Innovative approaches to worksite-based weight loss: Results of the WAY to Health study

Obesity is at epidemic proportions and costs US employers an estimated $78.5 billion annually. According to national data, only 16.9% of employers offer weight loss programs for their employees. Effective weight loss programs are needed that are adaptable to busy work environments, maintain employee privacy, and keep employees engaged over time to help avoid weight re-gain. WAY to Health is a NIH-funded, group randomized worksite-based weight loss study that takes place in 14 worksites where 1020 overweight employees enrolled and were randomly assigned to one of 4 intervention groups: cash incentives (CASH), web-based weight loss program (WEB), cash plus web (BOTH), or usual care (UC). Employee participants completed written surveys and weight was measured at 3, 6, 12 and 18 months. College was the unit of randomization and intervention; employee was the unit of analysis. Weight loss at 12 months was the primary outcome and 765 employees remained for the final analysis (75% overall retention rate). Among completers, average 12 mo weight losses (lbs) were -0.68(.71)(WEB); -2.52(.70)(CASH); -2.07(.69) (BOTH); -1.51(.93) (USUAL CARE). Clinically relevant weight losses (at least 5% weight lost from baseline to 12 months) by arm were: 13.8% (WEB); 16.4% (CASH); 16.4% (BOTH); and 15.9% (UC). At 12 months, 55.2% of enrolled employees in the WEB group lost any weight, compared with 57.7% CASH, 55.3% BOTH, and 52.2% UC. Minimal-intensity worksite-based interventions produced clinically relevant weight losses among overweight/obese employees. Employer options and considerations/implications for reach and impact are discussed.