A Reality Check for Wellness Programs

 Health Check for Wellness Programs” by Lauren Weber in today’s Wall Street Journal has some of the facts straight, which is better than most stories on this subject.

We have learned a great deal about “worksite wellness programs in the last half century, but we have not learned how apply those insights to those needing them most: Moderate and high risk employees. Therefore, it often happens that fit employees get fitter and the fat get discouraged.  

Some employee health and fitness directors believe we would do a lot better in promoting health lifestyle changes if we focused less on telling moderate and high risk employees they are at risk and what to do about it, and did more about analyzing eating behaviors, building self-esteem, explaining family systems theory, and offering such 12-step programs as Overeater’s Anonymous (OA) in their programs.  

First and foremost, experience has shown that moderate and high risk people do not respond well to motivation, instructions, skill development and the usual risk-factor assessments. Why? Because changing behaviors and empowering people to take care of themselves is a family systems proposition and has little to do with the physiology of exercise, enhanced eating behaviors, how to do a sit-up, stirring motivational speeches, joining multimillion dollar temples of exercise, and the like.  

All that hype may be effective to support the fit and healthy employees to become more so, but moderate- and high-risk employee usually stay stuck in their self-abusive and repetitive high-risk behaviors due to their low self-esteem.  

Why? For the same reasons almost all people at moderate and high risk for chronic disease find it difficult to change. They need support and training in how to address compulsive, obsessive patterns of self-abuse and commit to programs that promote peer counseling not unlike all the 12-step programs modeled on AA. At least that’s a real beginning that can dramatically reduce recidivism.

If traditional employee “wellness program strategies worked, why would the U.S. continue to lead the world with the number of such programs in business, industry and government and, at the same time, lead the world in worker morbidity and mortality caused by chronic disease conditions?

And not only does the U.S. lead all industrial nations in both morbidity and mortality caused by chronic disease behaviors, it also spends more private and public money to prevent them. 

It doesn’t take a clinician to tell us something is very wrong with this system.

  

© Health Designs International, 2017