Obesity Has Causal Impact on Job Absenteeism and Related Costs

Obesity increases health-related absenteeism by three days per worker per year, relative to normal weight, reports a study in the July Journal of Occupational and Environmental Medicine.

Led by John Cawley, PhD, of Cornell University, the researchers analyzed national survey data (the 2001-2016 Medical Expenditure Panel Survey) to estimate the causal effects of obesity on job absenteeism and associated productivity losses. The study included data on more than 50,000 employed adults aged 20 to 65 years.

Nearly one-third of workers (32.5 percent) had obesity, defined as a body mass index of 30 kg/m2 or higher. The year they were surveyed, 38 percent of workers missed at least one workday due to injury or illness, with an average of 3.58 lost workdays per year.

Obesity was causally related to increased work absenteeism due to illness or injury: three additional workdays per year relative to normal weight, for an increase of 128 percent. Absenteeism increased with severity of obesity—up to seven additional days per year in the most severe category. State-level trends mirrored those at the national level, with significant variations by state.

Estimated annual productivity losses due to obesity ranged from $271 to $542 per employee with obesity. At the national level, estimated productivity losses for 2016 ranged from $13.4 to $26.8 billion.

Previous studies have consistently shown that obesity is associated with missed workdays or lost productivity at work. The new study, using a method called instrumental variable analysis, provides the first-ever estimates of the causal impact of obesity on job absenteeism and productivity loss.

The findings suggest that obesity leads to substantially increased absenteeism and productivity loss—with high associated costs for employers. "These costs represent part of the economic burden of obesity, beyond direct medical costs," Dr. Cawley and coauthors conclude. "Avoidance of these costs should be included when calculating cost-effectiveness of treatments to prevent and reduce obesity."
About the Author
Dr. Cawley may be contacted for interviews at johncawley@cornell.edu.
ACOEM (www.acoem.org), an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the Journal of Occupational and Environmental Medicine
The Journal of Occupational and Environmental Medicine (www.joem.org) is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.


Cawley J, Biener A, Meyerhoefer C, et al. Job absenteeism costs of obesity in the United States: national and state-level estimates. J Occup Environ Med. 2021;63(7);565-573.