If it's your friends who are making you fat, can your employer make you fit?
That's the question now facing every workplace wellness program, after a recent big health study overwhelmingly fingered friendships as the reason people become obese.
If a friend becomes obese, that increases a person's odds of also becoming obese by 171 percent, according to research on more than 12,000 people over 32 years published in the New England Journal of Medicine. The effect also worked in reverse, in the smaller numbers of people who lost weight.
Families had less influence; neighbors had none.
So how could your boss?
Growing numbers of U.S. companies are installing wellness programs, as it becomes clear that chronic conditions such as obesity are the biggest-ticket items in their health insurance costs. A Watson Wyatt survey of U.S. employers showed that 74 percent will have health management programs next year, up from 64 percent this year. And some of these programs have been around long enough to demonstrate success, including one for the 1,400 Twin Cities employees of defense contractor BAE Systems, which saw health claim costs drop 3 to 4 percent a year over the past three years.
A lot of credit goes to features that counteract the powerful lifestyle influences the new study documents, experts said, and they include on-site fitness centers, sports teams, midday walking pals and discounted insurance premiums for the health conscious.
"My sense is that knowing that (the study's conclusions) makes the strong social support component more important," said Nico Pronk, executive director for the Health Partners Health Behavior Group, which develops and runs client wellness programs.
Accountability and convenience are what worked for JoAnn Abraham, 44, an engineering manager at Medtronic Inc. who lost 25 pounds since October using her employer's wellness program.
"It's really hard for me to say that I have not been doing something" I'm supposed to, said Abraham, who has about 100 more pounds to lose to reach her healthy weight.
She gets a call from a wellness counselor once a month and attends Weight Watchers at work - two check-ins that help keep her on track, she said.
An on-site fitness center with a treadmill and elliptical machine conveniently make exercise a regular part of her day, she said.
Before all this, she said, "The idea of a lifestyle change was overwhelming for me."
The power of groups to help similarly challenged people meet their goals is well documented - going back to 12-step programs - because they become a new social support network to replace the one that was all about old habits, Pronk said.
To him, the study suggests another important role for workplaces. It showed how people can get heavier over time because their social groups made that look normal, he said.
In contrast, a company can use its annual assessments as a touchstone, reporting the health measures in aggregate each year, he said.
That would reveal collective shifts that otherwise go unnoticed.
"It could say that, as a group, we gained an average of 2 pounds in a year," Pronk said, "and that's not a good health sign."
H.J. Cummins is a workplace columnist and reporter at the Star Tribune in Minneapolis. She can be reached at firstname.lastname@example.org.