"The results were disappointing. There seemed to be no causal effects."

August 7, 2018 10:14 AM

Workplace Wellness Programs Don’t Work Well. Why Some Studies Show Otherwise. Randomized controlled trials, despite their flaws, remain a powerful tool. (SLNYT by Aaron E. Carroll)
posted by crazy with stars (48 comments total)

Classic workplace paternalism
posted by wotsac at 10:38 AM on August 7, 2018 [2 favorites]

The most interesting thing about this study isn't the lackluster results about workplace wellness programs, it's the way they compared results from observational and randomized versions of the same data. Very interesting study design!
posted by vytae at 10:40 AM on August 7, 2018 [26 favorites]

This is not terribly surprising to anyone who has ever taken part in a workplace wellness program. The people who show up are inevitably the people who already were interested in the topic to start out with. (But I'll be a little bummed if workplace wellness programs go away, because I do value my reduced-price gym membership, and I occasionally get a free t-shirt for doing some dumb challenge or another. I've mostly managed to avoid the creepy surveillance aspects, although it is true that every year I am required to take a survey that identifies me as being in the pre-contemplation stage for healthy eating, when in fact I am in the maintenance stage for eating disorder recovery. Not everyone should be counting calories, assholes.)

But I agree that the differences between the observational and randomized versions is interesting.
posted by ArbitraryAndCapricious at 10:51 AM on August 7, 2018 [16 favorites]

What the heck is "randomised controlled"??
Surely in a truly scientific study like this, the control needs to be COMPLETELY random and untouched.
posted by Burn_IT at 11:03 AM on August 7, 2018

It means that the units of analysis are randomly assigned to receive the treatment.
posted by MisantropicPainforest at 11:05 AM on August 7, 2018 [3 favorites]

I’ll always have fond memories of putting my company’s proto-Fitbit kinetic activity monitor in the dryer
posted by Cogito at 11:08 AM on August 7, 2018 [17 favorites]

After getting nagging work emails for years, I finally just participated in my first and last "track your monthly goals" contest online, with a company that my employer has contracted with and will probably be replaced with a different company come November. We had to log our walking minutes; the top 3 winners would get a free goodie (headphones, I think).

The directions for signing up were very convoluted and confusing, and I navigate software for a living. Up until the last day, I was in 9th place, and then all of a sudden I got sniped at the last minute by someone who entered one more minute than me, thus putting me in 10th place.

I get that companies want us to be more fit, but this isn't the way to do it.
posted by Melismata at 11:20 AM on August 7, 2018

These programs involve duress. Participate or leave money on the table. What a crappy way to treat your employees. Last time I had one of these, the security of the site I had to use was terrible, but they wanted my health information. The materials available included some ridiculously old and dull videos. I'd launch them, let them run, then do work on the other monitor. What broke my health was a workplace that didn't meet code or OSHA regs, that I had to sue to get changed. A toxic, sexist workplace caused tons of stress. A workplace where staff left, didn't get replaced, and the work remained.
posted by theora55 at 11:41 AM on August 7, 2018 [28 favorites]

@Melismata I am continually astonished at the terrible interfaces my employers' third-party service apps have always presented me with. Benefits registration, provider search, inflated-before-discount goods and services, etc. It's not just the health-tracking stuff, sadly enough.

And I'm with you on the contests. My boss talks about entering his steps in one of them for a while, and there were several other "people" against whom he was pitted who reported exactly 30k steps, 7 days a week. Even understanding that it's likely a filtered maximum input, that's an implausibly high number, even for an Amazon warehouse employee.

Anecdotally, I'm a cubicle jockey in a Big Company who has become healthier than I've ever been. I believe the corporate-sponsored nonsense has done little enough for me individually, but almost everyone else on my team is also intentionally eating better and moving more.

Is my will free? Am I a lemming? Am I the successful outcome of a corporate propaganda machine? Dunno. But I never imagined 10 years ago that I'd ever have a growing collection of 5K race bibs hanging on my cube wall.
posted by phrits at 11:58 AM on August 7, 2018 [1 favorite]

But when the intervention group is compared with the control group as a randomized controlled trial, the differences disappear.

To be honest, I'm completely unsurprised by this.

In every "wellness program" I've ever experienced, the participants have either been coerced directly ("Sign up, or your health insurance is going to cost more") or indirectly (Your boss's metric says 100% participation, if you're the hold-out, plan on getting a lot of extra copies of the signup paperwork left on your desk.)

Unsurprisingly, this leads to what could charitably be called "fudging the numbers".
$100 off my health insurance premium if I run a 5k? Sure, I ran two this weekend!
Discounted gym membership? I'll take it, but only because the sauna is awesome!
Get out of a meeting to watch a poorly produced video on eating healthy? I have two monitors, sign me up!

And forget about long-term tracking. In two years, your company is going to switch insurance carriers, so you get to waste a day in the conference room to learn about the wonderful benefits of biometric screening all over again.
posted by madajb at 12:17 PM on August 7, 2018 [12 favorites]

It's very odd the way companies think competitions will motivate people. I am, to my eternal irritation, very competitive. I'm also someone who invariably doesn't win. What this has made me realise is that most of us competing are only there to give a context to the handful of people who actually will win (who are also the people who think them up and organise them) - without us losers, they aren't actually winners. This alienates me from ordinary competitions, but when you get work involved it has the complete opposite effect from the one intended.
posted by Grangousier at 12:17 PM on August 7, 2018 [14 favorites]

The thing that bugs me so much about my workplace wellness program is that there are very concrete things that my employer could do to improve wellness, such as give us all a lunch break and/or make sure there were some decent places to buy lunch within walking distance of the office. But it's cheaper and easier to encourage us all to sign up for the occasional 5K than to look at the ways that their policies are contributing to unhealthy habits. Workplace wellness programs feel like a figleaf to cover up the fact that workplaces are increasingly toxic.
posted by ArbitraryAndCapricious at 12:19 PM on August 7, 2018 [44 favorites]

It just makes me angry. The types of poor health targeted by these programs, lack of activity and poor diet, are caused in large part by systemic issues. If I've got a 9-5 job, spend an hour commuting each way because I can't afford to live any closer, have 2 kids with limited childcare and insanely high expectations for maternal involvement - when the fuck am I going to cook healthy meals and exercise, assholes?

But of course the only type of collective responsibility for these issues that we acknowledge is the responsibility of corporations to coerce their employees into wellness programs. And even that's not a responsibility, it's a fucking cost-saving measure.
posted by Kutsuwamushi at 12:20 PM on August 7, 2018 [48 favorites]

I once worked for a company that not only had workplace wellness programs, after a while they decided that they wanted to make SURE that you weren't lying about insurance. So unless you submitted to a blood test, they would declare that you were a smoker and you had to pay the higher rate.

Since I refused to literally bleed for the company, I paid more for a couple of years. But a lot of people submitted their arms for a sample. I'm 100% sure the results were not as firewalled as one would have hoped.

Tying health care to employment is stupid and a legacy of WW-II-era labor policies. It must go away if we want to ever have a fair society in the US. Your health shouldn't depend on what job you land.
posted by fifteen schnitzengruben is my limit at 12:38 PM on August 7, 2018 [4 favorites]

I'm not the best at reading the primary sources, but....

The RCT portion compared outcomes of those invited to participate in the wellness programs vs those not invited; the observational part consisted of comparing, within the group of people invited to participate, those who actually participated in the intervention against those did not participate in the intervention.

If the question is - does providing a wellness program do anything - then the RCT is set up to answer that question. If the question is - does actually doing the wellness program do anything - then the observational study is more appropriate for answering that question.

I don't think it's surprising that the results differ between observational and RCT - the people in the RCT arm that were assigned to be invited to the intervention is a mixture of people who did it and people who did not do it.


(if I'm reading it right, I sort of glazed over after awhile...)
posted by everythings_interrelated at 12:47 PM on August 7, 2018

We won't spend money to hire more staff or do anything else that could make your life suck less bad when you are here, but go do this stuff on your own time!
posted by jenfullmoon at 12:49 PM on August 7, 2018 [13 favorites]

If the question is - does providing a wellness program do anything - then the RCT is set up to answer that question. If the question is - does actually doing the wellness program do anything - then the observational study is more appropriate for answering that question.

Not necessarily. It could be that the people who chose to participate in the wellness program were already more healthy than the people who chose not to participate in the wellness program, and the wellness program didn't make any difference at all. That's sort of how it works in my office: every time there's a 5K, the people who sign up are already runners. They would have been running anyway, and they just sign up to get a t-shirt and whatnot. So yeah, the runners who sign up are probably healthier than the non-runners who don't sign up, but the act of signing up doesn't cause the difference.

We learned in stats class that observational studies don't tell you anything about causation. They can demonstrate a difference between populations, but they can't tell you why it exists. I think this is a classic example of that.
posted by ArbitraryAndCapricious at 12:55 PM on August 7, 2018 [9 favorites]

If the question is - does actually doing the wellness program do anything - then the observational study is more appropriate for answering that question.

It actually doesn't do that, since the treatment (in this case, participation in the wellness program) isn't randomly assigned, only the offering of the wellness program is.

The only thing that can tell us if the wellness program does do anything is the experimental part. Since the treatment was randomized, we have no reason to believe that the share of people who, conditional on them receiving the offer to participate, actually participated were different in the treated and control groups.
posted by MisantropicPainforest at 1:02 PM on August 7, 2018 [3 favorites]

Here at everyone's favorite trillion dollar fruit stand, we do these 2 or so times a year. Something like ~20k employees do it. Although that might be the amount of teams, not people.

In almost all cases, just doing the tracking activities (meals into Lose It, weight once per day, etc) gets each team enough points to get the "lowest" prize. Even then, "lowest" usually means a bronze fancy water bottle verses silver and gold versions of the same bottle. In fact, the only real difference between the lower teams and higher teams are the bonus points achieved by having all four people do all the things on the same day.

The main goal of these things is just to do the tracking and therefore pay more attention to our diet. It definitely works for me as far as eating healthier, even if the competition itself doesn't judge on how healthy anything is. I could spend the month eating nothing but Twinkies and still win as long as my team and I did all the logging we needed to do.

Seems like we've also done an Apple Watch focused "Close Your Rings" challenge a time or two. With those, these is some actual activities involved (standup for at least 1 minute of an hour for at least 12 hours out of the day, 30 mins "moving", some amount of active calories), but those three things can be tailored individually, so even that one is still really inclusive to everyone. Well, to those of us who constantly wear an Apple Watch. For this one the prize has been a unique watch band.
posted by sideshow at 1:25 PM on August 7, 2018 [3 favorites]

OMG, sideshow, you're in a F2P economy.
posted by infinitewindow at 1:35 PM on August 7, 2018 [2 favorites]

witchen: Equating "healthy eating" with calorie-cutting is problematic to begin with; at my workplace was so severe that my tailor-made meal plan had me starting at 1440 calories per day and eventually reducing to 900.

WTF? A "healthy eating" program had you aiming for 900 calories a day? Again, WTF??
posted by clawsoon at 1:37 PM on August 7, 2018 [4 favorites]

Ridiculous. %-<
posted by clawsoon at 1:40 PM on August 7, 2018 [1 favorite]

Yeah the real thrust of this article was about methodology. Very interesting. In an era where the science dialogue has become really bogged down with one-line headlines, p-hacking, industry funding, and general hand wringing and pearl clutching, understanding the nuances of how we are finding what we are finding and making it a priority to interpret everything within the context of methods is absolutely critical.

Also, as someone who works primarily in effectiveness research, his article on efficacy vs. effectiveness of opioids was also fascinating and very well done. This guy is smart.
posted by Lutoslawski at 1:42 PM on August 7, 2018 [5 favorites]

It could be that the people who chose to participate in the wellness program were already more healthy than the people who chose not to participate in the wellness program, and the wellness program didn't make any difference at all.

I agree with you upthread re the limitations of observational data, and was loose in my framing about what could be answered by the observational component - I don't know if they attempted to report a causal effect measure - probably not. But the underlying question the researchers want to ask is certainly causal - the impetus behind the research - the pursuit and allocation of funds, the thinking behind the study design, the work involved in execution - is about causation, not association. The underlying hypothesis is that wellness programs *cause* wellness.

See for example Hernan, here: The proscription against the C-word is harmful to science because causal inference is a core task of science, regardless of whether the study is randomized or nonrandomized. Without being able to make explicit references to causal effects, the goals of many observational studies can only be expressed in a roundabout way. The resulting ambiguity impedes a frank discussion about methodology because the methods used to estimate causal effects are not the same as those used to estimate associations.
posted by everythings_interrelated at 1:45 PM on August 7, 2018

If the question is - does providing a wellness program do anything - then the RCT is set up to answer that question. If the question is - does actually doing the wellness program do anything - then the observational study is more appropriate for answering that question.


Not quite. You're correct more or less on the first point. But the observational study doesn't actually tell you about the effectiveness of the wellness program, because you still haven't accounted for the ways in which those who participate and those who don't are different in ways wholly unrelated to the wellness program itself.

Now, the researchers did some very extensive controlling to try and "fix" this problem in the observational study, including some machine learning techniques I don't really understand, and still they found significant differences using the observational methodology that didn't exist in the RCT - and that is really the crux of why this is so interesting and potentially problematic.
posted by Lutoslawski at 1:54 PM on August 7, 2018 [2 favorites]

But the underlying question the researchers want to ask is certainly causal - the impetus behind the research - the pursuit and allocation of funds, the thinking behind the study design, the work involved in execution - is about causation, not association. The underlying hypothesis is that wellness programs *cause* wellness.

Right, that's the whole point. The observational studies made claims about causation, but they weren't claims that could be supported with observational evidence. And the experimental studies suggest that the claims were false.
posted by ArbitraryAndCapricious at 1:56 PM on August 7, 2018

Ah, but they don't - the experimental studies only randomized to invitation to participate, not actual participation. The RCT does not help us once somebody is conditioned on participation=1. And while the observational study may be confounded by propensity to participate, I'm pushing back against the notion that observational data cannot support causal claims - if you could estimate the propensity to participate, would the data then have the possibility to support some causal claim? If not, why do observational research at all?
posted by everythings_interrelated at 2:05 PM on August 7, 2018

One question those wellness programs never ask is "did your health insurance company recently spend $700,000 in one year to treat an aggressive cancer that will require more medication and expensive heightened levels of screening for many years to come?" Ha ha ha, suckers. Give me my Starbucks gift card.

Having had that cancer yet being rewarded for drinking 8 glasses of water and getting 10,000 steps (or whatever) really put these things into stark relief for me. Cancer aside, I'm a healthy active person who likes to record and track things, and it makes perfect sense that people who are already into this sort of thing are the ones who will use the program.
posted by something something at 2:05 PM on August 7, 2018 [4 favorites]

Wait, had you started the wellness program when you had cancer? And you’re in the wellness program now, and you don’t have cancer (but of course do still need to track it)?

I know correlation isn’t supposed to be the same as causation, but....
posted by Huffy Puffy at 2:22 PM on August 7, 2018 [1 favorite]

We learned in stats class that observational studies don't tell you anything about causation.

That's true-ish in the context of a statistics class but not in a broader research methods class.

It's only true-ish in a statistics class because there are a fair number of things you can do, **if** the universe has presented you with convenient data, to directly attack causal questions in a single, simple observational study. Natural experiments, regression discontinuities, etc. Econometricians would usually also add instrumental-variable approaches but I don't like throwing away real data and replacing it with pretend data I made up, even if I was SUPER CAREFUL about making it up.

It's not true in the broader research design sense because you can for sure address causal questions with observational data, even apart from lucky circumstances where you can do the fancy statistical things. The core idea is that you have some causal story about what's going on, and you keep asking what relationships you should observe if that causal story is true. Ideally, while also asking what relationships you'd see if some other competing causal stories were true. Then go look and see what relationships you observe.
posted by GCU Sweet and Full of Grace at 2:35 PM on August 7, 2018 [6 favorites]

But a lot of people submitted their arms for a sample. I'm 100% sure the results were not as firewalled as one would have hoped.

I sort of hope somebody with some influence does see my workplace wellness program blood test results. Maybe it'd result in actual incentives for bicycling, walking, and taking transit, instead of my employer's current practice of consistently discouraging workers from doing anything but driving everywhere.
posted by asperity at 2:56 PM on August 7, 2018 [1 favorite]

The Chicago PD ran a wellness program which would pay up to 3 grand a year to officers that hit certain fitness targets. Not improvements. Just targets. Not even all that impressive targets. Things like running a 9:00 mile. Year after year the same already fit police officers collected the 3 grand but almost no officers actually improved their fitness levels. Why? Because they could all make far more money doing overtime and side gigs and they all chose the rational wealth maximizing option.

WTF? A "healthy eating" program had you aiming for 900 calories a day? Again, WTF??

This sounds to me like a confusion of net versus gross calories. An older petite woman looking to lose 1.5lbs a week could have a target of around 900 kcals a day net after subtracting kcals burned by base metabolism + other activity. But a gross 900 kcals a day level is a Bridge over the River Kwai diet.
posted by srboisvert at 3:20 PM on August 7, 2018

At my last company, we probably had a high participation rate for our wellness program because someone figured out that if you uploaded a bunch of files to one of the connected accounts and which you ran 10 miles every day for every day of the team, you could get $200 worth of Amazon gift cards without stepping away from your desk.

We could also sit through a 20 minute unskippable video about healthy living for a few dollars, that someone also figured out how to skip right to the end and get credit for it. We also auto-clicked through a bunch of lessons describing the food pyramid.

This was all time that we conceivably could have been doing actual work.
posted by meowzilla at 4:37 PM on August 7, 2018 [3 favorites]

My previous workplace's wellness program (which gave you discounts on your health insurance premiums) was point-based, so you could pick and choose how to participate. The biggest point earner was an annual blood test testing for blood sugar, cholesterol, that sort of thing. You could do it during an on site event or go to your doctor, and it was probably a challenge if not impossible to earn enough points without the blood test.

But the rest of it was taking terrible online courses, attending equally terrible "lunch and learns" about "toxins" from scammy seeming presenters, or SELF REPORTING EXERCISE. No fitbits or anything, which was great from a privacy standpoint, but also meant you could literally just lie. I don't know how many people lied - I bike commuted nearly daily so it was easy to get all my points - but I'm sure some did. (There were also smoking cessation or weight loss programs that earned you points, but as someone who didn't participate in either I don't know how they worked.)

What I think actually helped contribute to people being more active or healthy was having a free on-site gym, secure bike parking in the building, and paying for up to $250 a year for race or exercise class fees. Incentives that make activity easier/cheaper to fit into your day, not the threat of higher insurance premiums and having to log into a stupid system to track imaginary points.

My current workplace just pays you straight cash for your gym membership, but you have to go 12 times a month to get reimbursed for that month, and because I run and bike commute I don't go to a gym that frequently.
posted by misskaz at 4:53 PM on August 7, 2018 [1 favorite]

My work also has one of these gym reimbursements and secure bike parking and, best of all, clean showers at work. Now it's easy for me to bike in and out although I don't get reimbursed for it. You have to go quite often to the gym for us (45+ times in 6 months) to get credit, which is ok by me because I like to rock climb. But like what others said above, I have friends in ED recovery who are on exercise restriction. Because they have a life threatening medical condition of which excessive exercise is an underappreciated symptom (you can never exercise too much!!!!). "Oh, but how could walking be a problem?" the person in charge of coordinating one of these wellness programs told a friend. Guess what! It sure as fuck can be! Are you a therapist/dietitian/MD with specialized ED experience? No? Aaaaaaa sorry for the rant but this topic makes me see red. So much of how these get implemented seems to revolve around performative status signalling rather than actually doing anything to help anyone. Want to know a great way to help people move more? Get them childcare after school.
posted by threementholsandafuneral at 5:20 PM on August 7, 2018 [8 favorites]

And while the observational study may be confounded by propensity to participate, I'm pushing back against the notion that observational data cannot support causal claims - if you could estimate the propensity to participate, would the data then have the possibility to support some causal claim?

Absolutely. If you can estimate the propensity score, then condition on it, you can do causal inference. Its just really hard to do and to know that you did it right.

RCTs work because we know the assignment mechanism (the thing that determines treatment). If you know the assignment mechanism, you can do causal inference, observational or not.

The RCT does not help us once somebody is conditioned on participation=1.

I'm not sure what this is trying to say--what is the variation you are trying to explain among those that participated?
posted by MisantropicPainforest at 5:43 PM on August 7, 2018 [1 favorite]

Never been part of these Big Brother-style wellness plans, but did read the fine print once on an employer's "health account" and discovered they'd reimburse me up to a grand a year for health equipment, and that included bikes. So the day before the plan closed for the year, I found a sweet Gary Fisher retro hardtail reduced to $999. I ride that bike still. The company? Barely remember their name.
posted by scruss at 6:12 PM on August 7, 2018 [5 favorites]

The NYT article is completely missing the key idea from the original paper:

Our selection results suggest these programs may act as a screening mechanism: even in the absence of any direct savings, differential recruitment or retention of lower-cost participants could result in net savings for employers.

From the employer's perspective, it's fine if the programs don't make anyone healthier. They just want to make some unhealthy people go away.

If people who can't run a 5k are more likely to quit, it saves the company money. It's OK if they can't run the 5k because they're overweight, but it's even better if they can't run the 5k because they have cancer. You only need a few people to quit to save a lot of money.

This is one of the problems with tying health insurance to employment.
posted by miyabo at 8:23 PM on August 7, 2018 [26 favorites]

(Also, journalists writing about science should always always include a link to the original article!)
posted by miyabo at 9:16 PM on August 7, 2018 [4 favorites]

miyabo: From the employer's perspective, it's fine if the programs don't make anyone healthier. They just want to make some unhealthy people go away.

That's... yeah. Now that you point that out, of course. And as an added bonus, the employer gets to take the moral high ground, since the employees who don't participate and then leave "made the choice" to not participate in wellness initiatives. It's Their Own Fault.

The follow-up I'd like to see is data-mining of the subjects to generate hypotheses about what might be the actual explanatory factors. If it's not sex, age, race, salary, or status, then what is it? Data mining should reveal a bunch of spurious correlations and hopefully a few relevant ones. Then run study #2 in exactly the same way at a different institution, but in the analysis control for the correlations discovered in data mining study #1. If I'm thinking this through correctly, that should allow a bunch of spurious correlations to be thrown out, and we're one step closer to finding likely causal factors.
posted by clawsoon at 3:32 AM on August 8, 2018

It just makes me angry. The types of poor health targeted by these programs, lack of activity and poor diet, are caused in large part by systemic issues. If I've got a 9-5 job, spend an hour commuting each way because I can't afford to live any closer, have 2 kids with limited childcare and insanely high expectations for maternal involvement - when the fuck am I going to cook healthy meals and exercise, assholes?

Seriously. Want to improve people's health? Work from home two days a week and set the working day to run from 10 to 4. That'll improve people's sleep and reduce stress massively. Double the length of your paid maternity leave, open an on-site crèche, watch parents measurably relax. Schools out but need everyone to continue to work long hours? How about you reimburse a few weeks of summer camp?

Oh, but that all sounds expensive so we won't be doing that! Have a fitbit instead.
posted by atrazine at 3:56 AM on August 8, 2018 [7 favorites]

The reality behind so-called wellness programs is that they're not about improving employees' health, but about improving the employers' bottom lines through cost-shifting. These programs target workers with expensive chronic health issues, whose conditions can't be improved by playing along, or may even mean the worker is physically unable to play along. In the short run, those people pay the financial penalty for non-participation; in the long run, the company may end up finding reasons to get rid of them. Additionally, workers who refuse to sacrifice their privacy to the notoriously insecure third-party companies that provide these services pay the price in the form of higher costs for their health insurance. In short, you have to choose between making your health information vulnerable, or paying a lot more for your health insurance. And yes, there have been numerous data breaches at the companies who administer these wellness programs.

My employer is on their third company administering their program. The first company had put everyone's health information on an unsecured, outward-facing website accessible to anyone with a casual Google search, and this wasn't discovered for over a year. The second company was fired after numerous complaints that its "coaches" (unqualified desk jockeys) were giving employees medical instructions despite not being MDs, such instructions often contradicting the individual's own doctor's instructions.

I willingly pay the hundreds of dollars extra per year to not interact with incompetents who'll mishandle my private data. I still don't completely escape their clutches - one company's "coaches" repeatedly called me at home, even though I wasn't enrolled in the program, and told the person answering the phone (not me), that I had no right to refuse to take their calls or participate in the program.

Given the choice between doing something that makes a meaningful difference and making a pointless gesture to merely give the appearance of making a difference, employers will choose the latter every time.
posted by Lunaloon at 6:47 AM on August 8, 2018 [7 favorites]

I've told this story before, but I really like telling it, so here it is again:

My previous employer did this: yearly health screenings, "just so we'll have the information on hand," CERTAINLY not to do anything nefarious with that data. {|} At first, it was voluntary, so I opted to pay the extra few hundred bucks in premiums every year. The next year, it was compulsory if you wanted the Cadillac plan, so I switched to the slightly more paperwork-intensive mid-tier plan. The following year, it was compulsory for everything except the Chevy Nova plan, so I grudgingly trudged to the clinic they had helpfully set up in the breakroom for my blood pressure test and blood screening. At this point, I had a 2-month-old infant at home, hadn't slept more than 3 hours at a clip in weeks, had drunk something like 6 cups of coffee to compensate, and had forgotten that there was a blood sugar test that required a 12-hour fast. My test results were, uh, not conducive to lowering company health care costs.

The next year, I loudly announced my plans to see if I could outperform the previous year's results, and ate an entire bag of chocolate-covered espresso beans before the screening. Upon looking at my numbers, the nurse seemed vaguely credulous that I was alive and able to walk and/or talk.

The next year, I left the company and went to work for someone who doesn't try to pull this kind of thing.

I'm not sure what the moral of this story is, but I heartily recommend doing anything you can to throw a wrench in the works of any employer who's using this kind of horseshit to try to shame their employees into behaving differently.
posted by Mayor West at 7:35 AM on August 8, 2018 [6 favorites]

The next year, I loudly announced my plans to see if I could outperform the previous year's results, and ate an entire bag of chocolate-covered espresso beans before the screening.

I don’t like to use the word “hero”, but you sir are truly a champion of biometrics.
posted by Huffy Puffy at 7:43 AM on August 8, 2018 [1 favorite]

Equating "healthy eating" with calorie-cutting is problematic to begin with

My workplace brought in a garbage "wellness" expert who gave us a lot of healthy snack tips, one of which was "low-calorie salt free pretzels." I raised my hand.

"My doctor recently told me to increase my salt intake because of a low blood pressure problem that has resulted in me fainting in dangerous places. Your tip is extremely dangerous for me."

She just looked at me blankly, and later complained about how far of a commute she had between her country estate and her in-town pied-à-terre.

The majority of these programs are run and sold by grifters to begin with, with misspelled worksheets full of "tips" ripped off from an issue of Shape Magazine from 1998, and compounding that element with the profit motive of the companies that implement them-- it's amazing they aren't doing MORE harm, let alone "not doing any good."
posted by a fiendish thingy at 10:20 AM on August 8, 2018 [8 favorites]

what infuriates me is that "wellness" pretty much only focuses on a) not being fat and b) not smoking. what about mental health? what about spiritual health? financial health? bring in an ergonomics specialist one day. bring in a yoga instructor once a week for voluntary use. let us volunteer one day a week without penalty. don't penalize us for having doctor's appointments to deal with our debilitating chronic health issues. i feel like "workplace wellness" is a truly american thing because of our utterly fucked healthcare system that financially incentivizes "good health" with a very narrow set of metrics.
posted by misanthropicsarah at 10:40 AM on August 9, 2018 [4 favorites]

On the contrary, my workplace wellness program has tons of stress reduction tips, such as "here are some yoga poses you can do at your desk" and "here are some tips to get a good night's sleep." But effective stress reduction would be things like "give us annual raises so our salaries keep up with the cost of living" or "don't require work that cannot possibly fit in an eight-hour day and then act like it's our fault that we're staying late." But hey, stretching is good, too!
posted by ArbitraryAndCapricious at 11:26 AM on August 9, 2018 [5 favorites]

My employer is on their third company administering their program.

Haha, amateurs. We get a new company pretty much every year. One company was so useless, they were like wait a minute, we put all this work into selling you our program and now you expect us to actually have a program? Snort.

What really gets my goat is that this whole thing would be avoided if we just addressed why health care is so expensive in the first place, but no one is interested in doing that.
posted by Melismata at 9:10 AM on August 13, 2018 [1 favorite]