Obesity prevention and control in the worksite: What works?

Background: Obesity affects nearly 60 million adults in the United States. Obesity is linked to many co-morbid conditions resulting in increased health care costs. It is estimated that employers spend $13 billion annually on the total cost of obesity. To help employers respond to this epidemic, we identified promising worksite strategies for obesity prevention and control.

Methods: Using a methodology that closely parallels and broadens the Community Guide review process; we conducted a systematic review to identify worksite interventions addressing environmental and policy, informational and educational, and behavioral strategies. Our review included studies such as randomized control trials, before and after, time series, and other designs with concurrent comparison groups. Studies were evaluated based on suitability of study design, quality of execution, sample size, and effect size. Changes in weight-related outcomes were used to assess effectiveness.

Results: Six promising strategies were identified: 1) enhanced access to physical activity with health education: -3.24% (n=5 studies) 2) exercise prescription alone: -2.45% (n=14 studies) 3) multi-component educational interventions which incorporated exercise prescriptions, nutrition prescriptions, and/or small media in addition to health education sessions: -2.24% (n=25 studies) 4) weight-loss competitions: -2.66% (n=17 studies) 5) behavioral strategies with incentives: -3.46% (n=17 studies) 6) behavioral strategies without incentive: -1.89% (n=46 studies)

Conclusion: These promising strategies can help employers build effective interventions for their employees. Our review allows us to identify research gaps and acknowledges the need for further evaluation of promising worksite strategies for obesity prevention and control.