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Obese Workers vs Smokers – Who Costs Your Healthplan More?

Smoking has been the “easy target” for many wellness plans for more than 30 years.  It’s viewed by many (even some smokers) as a “nasty” habit and it has a seemingly endless list of destructive health effects – in fact, we all know them so well, listing them here would certainly be met with a chorus of “Yeah, yeah, tell us something we don’t know…”

Well, what you may not know is that smokers cost employers over $1,275 a year in additional healthcare costs (versus non-smokers) – not including losses in productivity, etc.

But the “new” news, is that, according to a study of more than 30,000 Mayo Clinic employees and retirees who had continuous health insurance from 2001 to 2007, obese workers cost $1,850 more in healthcare costs than those with normal weight.  That’s 45% higher than smokers.

Worse yet, healthcare costs for morbidly obese people were up to $5,500 more a year than for normal weight people.

As ominous as these facts are, the greater concern, is that while the percentage of adult smokers has been slowly decreasing over the last decade (from 23.3% in 2000 to 19.3% in 2010), the rate of obesity in adults continues to skyrocket (from 19.4% in 1997 to 35.7% today)!

Obesity carries with it a surprisingly similar list of health effects as smoking, including cancer, heart disease, stroke, etc.  But obesity’s most immediate threat to employees’ health and our shared healthcare costs, is diabetes.  Countless articles have been written on the diabetes epidemic in the US and many experts agree that this is a principle cause of rising health insurance costs.

A critical consideration for those establishing and managing wellness plans is the immediacy of disease progression and/or co-morbidity relative to those diseases being targeted for intervention.  From this perspective, the most invasive and expensive treatments related to smoking (for lung cancer, COPD, etc.) may be delayed for many years (often until after the employee has retired or moved on to another job).

Obesity, on the other hand, is more often associated with diseases and conditions likely to develop in the near future (i.e. high cholesterol, high blood pressure, heart attacks, certain cancers and joint and musculoskeletal problems).  Furthermore, many of these conditions are likely to impact the employee’s job performance and attendance more so than smoking.

Consequently, as employers search for ways to reduce healthcare costs – such as smoking cessation and fitness programs – the impact of obesity in the workforce must be addressed as an urgent and rapidly accelerating healthcare cost challenge in wellness plan design in order to optimize both health and financial outcomes.


Credit to HealthDay News for bringing this study to my attention.

Smoking Prevalence Among U.S. Adults 1955-2010

Obesity Rates in the U.S.


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