Employer Wellness Programs: A Tool of the Diet Industry

A few years ago, a good friend of mine and fellow social worker shared with me that his employer wellness program was triggering his eating disorder. Among activities like providing fresh fruit in the staff room and encouraging taking short breaks throughout the day, the organization incentivized weight loss by providing a reward if you did not gain weight at certain intervals of the year. In a courageous move, my friend thoughtfully wrote an email to the person in charge of the program, explaining concerns that this messaging could be harmful for those with an eating disorder. He asked if employees could opt out of receiving the recurring emails advertising their activities or participate in a separate event.

The response? He was told to just delete the emails; they would not adjust their program or messaging. While my friend recently celebrated a year in recovery, at the time this dismissiveness and inaction further fueled his eating disorder. This specific employer provided outpatient mental health treatment, so you would think that out of all the sectors and industries, someone at this organization would have been aware of or sensitive to the fact that this type of activity could be problematic, and be responsive to a request for change. Unfortunately, this experience is not unique. There are many stories out there of workplace “Biggest Loser” competitions, public weigh-ins, and untrained vendors making health determinations off of numbers on a scale and directing staff to exercise more or eat less [1].

Wellness” in the workplace

Wellness, “the active pursuit of activities, choices and lifestyles that lead to a state of holistic health,” encompasses at least six different realms: physical, mental, emotional, spiritual, social, and environmental [2]. While the definition sounds lovely on the surface, its workplace implementation often focuses on the physical realm and overlaps with diet culture messaging. Christy Harrison, MPH, RD, CEDS writes about the issue with wellness culture, explaining it as “a set of values that equates wellness with moral goodness, and posits certain behaviors—and a certain type of body—as the path to achieving that supposed rectitude” [3]. Her new book set to release in 2023 examines how wellness culture actually “creates harm and robs people of true well-being” [3].

This can be observed in how wellness is presented in the workplace. Some of the common employer wellness programs include nutrition education, exercise programs and activities, health risk assessments, health screens, and weight loss programs [4]. While there is support to remove weight loss from employer wellness programs [5], the themes of weight loss, obesity, healthy/unhealthy foods, and exercise are still often emphasized [6, 7, 8]. When anyone institutes activities focused on health or mental health without adequate training, they can harm the very people they are trying to help.

Driven by a desire to reduce insurance costs and/or increase productivity and morale, many employers see wellness programs as a fix and are marketed to by vendors looking to sell their products and promising the world. Research indicates that wellness programs do not significantly reduce health care costs [9], improve clinical measures of health, or impact absenteeism or work performance [10]. If employers pay vendors for wellness program implementation, these “poor outcomes” can lead to blaming the employee [11]. Companies can also turn to wellness programs as a superficial Band-Aid for larger issues in the work environment, such as long hours, intense pressure to perform, high turnover, or low pay [12]. Wellness activities cannot replace adequate staffing and feeling supported by your manager, being empowered and able to physically and mentally clock out on time, and having the necessary resources to do your job well and feel your work is important.

What to do when you encounter negative wellness and diet culture messaging at work

If your employer is instituting a wellness program that has harmful messaging or if your colleagues are talking frequently about weight loss or moralizing about food, here are some ways to navigate these situations.

• Take care of your mental health first. Process feelings in therapy, share your frustrations in a support group, or lean into your relationships for support. You don’t need to manage these triggers or experience the discomfort they cause you alone.
• Identify your boundaries. You do not need to disclose your medical or mental health history to your employer or coworkers, but some people don’t mind sharing their experiences. Either way, figure out what you are or are not willing to share ahead of time so you aren’t caught off guard by questions and accidentally say something you’d rather keep private.
• Know that you’re not alone. You likely have coworkers who are not pleased with the messaging for a variety of reasons, but don’t want to rock the boat or appear like they aren’t a team player. Speaking up may validate someone else and give them encouragement to push back.
• There is power in numbers. One voice raising a concern will not be taken as seriously as pushback from a group [13]. If you know others have taken issue with the messaging or constant diet talk, see if you can collectively bring up the issue to your boss or Human Resources representative.
• Have a plan when the diet talks starts. Some options could be:
  • Excuse yourself and leave the space. If this is not practical, like the conversation is occurring within earshot of your workstation and you can’t leave, some alternatives could be turning on some soft music or a noise machine, or putting on headphones.
  • Pivot the conversation:
    • Back to work, such as “How did your presentation to the new partner go?” or “Could you explain such-and-such from the staff meeting to me?” Or,
    • To an unrelated topic, such as asking for updates on your coworker’s foster cat or how their vacation went, or sharing opinions on the newest season of a popular show.
  • State directly that you don’t like discussing body size, weight loss, calories, or activities people use to punish their bodies. You can say that there is so much shame in these topics and you’re not going to participate in these conversations. If you are pressed for more information, you can be firm and assert that this is not something you want to discuss.
• Share resources. This webinar, The Silent Epidemic of Eating Disorders in the Workplace by the Center for Health, Work and Environment and the Eating Disorder Foundation, provides education and furthers understanding of the issue. This Health Links handout, Eating Disorders in the Workplace, provides an overview of eating disorders and tips on messaging and implementing wellness programs in the workplace with an awareness of eating disorders, and additional resources to learn more.

Sources

1. Lewis, A. (n.d.). Wellness programs and eating disorders: A potentially lethal combination. Corporate Wellness Magazine. https://www.corporatewellnessmagazine.com/article/16740
2. Global Wellness Institute. (n.d.). What is wellness? Retrieved July 11, 2022 from https://globalwellnessinstitute.org/what-is-wellness/
3. Harrison, C. (n.d.). Wellness culture. https://christyharrison.com/wellness-culture
4. Society for Human Resource Management. (n.d.). How to establish and design a wellness program. Retrieved July 11, 2022
5. Lewis, A., Khanna, V., & Montrose, S. (2015). Employers should disband employee weight control programs. The American Journal of Managed Care, 21(2), 91-94. https://www.ajmc.com/view/employers-should-disband-employee-weight-control-programs
6. Interdisciplinary Center for Health Workplaces & University of California, Berkeley. (2018). 2018 Employer guide: Finding fit: Implementing wellness programs successfully. https://transamericainstitute.org/docs/default-source/berkeley/2018employerguide.pdf?sfvrsn=80bd5e9b_4
7. Institute for Health and Productivity Studies, Johns Hopkins Bloomberg School of Public Health. (n.d.). Nutrition and weight management in the workplace: A guide for employers. https://www.jhsph.edu/research/centers-and-institutes/institute-for-health-and-productivity-studies/_docs/archived-projects/WHRN_NWM.pdf
8. Shoaibi, C., Moskow, A., & Alexander, E. (2020). Obesity in the workplace: What employers can do differently. Milken Institute. https://milkeninstitute.org/sites/default/files/reports-pdf/Obesity%20in%20the%20Workplace-FINAL_0.pdf
9. Mattke, S., Liu, H.H., Caloyeras, J.P., Huang, C.Y., Van Busum, K.R., Khodyakov, D., &  Shier, V. (2013). Workplace Wellness Programs Study: Final report. RAND Corporation. https://doi.org/10.7249/RR254.  
10. Song, Z. & Baicker, K. (2019). Effect of a workplace wellness program on employee health and economic outcomes: A randomized clinical trial.  JAMA, 321(15), 1491-1501. doi:10.1001/jama.2019.3307
11. Fournier, J. & Mattke, S. (2017, March 4). Do corporate wellness programs work? Society for Human Resource Management. https://www.shrm.org/hr-today/news/hr-magazine/spring2021/pages/do-corporate-wellness-programs-work.aspx
12. Malleret, T. (2021, October 19). The “great resignation” phenomenon: It’s a reckoning for so much unwellness at work. Global Wellness Institute. https://globalwellnessinstitute.org/global-wellness-institute-blog/2021/10/19/the-great-resignation-phenomenon-its-a-reckoning-for-so-much-unwellness-at-work/
13. Green, A. (2018, February 19). How to speak up as a group at work. Ask a Manager. https://www.askamanager.org/2018/02/how-to-speak-up-as-a-group-at-work.html