Sarah Wells Kocsis, a director on the public health team at the Milken Institute, shared during Iowa Healthiest State Initiative’s second Obesity Roundtable on Sept. 17 that employers have a “tremendous role” in fighting obesity.

Highlighting a GlobalData report from February 2024 that showed employees with obesity or who are overweight in the nonfarm, civilian workforce cost about $425.5 billion, Kocsis said the cost of not addressing the issue is much greater than the cost of tackling it.

Included in that $425.5 billion cost are $146.5 billion in higher medical costs to employers ($89.8 billion) and employees ($56.7 billion), along with $242.6 billion in costs associated with absenteeism and presenteeism.

Kocsis was the principal director in crafting the “Modernizing Care for Obesity as a Chronic Disease” how-to guide for employers, which outlines four opportunities for action including education, culture change, strategic benefit design planning and public policy.

The first step, Kocsis said, is recognizing obesity as a chronic disease.

“But then, as you learn more about obesity as a chronic disease, you understand the need for a comprehensive approach because it’s very tempting to go to one modality or solution, like drugs or surgery,” she said. “It has to be a continuum, and a whole comprehensive set of options for people to look at. And I think employers, patients, insurance companies, everybody needs to see it from more of a holistic perspective.”

Over one-third of adults in Iowa, or 36.4%, are classified as having obesity, according to the Iowa Healthiest State Initiative, and an additional 34.3% are classified as being overweight.

“The role of the employer is just so tremendous, and it’s because of the workforce numbers that we have in this country,” Kocsis said. “It’s the access to care through our benefits and insurance. And we still have government programs, but employers have a critical role in terms of investing in the health of their workforce, so they need to understand these issues and the root causes behind them.”

Some of the opportunities for action outlined in the how-to guide include increasing awareness and understanding of obesity as a chronic disease and its economic and social impacts on the workplace, creating a culture of health and well-being in the workplace, and addressing barriers to access to high-quality, efficient and evidence-based obesity care.

“Employers know that they need to tackle this issue, but they also are so sensitized to cost that it’s almost like we need to have more of the conversation around it,” Kocsis said. “It’s a lot of sound bites, and there’s information that is being discussed, but I think it’s almost like employers need help in navigating the decision-making process, and there have been other diseases in the past that have been very expensive.”

The Milken Institute report was not intended to be exhaustive, Kocsis said, but instead serve as more of a conversation starter.

“This report did not go deep enough,” she said. “So now, it’s really saying, ‘How can we take this to the next level?’ And we came up with these opportunity areas for action, but I think we need to lean into the ones that employers of certain sizes or readiness feel like they can tackle, and then really give them concrete and tangible tools to work from.”