Last week Southwest passenger Kevin Smith was asked to leave his flight from Oakland to Burbank, CA because he was obese and would infringe on fellow passengers because he didn’t fit in a single seat. Now, Southwest is barraged with publicity about its “customer’s of size” policy which requires passengers who cannot comfortably sit in a single seat to purchase an additional seat.

It’s no secret that Americans’ waistlines have been expanding for years and employers are searching for effective ways to help – or force – them to deal with it as a means of controlling rising healthcare costs, improving productivity and lowering absenteeism. According to Watson Wyatt and the National Business Group on Health, one of the most effective tools companies can use is to offer incentives for participation in lifestyle management and wellness programs. According to their study, even moderate incentives ($51 to $100) can boost participation and promote healthier behaviors, including smoking cessation and weight management.

According to Sherri Potter, Watson Wyatt’s senior group and health care consultant, “The relationship between the amount of the incentive and the level of program participation among employees is strong”. Consider the following statistics:

  • 61% of employers surveyed offered incentives in 2009 – up from 53% in 2008
  • 34% of employers surveyed in 2009 offered incentives for weight management – up from 31% in 2008
  • 73% of employers offered full coverage for preventive coverage – up from 53% in 2008

Even state governments are getting into the act. In 2011 two states, Alabama and North Carolina, both with high percentages of overweight residents, will begin requiring state workers to undergo medication screenings for various conditions including body mass index. Those employees found to be obese, have high blood pressure, high cholesterol or high glucose will have to pay an addition $25/mo for their health insurance.

The looming question is whether a stick or carrot is the most effective way to promote healthier lifestyles and HR managers are going to be in the thick of this debate.  Carrots are usually preferred over punitive actions to keep the program positive and engage employees in the process.

Some tips to help your teams effectively consider lifestyle management program objectives and incentives include:

  • Craft incentives carefully to ensure they promote health behaviors
  • Incentives can create dependency and the behaviors could be reversed once the incentives end
  • If you use an honor system, remember some employees may exaggerate their participation to receive the incentive, so you may want to include a statement on the application form employees sign stating that they agree to abide by the intent of the program and honestly participate.
  • One size, in incentives or punitive actions, does not fit all. Craft your policies with care and consideration for your culture and your objectives.

Today, obesity is not protected under the Civil Rights Act of 1964 or 1991, but there are a number of actions pending, and who knows, maybe Kevin will even file a suit against Southwest. Although there are no federal laws expressly protecting obesity, some states have enacted laws protecting obese employees from discrimination. To be sure you are in compliance, check with your attorney on any proposed changes to your policies.