On-the-job training

Forget dashing to the gym at lunch. Today, there are extra benefits to working out at work.

By Stephen Smith

Just the other day, Katie Abbott was trundling through the neighborhood market, cart laden with food for her family. She rounded a corner and happened upon Debbie Ouellette, a pal from the social service agency in Gardner where she works.

" 'I hope you have all healthy food in that carriage,' " Abbott recalled her colleague saying, with an air of encouragement.

It was a meaningful chance encounter. The women stand at the vanguard of a state experiment that takes the battle against obesity right to where people work.

When Governor Deval Patrick unveiled a far-reaching campaign to combat obesity this month, much of the attention focused on two potentially contentious measures: forcing fast-food joints to prominently post calorie counts, and ordering schools to issue weight report cards to students.

But the architects of the initiative decided that wasn't enough. So they're giving seed money to employers - including the social service agency where Abbott and Ouellette work - to help workers eat less and exercise more.

Now, the two women, along with roughly a dozen colleagues, are shedding pounds with the blessing of their bosses, who are providing advice from nutrition specialists, space for meetings, even prizes.

"It's people you see every day at work, and you feel a little bit more accountable," Abbott said. "Say I see Debbie and I have a cookie in my hand. She's going to say, 'You shouldn't be eating that cookie.' "

The workplace program reflects government and employers' frustration over twin crises, inseparably intertwined: the nation's exploding tab for healthcare and the expanding waistline of its citizens, a harbinger of heart disease, diabetes, and other chronic conditions.

"People are spending more and more time working, so putting wellness initiatives in the workplace is sort of meeting people where they are," said Dr. JudyAnn Bigby, the state's top health official.

In fact, studies show that such initiatives are gaining in popularity among employers, with one report finding that more than three-quarters of major US companies now offer them. In some cases, workers who participate get a break on insurance payments.

At technology company EMC, employees save 12 percent on their health insurance by completing an annual health risk survey, which the Hopkinton company said is voluntary and confidential. Depending on the results, workers then receive a computer-generated blueprint on how to improve their health.

An elaborate health initiative introduced in 2003 by the company appears to be making workers and the bottom line more robust. EMC's insurance costs, for example, have not risen as quickly as the national average. And when Boston University doctors introduced a diet program at EMC aimed at reducing cardiovascular disease, medical charges for workers who participated were $1,000 lower on average compared with those who didn't.

We spend millions of dollars on hypertension medicine as well as cardiovascular claims in general," said Delia Vetter, the company's senior benefits director. "This type of program was just a natural fit for EMC." Discuss

The push to introduce on-the-job health initiatives can venture into troubling terrain, both social and legal.

There's usually no problem with an employer or health plan offering discounted insurance rates to workers who agree to complete a health assessment or take a fitness class. But things can turn dicey - and, maybe, even illegal - if incentives are tied to actual success in losing weight or lowering blood pressure.

"Creating a culture of wellness is going to be attractive to some employees and very unattractive to others, who view it as, if not coercive, then maybe paternalistic," said Michelle Mello, a Harvard School of Public Health professor and coauthor of a 2008 New England Journal of Medicine report on the legal limits of workplace health campaigns.

"And it raises larger questions about the appropriate role of employers in influencing people's lifestyle: Where are the boundaries between your employment and the rest of your life?"

For Cindy Soule, the problem was that the rest of her life - the few hours not spent at work or getting there - left little time to exercise.

Which explains why, during one recent lunch hour, Soule was on the flat of her back at her workplace, the Montachusett Opportunity Council, the same regional social service agency where Abbott works.

She was among seven employees bending and twisting during a pilates class in a conference room, even as a box of chocolates sat on a credenza, beckoning.

"It's not just my friends on the phone saying, 'Oh, we should be doing something more about staying fit now that we're in our 50s,' " said Soule, who works to prevent childhood lead exposure. "That tended to be more emotional support, but it wasn't getting anything done. This is working better than any fitness initiative I've done on my own, because this is built into my work day."

The pilates classes - and the weight-loss program that Abbott joined - are the latest offerings from the social service agency, which has partnered with the city of Fitchburg. It all started when Mary Giannetti, director of nutrition and wellness, was seeking state money to help make Fitchburg workers more fit. "I thought, this is something we ought to offer to our own staff, too," she said.

So they did, with as much as $300,000 from the state underwriting the campaign across five years. Agency and city workers took to the streets of Fitchburg last year, led by Mayor Lisa Wong, and walked thousands of miles.

But they're not just breaking a sweat - they're shattering attitudes. That became evident when agency executive director Kathleen McDermott encountered workers discussing what makes for a healthy waistline.

"One of them wound up measuring her waist to show me how big it was," McDermott said. "That never would have happened before."

As for Abbott, two weeks into the Survival of the Fittest weight loss program, she's already lost nine pounds.

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