PepsiCo Chairman and CEO Indra Nooyi and Delos Cosgrove, President and CEO of the Cleveland Clinic, analyze strategies for addressing obesity.
The solution to the nation's obesity epidemic is mostly in the mirror, but food manufacturers, retailers and the government can play an important role in encouraging healthy living, panelists said.
The choices people make about diet and exercise ultimately determine the balance between calories in and calories out. Behavioral factors are responsible for a large number of deaths every year, and there is a limit to what medicine, employers and policymakers can do, speakers said.
But some businesses have taken the initiative in improving the health of employees and the consumers they serve. Employer-based programs require an initial financial outlay, but they have secured short-term returns. For example, Steven Burd said Safeway recently introduced a Healthy Measures program that adjusts employees' insurance premiums based on tobacco use, weight, blood pressure, and cholesterol; employees are refunded the difference at year's end if they improve in those categories.
"You have to measure so you know where you stand, then you have to make progress on that," Burd said. By shifting financial responsibility onto individuals, employees bear the consequences of their choices.
The Cleveland Clinic also has been successful at making the workplace healthier, promoting better food choices and reducing smoking — all without increasing employer costs, Delos Cosgrove said.
The Cleveland Clinic improved on-site food options; labeled cafeteria portions and calories; and provided free access to Weight Watchers, Curves and exercise classes. Although the changes cost the clinic $5 million in the first year, the 80,000 pounds lost by its employees in the first six months were estimated to save $6 million in health-care costs, Cosgrove said.
Manufacturers share the responsibility. "Food and beverage companies have to actively agree to reformulate their products," Indra Nooyi said. If healthy products end up costing more, or tasting worse, then they have failed. Industrywide standards for nutrition labeling and consumer education are also needed, Nooyi said.
"We're putting wiser, healthier options up front without serious trade-offs in quality, taste and price," moderator Andrew von Eschenbach said.
In addition to the "calories in" component, more exercise is required to affect the "calories out" part of the equation, panelists said. Physical education is disappearing from schools and from children's daily lives, which Nooyi called a serious threat. For adults, building fitness centers near workplaces improves exercise opportunities, Mark Mastrov said.
However, widespread promotion of health programs faces a number of challenges. Businesses that are self-insured focus more on administration solutions than on health promotion, and they are unaware that premiums can be adjusted to incentivize behavioral change. Policymakers in Washington, D.C., are increasingly aware of the societal costs of obesity, but they need to support the development and expansion of effective programs.
The law around obesity is part of the problem.
"Obesity is protected by the Americans with Disabilities Act, which seems to me to send the wrong message from the government about what obesity is and what it represents," Cosgrove said.
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