Lead NORC researchers said the survey findings demonstrates willingness to and a desire for help. Across the board, all employees – including people who are average weight, overweight, and people who are obese - exhibited a strong desire for weight management help from their employers. They also indicated a willingness to pay more for various workplace weight-loss options, including exercise programs, nutritional counseling and other means. Employers also acknowledged their role in providing obesity prevention and management options for their employees.

"Effective obesity prevention interventions can help save millions of American lives and reduce health care costs in our nation. The workplace is where adults spend the bulk of their time and employers can play an important role in promoting healthy lifestyles and providing options to overcome overweight and obesity," said Richard H. Carmona, M.D., M.P.H., FACS, 17th Surgeon General of the United States (2002-2006), Vice Chairman of Canyon Ranch, President of the non-profit Canyon Ranch Institute, Distinguished Professor at the Mel and Enid Zuckerman College of Public Health at the University of Arizona, and Health and Wellness Chairperson for the Alliance Steering Committee. "With its diverse collaboration of organizations, the STOP Obesity Alliance is uniquely positioned to help employers identify new, effective solutions that address the nation's obesity epidemic."

Relating to this need, two STOP Obesity Alliance Steering Committee members, DMAA: The Care Continuum Alliance and Service Employees International Union (SEIU), have joined to examine an obesity benefit designed by DMAA that may be piloted by SEIU employees. This effort, which if executed will be evaluated for effectiveness, supports a STOP Obesity Alliance policy recommendation for innovative approaches to preventing and managing overweight and obesity. It also typifies the kind of innovation that could help the country take a step toward overcoming obesity.

Key Employer & Employee Survey Findings

• 71% of employers view offering obesity-related services as appropriate
• 80% of employees, regardless of weight, agree healthy lifestyles/weight management programs belong in the workplace
• 73% of employers view offering obesity-related services as effective
• 67% of employers are concerned about the effects of obesity on medical claims expenses
• 93% of employers see obesity as a preventable condition and the result of poor lifestyle choices
• Less than half of employers believe their company has given enough attention to the problem of obesity

"Facing rising health care costs, employers are willing to address obesity head-on in the workplace," said Jon Gabel, a Senior Fellow at NORC and the principal investigator, on the study. "By their actions, businesses seem to be saying that regardless of whose fault it is, obesity is my company's problem. And I need to do something about it."

Additional results from the survey are currently under review for future publication.

For more information about the STOP Obesity Alliance/NORC survey results and additional information, visit www.stopobesityalliance.org. Visit the DMAA site, www.dmaa.org, for information on the obesity benefit design under review by SEIU.

About the STOP Obesity Alliance

The STOP Obesity Alliance is directed by Associate Professor Christine Ferguson, J.D., P.I. of The George Washington University's Department of Health Policy and former Health Commissioner for the State of Massachusetts. The Alliance Steering Committee is comprised of the following public and private sector organizations: the American Academy of Pediatrics, American Diabetes Association, American Heart Association, America's Health Insurance Plans, American Medical Group Association, Canyon Ranch Institute, CDC's Division of Nutrition, Physical Activity and Obesity (DNPAO), DMAA: The Care Continuum Alliance, National Business Group on Health, National Committee for Quality Assurance, National Quality Forum, The Obesity Society, Reality Coalition, Service Employees International Union and Trust for America's Health. The Alliance is sponsored by sanofi-aventis U.S. LLC, a world leader in the pharmaceutical industry with a commitment to improving public health and a heritage in therapeutic areas including cardiovascular and metabolic diseases.

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"Obesity is no longer an isolated problem," said Richard H. Carmona, M.D., M.P.H., FACS, 17th Surgeon General of the United States (2002-2006), vice chairman of Canyon Ranch, president of the non-profit Canyon Ranch Institute, distinguished professor at the Mel and Enid Zuckerman College of Public Health at the University of Arizona, and Health and Wellness Chairperson for the Alliance Steering Committee. "Obesity impacts every aspect of our lives, including business productivity, national security, and the future of our healthcare system. Today, the obesity epidemic is exacting an enormous financial and human toll. We must focus critical thinking and innovative, multi-sector approaches on addressing the obesity epidemic. Only then will we improve our nation's overall health and prevent diseases such as diabetes and heart disease that cause tremendous suffering and early death throughout our nation."

Dr. Carmona noted that the Alliance's new recommendations provide an important perspective about combating adult obesity and reflect input from a diverse Steering Committee representing many sectors of American society.

The Alliance's policy recommendations focus on four key areas where both the private and public sectors can impact the nation's ongoing struggle.

• 1. Redefining Success: A growing body of evidence suggests that losing between five to 10 percent of current weight leads to major health improvements, including decreasing risks for diabetes and heart disease. However, there is no shared, evidence-based definition of what constitutes successful weight loss, leaving the field open to interpretation. The STOP Obesity Alliance recommends promoting the use of a sustained loss of five to 10 percent of current weight as a key measure to judge the effectiveness of weight-reduction interventions.
• 2. Encouraging Innovation and Best Practices in Obesity Treatment: The Alliance recommends innovative approaches for obesity treatment, intervention, and disease management for patients who have been unsuccessful with traditional nutrition and exercise only programs. Currently, individual programs rarely leverage possible best practice models that combine multiple interventions, such as diet, exercise, medication, and behavioral treatment.
• 3. Addressing and Reducing Stigma as a Barrier to Obesity Treatment: No evidence suggests that stigmatizing overweight and obese individuals is a motivator for losing weight. The Alliance recommends that healthcare professionals, government, and private entities address the issue in a way that promotes open discussion rather than isolating those who are affected. The Alliance recognizes the broader societal barriers to weight loss and promotes programs that go beyond recognizing the single role of personal responsibility.
• 4. Broadening the Research Agenda for Obesity: Healthcare decision makers need reliable information to assess the relative value of preventing and reducing obesity. The Alliance recommends a broadened research agenda that examines all of the important factors contributing to the obesity epidemic and how they interact with each other, as well as applied research to address the immediate needs of payers, providers, individuals and others on the front lines.

"Our overweight and obese state of the union demands smart solutions," said Christine Ferguson, J.D., P.I., and the director of the STOP Obesity Alliance. "The STOP Obesity Alliance's policy recommendations are designed to leverage the combined influence of consumers, providers, businesses, labor, government, health insurance and quality-of-care organizations to provide the kind of dynamic thinking that will help us change the shape of the union."

Strategies to Overcome and Prevent (STOP) Obesity Alliance Proposes Plan to Address the State of the Union's Obesity Crisis

Members of the STOP Obesity Alliance welcomed Richard H. Carmona, M.D., M.P.H., FACS, as Health and Wellness Chairperson for the Alliance Steering Committee. Dr. Carmona is the 17th Surgeon General of the United States (2002-2006), vice chairman of Canyon Ranch, president of the non-profit Canyon Ranch Institute, and distinguished professor at the Mel and Enid Zuckerman College of Public Health at the University of Arizona. The Alliance Steering Committee, which includes consumer, provider, business, labor, health insurance and quality-of-care organizations, met with Dr. Carmona this morning before he delivered a keynote address at GW University. In his remarks, he said that identifying cultural and systemic challenges is an important early step in reducing the prevalence of overweight and obesity and helping to prevent chronic disease in America.

"Overweight, obesity, and the conditions they can lead to — such as diabetes and heart disease — are very often preventable. But prevention is still a radical concept to most Americans," said Dr. Carmona. "As a nation, we must join together and move from being a treatment-oriented society to being a prevention-oriented society."

According to Christine Ferguson, J.D., P.I., associate research professor at GW's SPHHS and the director of the STOP Obesity Alliance, the academic analysis provides an opportunity to shift how we approach the obesity epidemic.

"Programs and products targeting obesity are pervasive in America today, yet its incidence continues to rise," said Ferguson, "The Alliance is challenging the private and public sectors to examine new obstacles, re-evaluate older approaches, and focus on a new model for overcoming obesity."

The Alliance requested the analysis from GW following its first Steering Committee meeting in July. The report will serve as the research foundation for policy recommendations that the Alliance will release this year.

The GW research and analysis focuses on three barriers, which include:

• The definition of success: There is no agreement today on what constitutes successful weight loss. The result is that people generally have unrealistic expectations of weight loss, and those expectations are often not focused on their individual health needs.
• Perceptions of treatment: With treatment results held to unrealistic definitions of success, many patients and health care professionals believe that the time and effort associated with weight-loss treatments are not justified by the outcomes.
• Stigma: Research shows that as obesity increases in prevalence throughout America, so do stereotypes and discriminatory attitudes. This stigma reinforces a perception that obesity is solely an individual, not a societal, responsibility.

"We must apply evidence-based science to break down the barriers that prevent people from achieving and maintaining a healthy weight," Dr. Carmona said. "If we choose to turn away from this challenge and continue to focus on treating disease only after it occurs, instead of preventing disease, we risk becoming a nation burdened with chronic diseases that we cannot afford to pay for, and a population that is too ill to be productive and successful."

About the STOP Obesity Alliance

The STOP Obesity Alliance is directed by Associate Professor Christine Ferguson, J.D., P.I. of The George Washington University's Department of Health Policy and former Health Commissioner for the State of Massachusetts. The Alliance Steering Committee is comprised of the following public and private sector organizations: the American Academy of Pediatrics, American Diabetes Association, American Heart Association, America's Health Insurance Plans, American Medical Group Association, DMAA: The Care Continuum Alliance, National Business Group on Health, National Committee for Quality Assurance, National Quality Forum, The Obesity Society, Trust for America's Health, and the Service Employees International Union. The Alliance is sponsored by sanofi-aventis U.S. LLC, a world leader in the pharmaceutical industry with a commitment to improving public health and a heritage in therapeutic areas including cardiovascular and metabolic diseases.

About the George Washington University School of Public Health and Health Services

SPHHS is part of The George Washington University Medical Center, an internationally recognized interdisciplinary academic health center that has consistently provided high quality clinical care, education and research in the Washington, DC metropolitan area for more than 176 years.

New Academic Analysis Identifies Three Barriers to Achieving Healthy and Achievable Policies to Combat Obesity in America

To help cut through the clutter, the Strategies to Overcome and Prevent (STOP) Obesity Alliance, a powerful collaboration of consumer, provider, business, labor, health insurance and quality organizations, met for the first time in Washington to lay out a roadmap for identifying new approaches in America's race against obesity that must accompany the personal responsibility of individuals.

"The growth of obesity and its related health problems have exploded over the past ten years, signaling an urgent need to change how we manage the condition," said STOP Obesity Alliance director Christine Ferguson. "But there has been a real disconnect between our ability to make societal changes and what we know from a medical and public health perspective. Whether this is rooted in the belief that obesity is a matter of personal responsibility or that treatments are ineffective, it's in our national interest to find a new direction."

At a recent meeting at George Washington University Hospital, The Alliance's Steering Committee committed to developing innovative and practical strategies to help reverse America's rising trend in overweight, obesity and preventable weight-related chronic diseases such as diabetes and heart disease. Group members said the approach will complement other efforts focusing on personal actions by:

• Identifying and addressing the different barriers — some systemic, some cultural — that prevent effective weight management;
• Re-defining success based on criteria other than societal norms;
• Highlighting research-based initiatives to improve patient care and prevention; and
• Identifying, recommending and promoting innovations in health care delivery and financing systems.

Steering Committee members agreed to undertake a set of actions targeted to thought and policy leaders. In the next 100 days, the Alliance will:

• Issue a Stigma of Obesity brief in the fall and a formal white paper by end of the year, presenting scientific evidence on the effect stigma has on obesity-related health outcomes. The white paper will include a definition of sustained weight loss success and evaluate treatment and interventions.
• Co-host, in partnership with The Obesity Society, a presidential candidate public policy forum called, "Obesity: What the Next President Should Do." The forum will feature a roundtable discussion among presidential candidates' top health and policy advisors on how the candidates view obesity and prevention as a part of comprehensive health reform.
• Develop and present specific policy recommendations that take an innovative and practical approach to the systems that affect obesity.

Researchers at George Washington University presented the Steering Committee with medical and scientific data demonstrating the role stigma plays in America's battle with obesity, the current definitions of successful weight loss and beliefs of the futility of treatments. The Committee discussed paths to overcome barriers and break the cycle of failure that most adults experience in achieving and sustaining weight loss.

"Obesity is a major health and economic crisis in the Unites States. While there have been valiant efforts to educate Americans on the importance of eating right and exercising, we must look beyond the obvious to tackle this complex issue affecting millions — myself included," said Armeta Dixon, Vice President of 1199SEIU, United Healthcare Workers East. "Personal weight loss and weight management must be paired with changes in the larger system to fully address this reversible trend."

About the STOP Obesity Alliance

The STOP Obesity Alliance is directed by Associate Professor Christine Ferguson, JD, PI of The George Washington University's Department of Health Policy and former Health Commissioner for the State of Massachusetts. The Alliance is comprised of the American Academy of Pediatrics, American Diabetes Association, American Heart Association, America's Health Insurance Plans, American Medical Group Association, Disease Management Association of America, National Business Group on Health, National Committee for Quality Assurance, National Quality Forum, The Obesity Society and the Service Employees International Union. The Alliance is sponsored by sanofi-aventis U.S. LLC, a world leader in the pharmaceutical industry with a commitment to improving public health and a heritage in therapeutic areas including cardiovascular and metabolic diseases.

Thought Leaders Call for Changes in the Policies and Systems Governing How America Fights Obesity

The Alliance will operate out of the GW School of Public Health and Health Services Department of Health Policy, under the direction of Christine Ferguson, JD, a former public health commissioner for the state of Massachusetts who is now on faculty at the University.

"America is in a race against obesity and we're tripping over hurdles we don't even see," said Ferguson. "We can and must win the race or risk having a population that overwhelms our current systems. And that starts with inspiring people—whether they are overweight or not—to engage in building hope and creating lasting change."

The initial charge of the STOP Obesity Alliance is to form consensus on the different barriers—some systemic, some cultural—that prevent effective weight management. The goal is to break down those barriers, seek out and build on current promising efforts, and develop new approaches and actions. Groups that have signed on to form the STOP Obesity Alliance's steering committee reflect the key systems that this initiative will target for change. They include the American Academy of Pediatrics, American Diabetes Association, American Heart Association, America's Health Insurance Plans, American Medical Group Association, Disease Management Association of America, National Business Group on Health, National Committee for Quality Assurance, National Quality Forum and the Service Employees International Union. Together, they will provide guidance, communications and research support to the Alliance.

Affecting nearly two-thirds of adults, the overweight and obese population is one of the fastest growing segments in American society. Excess weight, specifically abdominal obesity, increases the incidence of insulin resistance, dyslipidemia, hypertension and other health problems. In fact, obesity is the country's second highest cause of preventable death behind smoking.

"There is no lack of science proving the seriousness of overweight and obesity and its link to deadly conditions such as diabetes and heart disease," said Ferguson. "The Alliance will drive home the broader impact of weight and identify practical solutions that both improve health and have a clear return on investment. The good news is that great work is already being done and the structure and diverse nature of the Alliance will allow us to amplify and expand the impact of those efforts."

Specifically, the Alliance leaders and steering committee will work on a tiered action plan to: 1) conduct and assemble research that identifies any cultural and systemic biases in combating obesity; 2) consider research-based initiatives to improve patient care and prevention; and 3) make recommendations for and promote needed systems changes.

According to Ferguson, the Alliance will examine the disconnect between the scientific data demonstrating the harmful health and economic effects of overweight and obesity, and the insufficient action to change the systems that form barriers against effective weight management. The initiative will find paths to overcome these barriers to help break the cycle of failure most adults face in achieving and maintaining weight loss. It also will explore what has been effective and why, in order to map out steps for real change.

The Alliance is sponsored by sanofi-aventis U.S. LLC, a world leader in the pharmaceutical industry with a commitment to improving public health and a heritage to therapeutic areas, including cardiovascular and metabolic diseases. The idea for this initiative was born from the company's recognition that making a meaningful difference demands support that extends far beyond a portfolio of products. Sanofi-aventis will serve as a non-voting member of the STOP Obesity Alliance so the group can easily tap into the knowledge amassed by the company through its work in obesity, metabolic disorders and cardiovascular disease.

"We're excited about the possibilities of this unique partnership and its ability to foster and change behaviors and the public dialogue about overweight, obesity and what we can do about this serious medical condition," said Tim Rothwell, chairman, sanofi-aventis U.S. Pharmaceutical Activities. "We have great confidence in this all-star public health team in changing the status quo so that more people have a chance to live healthier lives."

About Overweight and Obesity

Considerable evidence suggests that overweight and obesity are associated with significantly increased risk of diabetes, hypertension, dyslipidemia, certain forms of cancer, sleep apnea and osteoarthritis. Previously, obesity experts concentrated on total body fat as the main predictor of weight-related disease. Now, location of fatty tissue is thought to be equally if not more important than total body fat. Specifically, excessive body fat stored around the stomach and abdomen is a key risk factor for weight-related disease.¹ The risks of many medical complications grow with increasing body mass index and abdominal obesity:

• Almost 90 percent of people with type 2 diabetes are overweight². In addition, in one large study of more than 27,000 people, those in the highest 10 percent of waist circumference were 20 times more likely to get type 2 diabetes than those in the lowest 10 percent of waist circumference³
• Research shows that even small amounts of weight loss in the range of 5-10 percent can prevent or delay the development of type 2 diabetes among high-risk adults⁴
• In the Framingham Offspring Study, obesity was responsible for 78 percent of cases of hypertension in men and 64 percent in women⁵
• High waist circumference has been shown to increase risk of death by 35 percent compared to normal waist circumference⁶
• The well-known Nurses Health Study of more than 44,000 women found high waist circumference resulted in a two-fold increase in coronary heart disease⁷
• Overweight and obesity are clearly associated with increased risks for certain types of cancer, including kidney, endometrial, colorectal and postmenopausal breast cancer⁸
• The prevalence of obesity and overweight has dramatically increased over the past 25 years, moving from 46 percent of the population during 1976-80 to 64 percent in 1999-2000, according to the Centers for Disease Control and Prevention's National Health and Nutrition Survey⁹
• A study in the journal Health Affairs, noted that per person healthcare spending for obese adults is 56 percent higher than for normal-weight adults. Over 15 years, the additional costs incurred by obese adults with private health insurance versus normal-weight adults increased from $272 to $1,244 per person per year¹⁰
• A study published in the Archives of Internal Medicine suggests that obese employees file twice as many workers' compensation claims, have seven times higher medical costs, and 13 times more lost work days than their non-obese counterparts¹¹
• Obesity is also the prime culprit behind the recent sharp increases in Medicare spending. The number of obese Medicare recipients nearly doubled between 1987 and 2002 and the cost of treating them almost tripled.¹²

About The George Washington University School of Public Health and Health Services

The GW School of Public Health and Health Services was established in July 1997, bringing together three longstanding university programs in the Schools of Medicine, Business and Education. Today, more than 900 students from nearly every U.S. state and more than 35 nations pursue undergraduate, graduate and doctoral-level degrees in public health. The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, D.C. metropolitan area for 176 years. The Medical Center comprises the School of Medicine and Health Sciences, the 11th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation's capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit www.gwumc.edu.

The George Washington University School of Public Health and Health Services Aligns Patient, Provider, Business, Labor, Health Insurance and Quality Organizations to Change the Way America Understands and Fights Obesity

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