Examine whether obesity is associated with increased presenteeism.• Identify any associations between BMI grouping and absenteeism. • Estimate annual per-worker costs of health-related productivity losses and

Examine whether obesity is associated with increased presenteeism.• Identify any associations between BMI grouping and absenteeism. • Estimate annual per-worker costs of health-related productivity losses and

Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity

Donna M. Gates, EdD, RN, FAAN Paul Succop, PhD Bonnie J. Brehm, PhD, RD Gordon L. Gillespie, MSN, APRN, BC Benjamin D. Sommers, MD, PhD

Learning Objectives • Relate presenteeism, as reflected by scores in four dimensions of work and

percentage productivity lost on the Work Limitations Questionnaire, to body mass index (BMI) in this study of 341 manufacturing employees.

• Identify any associations between BMI grouping and absenteeism. • Estimate annual per-worker costs of health-related productivity losses and

absenteeism as related to BMI.

Abstract Objective: To examine whether obesity is associated with increased presen-

teeism (health-related limitations at work). Methods: Randomly selected manu- facturing employees (n � 341) were assessed via height and weight measures, demographic survey, wage data, and the Work Limitations Questionnaire. The Work Limitations Questionnaire measures productivity on four dimensions. Analyses of variance and analyses of covariance were computed to identify productivity differences based on body mass index (BMI). Results: Moderately or extremely obese workers (BMI �35) experienced the greatest health-related work limitations, specifically regarding time needed to complete tasks and ability to perform physical job demands. These workers experienced a 4.2% health-related loss in productivity, 1.18% more than all other employees, which equates to an additional $506 annually in lost productivity per worker. Conclusions: The relationship between BMI and presenteeism is characterized by a threshold effect, where extremely or moderately obese workers are significantly less productive than mildly obese workers. (J Occup Environ Med. 2008;50:39–45)

I n the early 1970s an editorial in theLancet1 identified obesity as the mostimportant nutritional disease affectingaffluent countries. Yet, over 30 years later, the US prevalence of obesity has increased dramatically among children, adolescents, and adults. Human obesity has serious consequences on health, in- cluding increased risks for depression,2

noninsulin-dependent diabetes melli- tus,3,4 cancer,5,6 rheumatoid and osteoar- thritis,7,8 hypertension,9,10 and heart disease.11,12 In addition, obesity has been found to reduce the quality of life for both men and women2,4,13,14 and markedly reduces life expectancy,15,16

The risks associated with overweight and obesity are alarming because ap- proximately 66% of US adults are over- weight or obese (body mass index [BMI] �25), with 32% being obese (BMI �30).17

The obesity-related costs to soci- ety are astounding. Finkelstein et al18

recently estimated obesity-attribut- able medical expenditures in the United States to be $75 billion in 2003, with one half of these expen- ditures financed by Medicaid and Medicare. Employers are struggling with increasing costs related to health care and absenteeism. US em- ployers are spending in excess of $900 billion per year for medical expenditures.19 Researchers have es- timated that costs attributed to obe- sity represent between 2% and 7.8% of the total health care expenditures of US businesses,20,21 and that obe

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