone in the Information Technology department might need to lift a computer once in a while, but in general, what physical task is so daunting that a worker in the top obesity classification would be slowed down, stopped, or injured by its performance?

Okay, the IT person probably has to get under a desk now and then, to check on or reorganize some wiring. For a morbidly obese employee, this would be a struggle, costing time and possibly medical expenses.

It is easy to see why fitting beneath a desk, in the category of physical demands, could be problematic. However, seemingly, it would also qualify as a time issue, because the other employee who should be using that machine to complete work is unable to. Adding insult to injury, hashing out these procedural details adds to the time it takes to finish such studies.

Your responses and feedback are welcome!

Source: “Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity,” Academia.edu, 2008
Image by Pexels/Pixabay