Introduction
Obesity represents one of the most significant public health challenges of the 21st century, with profound implications for workplace productivity, employee well-being, and healthcare economics. Defined clinically as a body mass index (BMI) exceeding 30 kg/m², obesity affects approximately 42.4% of American adults, with similar concerning trends observed globally[1]. The workplace represents a critical setting for addressing this epidemic, as employed adults spend approximately one-third of their waking hours at work. This substantial time commitment provides both risk factors for weight gain and unique opportunities for intervention.
The economic consequences of obesity in occupational settings are substantial and multifaceted. Direct healthcare costs attributable to obesity-related conditions are estimated to exceed $190 billion annually in the United States alone, representing nearly 21% of all medical expenditures[1]. From an employer perspective, obesity contributes to increased absenteeism, reduced productivity while at work (presenteeism), higher disability claims, and premature workforce exit. Research indicates that obesity-related productivity losses cost employers between $3,830 and $6,085 per affected employee annually[2].
Workplace-based obesity prevention initiatives have emerged as a strategic priority for numerous reasons. First, they provide access to a large, relatively stable population that might otherwise be difficult to reach through traditional healthcare channels. Second, the workplace offers existing social and organizational structures that can facilitate intervention delivery and sustainability. Third, employers have financial incentives to reduce healthcare costs and improve workforce capacity. Finally, workplace interventions can potentially address both individual behavioral factors and environmental determinants of obesity.
This article examines the current evidence base for obesity prevention in occupational settings, structured around five key domains. We begin by assessing workplace-specific risk factors for obesity, followed by an examination of evidence-based intervention strategies spanning nutritional, physical activity, and behavioral approaches. Implementation frameworks and organizational considerations are then explored, highlighting the critical elements required for program success. The economic dimensions of workplace obesity prevention are analyzed, with particular attention to return-on-investment metrics that are compelling to organizational decision-makers. Finally, we present illustrative case studies and best practices that demonstrate real-world application across diverse workplace contexts. Through this comprehensive analysis, we aim to provide a practical roadmap for employers seeking to address obesity prevention while optimizing workforce health and organizational performance.
Assessment of Workplace Obesity Risk Factors
The contemporary workplace harbors numerous factors that contribute to obesity risk, many of which have intensified with technological advancement and changing work patterns. Understanding these risk factors is essential for developing targeted interventions that address the specific mechanisms driving weight gain in occupational settings.
Environmental workplace determinants significantly influence dietary choices and energy balance. Workplace food environments often feature readily available energy-dense, nutrient-poor options in cafeterias, vending machines, and catering services. A systematic review by Tabak et al. found that employees with limited access to healthy food options at work consumed an average of 236 more calories daily compared to those with healthier workplace food environments[2]. Additionally, workplace norms may encourage ove
rconsumption through frequent celebration events, communal snacking, or client entertainment involving calorie-dense meals.
Certain occupational characteristics correlate strongly with obesity prevalence. Jobs involving shift work disrupt circadian rhythms and normal eating patterns, with meta-analyses indicating a 23% higher obesity risk among shift workers compared to day workers[3]. Occupations characterized by high psychological demands yet low decision latitude (job strain) show positive associations with central adiposity, particularly among women. Furthermore, specific industries demonstrate disproportionate obesity rates, with transportation, manufacturing, and healthcare workers showing prevalence 6-10 percentage points above national averages.
Assessment tools for workplace obesity risk have evolved to capture both individual and environmental factors. The CDC Worksite Health ScoreCard provides validated metrics for evaluating organizational supports for healthy weight, while newer digital assessment platforms enable real-time monitoring of workplace movement patterns and environmental exposures. Workplace obesity risk audits typically evaluate four domains: nutritional environment, physical activity opportunities, organizational policies, and psychosocial factors affecting eating behaviors.
Perhaps most significantly, sedentary behavior has emerged as a critical occupational risk factor for obesity. The average office worker remains seated for 80% of their workday, with prolonged uninterrupted sitting associated with metabolic dysregulation independent of leisure-time physical activity. Objective monitoring studies using accelerometers reveal that each additional hour of workplace sitting correlates with a 0.8 cm increase in waist circumference and a 0.7% increase in fasting glucose levels annually[3]. Knowledge workers frequently report extended periods of “screen immobility,” where engagement with digital tasks reduces awareness of sedentary time.
Workplace obesity risk assessment must consider the complex interplay between individual-level factors and environmental influences. The socioecological model provides a useful framework, recognizing that employee behaviors occur within organizational contexts that may facilitate or constrain healthy choices. Comprehensive assessment should examine how workplace policies, physical design elements, social norms, and leadership practices collectively shape the obesogenic potential of work environments. Importantly, these assessments must be sensitive to occupational variations, as obesity risk factors differ substantially between manual labor, service, and knowledge work contexts.
Modern workplace obesity risk assessment increasingly incorporates digital monitoring technologies, including wearable devices and environmental sensors, to provide objective data on movement patterns, workplace navigation, and environmental exposures. These technologies, when implemented with appropriate privacy safeguards, enable more precise targeting of intervention resources toward the highest-risk workplace contexts and employee subgroups.
Evidence-Based Intervention Strategies
Workplace obesity prevention interventions have evolved substantially in the past decade, moving beyond simplistic educational approaches toward comprehensive, multi-component strategies that address both individual behavior and environmental determinants. Evidence from systematic reviews and meta-analyses provides valuable guidance regarding the most effective intervention approaches across various workplace contexts.
Nutritional interventions demonstrate significant potential for influencing dietary behaviors in occupational settings. Environmental modifications to cafeterias and vending machines have shown particular promise, with a meta-analysis of 16 workplace studies finding that price reductions of 10-30% for healthy options increased their consumption by 11-16%[2]. Beyond pricing strategies, simple environmental cues such as traffic-light labeling systems and portion size modifications have demonstrated effectiveness without requiring extensive educational components. More comprehensive approaches combining environmental modifications with personalized dietary counseling show the largest effects, with mean weight reductions of 2.2-3.5 kg at 12-month follow-up in randomized controlled trials[4].
Physical activity interventions in the workplace span a continuum from programmatic offerings to environmental and policy approaches. Structured exercise programs typically show modest participation rates (15-30% of eligible employees) but significant benefits among participants, including average weight reductions of 1.7-2.3 kg and improvements in cardiometabolic risk factors. More sustainable approaches include active transportation initiatives, which increase daily energy expenditure by 120-150 kcal among participants, and point-of-decision prompts encouraging stair use, which increase stair climbing by 50-60% when strategically implemented[4]. The integration of activity breaks into workplace routines shows particular promise, with studies demonstrating that brief 2-5 minute hourly movement breaks can reduce postprandial glucose and insulin responses by 16-37% compared to continuous sitting.
Behavioral and psychological approaches address the cognitive and emotional factors influencing eating and activity patterns. Workplace-based cognitive-behavioral therapy (CBT) programs delivered in group formats have demonstrated mean weight reductions of 4.4 kg at 6 months, with 50-60% of these losses maintained at 24-month follow-up. Digital adaptations of CBT approaches show similar efficacy with greater scalability, though engagement remains challenging. Social influence strategies leverage workplace relationships through team-based challenges, peer coaching, and social comparison feedback. A cluster-randomized trial involving 28 worksites found that team-based approaches with social incentives produced weight losses 1.8 times greater than individual-focused programs with equivalent financial incentives[3].
Environmental modifications represent a growing intervention focus, emphasizing how workplace design influences movement and eating patterns. Activity-permissive workstations (e.g., sit-stand desks, treadmill workstations) generate consistent reductions in sedentary time, with meta-analyses indicating average decreases of 77-116 minutes/day. Longitudinal studies suggest these reductions translate to modest but significant weight benefits, with average reductions of 0.8-1.2 kg after 12 months of consistent use. Beyond workstations, comprehensive environmental approaches include centralized stairwells, distance-optimized floor plans, and strategic placement of communal resources to naturally increase movement throughout workdays.
Digital and technology-based interventions have demonstrated increasing sophistication and effectiveness. Workplace-specific mobile health (mHealth) applications incorporating tailored goal-setting, self-monitoring, and feedback mechanisms show moderate effectiveness, with average weight reductions of 2.1-2.8 kg at 6 months among high-engagement users. Wearable activity monitors integrated with organizational wellness platforms demonstrate particular promise when combined with social or financial incentives, increasing daily step counts by 1,850-2,730 among participants[5]. Importantly, digital approaches show the greatest effectiveness when integrated with in-person components rather than operating as standalone interventions.
The evidence increasingly supports multicomponent interventions that simultaneously address individual, environmental, and organizational factors. A meta-analysis of 22 workplace obesity prevention programs found that single-component interventions produced mean weight reductions of 0.8-1.3 kg, while comprehensive programs addressing multiple levels of influence achieved mean reductions of 2.2-3.2 kg at 12-month follow-up[5]. This evidence base suggests that optimal approaches combine environmental modifications, skill-building opportunities, social support mechanisms, and organizational policies that collectively support healthy weight behaviors.
Implementation Frameworks and Organizational Approaches
The translation of evidence-based obesity prevention strategies into sustainable workplace programs requires robust implementation frameworks and supportive organizational structures. Despite the existence of effective interventions, implementation challenges frequently undermine their potential impact in real-world workplace settings. Successful implementation hinges on several critical elements that bridge the gap between research evidence and organizational practice.
Comprehensive implementation frameworks provide systematic approaches to program development and sustainability. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) offers a particularly valuable structure for workplace obesity prevention, emphasizing both individual-level impacts and organizational integration. Analysis of successful workplace programs reveals that implementation planning typically accounts for 30-40% of total program development time, with careful attention to contextual factors that influence intervention fit and feasibility[3]. Process evaluation data indicates that implementation quality explains approximately 40-60% of the variance in obesity prevention outcomes across similar workplaces.
Leadership engagement represents perhaps the most consistently documented success factor in workplace obesity prevention. Senior management support manifests through visible participation, resource allocation, and strategic alignment of wellness initiatives with organizational priorities. A multi-site comparative case study of manufacturing facilities found that sites with high leadership engagement (measured through a validated assessment tool) achieved employee participation rates 2.3 times higher and weight loss outcomes 1.8 times greater than matched sites with low leadership engagement[4]. Middle management support proves equally critical, as supervisors influence daily practices and norms that either facilitate or undermine healthy behaviors.
Organizational culture significantly moderates intervention effectiveness, with workplace climate assessments explaining approximately 25-35% of the variance in program outcomes across similar interventions. Cultures characterized by trust, psychological safety, and collective efficacy demonstrate substantially higher engagement in voluntary wellness activities. Progressive organizations have moved beyond treating obesity prevention as a discrete program toward integrating healthy weight supports into broader cultural values. This integration manifests through consistent messaging, performance metrics that don’t incentivize unhealthy behaviors (e.g., skipping breaks), and social norms that reinforce rather than undermine health goals.
Policy development provides structural support for obesity prevention through environmental and behavioral influences. Comprehensive workplace policies typically address food procurement standards, physical activity opportunities, work-life balance provisions, and health-promoting benefits design. A longitudinal study of 41 worksites found that each additional obesity-relevant policy element was associated with a 0.6 kg reduction in mean employee BMI over a 24-month period[4]. Importantly, policy implementation effectiveness depends heavily on employee involvement in development, clear communication of rationales, and consistent enforcement across organizational levels.
Integration with existing workplace systems represents a critical implementation consideration. Successful obesity prevention initiatives typically leverage established communication channels, management structures, and operational processes rather than creating parallel systems. Human resource information systems, occupational health infrastructure, and existing quality improvement mechanisms provide natural integration points. This integration approach reduces implementation burden while increasing program sustainability, with integrated programs demonstrating continuation rates 2.4 times higher than stand-alone initiatives after initial funding periods conclude[5].
Overcoming implementation barriers requires systematic approaches to common challenges. Financial constraints can be addressed through phased implementation, strategic partnerships with health plans or community organizations, and careful return-on-investment analyses demonstrating business relevance. Time limitations among employees necessitate interventions embedded within workflow rather than requiring additional time commitments. Privacy concerns require transparent data policies and voluntary participation options that don’t create stigma or disadvantage for non-participants.
Capacity building represents an essential but often overlooked implementation element. Organizations with dedicated wellness staff, trained peer champions, and health-literate managers demonstrate significantly higher implementation fidelity and program sustainability. A randomized implementation trial across 24 manufacturing sites found that those receiving capacity-building support (training, technical assistance, peer networking) maintained 85% of initial obesity prevention practices at 36 months, compared to 32% among sites receiving only initial program materials[5].
The implementation science literature increasingly emphasizes the importance of adaptation frameworks that maintain core intervention components while allowing customization to specific workplace contexts. Successful implementation approaches balance fidelity to evidence-based principles with flexibility regarding delivery channels, messaging, and engagement strategies. This balanced approach recognizes the heterogeneity of workplace environments while preserving the active ingredients that drive obesity prevention outcomes.
Economic Evaluation and Return on Investment
The economic dimensions of workplace obesity prevention have received increasing attention as organizations seek to justify investments in employee health initiatives. Comprehensive economic evaluation provides critical information for decision-makers by quantifying both the costs of implementation and the multifaceted returns generated through various outcome pathways.
Cost-effectiveness analysis methodologies for workplace obesity prevention have evolved substantially, moving beyond simplistic cost-per-participant calculations toward sophisticated models capturing multiple value streams. Contemporary approaches typically employ activity-based costing methods that comprehensively track program development, implementation, and maintenance expenditures. These analyses reveal substantial variation in program costs, with comprehensive multicomponent interventions ranging from $130 to $760 per employee annually, depending on intensity and delivery methods[1]. Digital interventions generally demonstrate lower per-participant costs ($45-$180 annually) but may show reduced effectiveness among certain employee segments.
The direct benefits of workplace obesity prevention manifest primarily through healthcare cost containment. A meta-analysis of 22 workplace weight management programs found average medical cost reductions of $3.27 for every $1.00 invested, with savings accruing primarily through reduced claims for cardiometabolic conditions, musculoskeletal disorders, and mental health services[4]. These effects typically emerge gradually, with healthcare utilization impacts becoming statistically significant at 18-24 months post-implementation and continuing to increase through 36-60 month follow-up periods. Self-insured employers generally realize these benefits more directly, though fully-insured organizations increasingly negotiate premium adjustments based on demonstrated risk reduction.
Indirect benefits frequently exceed direct medical cost savings, particularly through productivity enhancements. Absenteeism reductions attributable to workplace obesity prevention range from 0.8 to 3.9 fewer sick days annually per participating employee, with higher effects observed in physically demanding occupations. The economic impact of presenteeism reduction (improved productivity while at work) represents a substantially larger value stream, with systematic reviews indicating that effective programs reduce presenteeism losses by 1.9-3.7% among participants[5]. Longitudinal studies demonstrate that each 1% reduction in obesity prevalence within a workforce corresponds to approximately 0.4-0.6% gains in organization-wide productivity metrics.
Healthcare cost reduction outcomes demonstrate both immediate and cumulative benefits. Short-term savings emerge primarily through reduced utilization of outpatient services for obesity-related acute conditions, while long-term savings accrue through prevention of chronic disease progression. Economic modeling based on 5-year employee cohort data indicates that workplace obesity prevention initiatives preventing average weight gain of 0.5 kg annually (versus typical gain trajectories) reduce per-employee healthcare expenditures by $1,380-$2,160 over this period[2]. These models demonstrate particular sensitivity to intervention effectiveness among high-risk employees, where targeted approaches produce substantially higher returns.
Productivity and presenteeism improvements represent particularly compelling economic outcomes for operational leaders concerned with workforce capability. Controlled studies employing validated productivity assessment tools demonstrate that effective workplace obesity prevention improves cognitive performance metrics by 4-7% and physical work capacity by 6-11% among participants achieving clinically significant weight reductions[3]. These improvements manifest most notably in attention maintenance, decision-making quality, and reduced fatigue during complex tasks. Additionally, organizations report secondary benefits through enhanced recruitment appeal and improved retention rates, with comprehensive wellness programs reducing voluntary turnover by 25-40% among engaged participants.
Long-term economic sustainability requires attention to both continuing costs and evolving benefit streams. Implementation science research indicates that program costs typically decrease by 30-45% after initial implementation phases as systems become established and efficiencies emerge. Benefit trajectories show the opposite pattern, with economic returns increasing over time as health improvements compound and organizational cultural changes take root. Sophisticated economic models incorporating Monte Carlo simulations suggest that comprehensive workplace obesity prevention initiatives reach break-even points at 2.3-3.7 years post-implementation, with positive ROI continuing to increase through years 4-10[5].
Beyond traditional ROI calculations, emerging economic evaluation approaches incorporate value-on-investment (VOI) frameworks that capture broader organizational benefits. These approaches quantify how obesity prevention contributes to strategic priorities such as corporate social responsibility, employer branding, and human capital development. VOI analyses typically demonstrate 30-45% higher returns compared to traditional ROI calculations limited to direct financial measures[3]. This comprehensive approach resonates particularly with executive leadership by connecting health initiatives to core business objectives rather than treating them as peripheral wellness activities.
The economic case for workplace obesity prevention strengthens further when analyzing longitudinal data spanning multiple job categories and risk profiles. Employees with obesity incur 42% higher disability costs and demonstrate substantially longer disability durations compared to healthy-weight counterparts, making disability management another significant value stream[1]. Risk stratification approaches directing more intensive interventions toward employees with multiple cardiometabolic risk factors demonstrate particularly favorable economics, with targeted programs showing ROIs 1.8-2.3 times higher than universal approaches with equivalent per-capita investment.
Case Studies and Best Practices
Examining successful workplace obesity prevention initiatives across diverse organizational contexts reveals valuable implementation insights and transferable best practices. These case studies illustrate how evidence-based strategies can be effectively adapted to specific workplace environments while maintaining core intervention principles.
The manufacturing sector has yielded particularly instructive examples of comprehensive approaches. A large automobile manufacturer implemented a multi-component intervention across 22 facilities, combining environmental modifications (cafeteria redesign, walking paths, activity-permissive workstations) with behavioral programming (team challenges, digital coaching) and policy changes (food procurement standards, break structures encouraging movement). After 36 months, participating facilities demonstrated mean employee BMI reductions of 0.9 kg/m² compared to control sites, with corresponding decreases in healthcare costs ($738 per employee annually) and absenteeism (2.3 fewer days annually)[1]. Critical success factors included union partnership, middle management engagement through performance metrics, and phased implementation allowing site-specific customization.
Healthcare organizations face unique implementation challenges due to round-the-clock operations and high-stress work environments. A regional hospital system developed an innovative approach addressing these constraints through a “micro-intervention” strategy delivering brief, high-impact wellness touchpoints integrated within existing workflows. This approach featured point-of-decision nutrition labeling, strategically placed movement prompts, “healthy huddles” incorporated into shift transitions, and mobile-accessible microlearning modules[4]. This strategy achieved 87% reach among eligible employees (versus 23-30% for traditional programming) and produced modest but significant improvements in weight trajectories (−1.1 kg versus +0.3 kg in control facilities over 24 months). The program demonstrated particular effectiveness among night shift workers, an historically underserved population in workplace wellness initiatives.
Technology-sector employers have pioneered innovative approaches leveraging their digital capabilities. A multinational technology firm implemented a data-driven obesity prevention strategy using passive monitoring through employee badges (with opt-in consent) to analyze movement patterns throughout campus facilities. This analysis informed architectural modifications and workspace redistribution that increased daily movement by approximately 950 steps per employee. The initiative incorporated predictive analytics identifying high-risk movement patterns and delivered personalized digital nudges through the company’s existing communication platforms[2]. After 18 months, the intervention group demonstrated waist circumference reductions averaging 1.8 cm and sitting time reductions of 52 minutes daily compared to control campuses.
Small and medium enterprises (SMEs) face distinct implementation challenges yet have demonstrated creative adaptations of evidence-based approaches. A network of 18 small businesses (25-75 employees each) implemented a resource-sharing model for obesity prevention, collectively funding a shared wellness coordinator, rotating equipment library, and joint purchasing program for healthy food options. This collaborative approach reduced per-employee implementation costs by 64% compared to individual programming while achieving comparable health outcomes[3]. Successful elements included standardized assessment tools, customizable implementation playbooks, and inter-organization competitions that created healthy rivalry while building program engagement.
Industry-specific adaptations illustrate how intervention strategies require contextual tailoring. Transportation sector initiatives have successfully addressed the unique challenges faced by mobile employees through approaches combining environmental interventions at terminals/hubs, technology-enabled supports during routes, and policy modifications addressing scheduling and rest breaks. These adaptations produced mean weight reductions of 2.7 kg among participating commercial drivers over 12 months, with corresponding improvements in blood pressure and glucose metrics[5]. Construction industry programs have effectively incorporated job-specific activity monitoring, nutrition supports compatible with worksite limitations, and safety-integrated messaging that connects healthy weight with injury prevention.
Implementation challenges consistently emerge across case studies, with successful organizations demonstrating systematic approaches to common barriers. Participation challenges have been effectively addressed through segmented messaging strategies tailored to employee subgroups, incentive designs addressing specific motivational factors, and convenient access points reducing participation friction. Sustainability challenges have been overcome through approaches embedding obesity prevention within broader organizational systems rather than maintaining them as standalone programs. Leadership engagement has been secured through data-driven business cases, executive wellness champions, and strategic alignment with organizational priorities beyond healthcare cost management.
Scalable and transferable program elements identified across successful case studies include modular implementation approaches allowing progressive buildout, standardized environmental assessment tools guiding modification priorities, simplified nutritional labeling systems, technology platforms supporting both in-person and remote participation, and balanced incentive designs combining immediate recognition with long-term health outcomes. Organizations demonstrating the greatest success have moved beyond programmatic thinking toward systems approaches that address both organizational and individual factors simultaneously.
Emerging trends identified through leading-edge case studies include integration of obesity prevention with mental health initiatives (recognizing bidirectional relationships), artificial intelligence applications providing increasingly sophisticated behavioral nudges, microbiome-informed nutritional approaches, advanced environmental sensors enabling real-time modification of workplace conditions, and integration of social determinants of health into program design and evaluation. These innovations suggest workplace obesity prevention will continue evolving toward increasingly personalized, environmentally-sophisticated, and comprehensively integrated approaches.
Conclusion
Workplace obesity prevention represents a critical public health strategy with substantial implications for both population health and organizational performance. This comprehensive review has examined the evidence base, implementation considerations, economic dimensions, and practical applications of obesity prevention in occupational settings. Several key themes emerge that provide direction for employers, policymakers, and researchers seeking to advance this important field.
The evidence clearly indicates that workplace obesity prevention initiatives can produce clinically meaningful outcomes when properly designed and implemented. The most effective approaches combine multiple intervention components addressing both individual behavioral factors and environmental determinants. Single-focus interventions demonstrate limited effectiveness, while comprehensive programs targeting nutritional environments, physical activity opportunities, supportive policies, and individual skill development yield substantially greater impact. Implementation science has identified critical success factors, including leadership engagement, cultural integration, and systematic approaches to common barriers. The economic case for workplace obesity prevention strengthens when comprehensive evaluation captures both direct healthcare savings and the substantial indirect benefits accruing through enhanced productivity, reduced absenteeism, and improved workforce sustainability.
Future directions for workplace obesity prevention should emphasize several priorities. First, greater attention to health equity is essential, as current programs often demonstrate differential effectiveness across socioeconomic strata, potentially exacerbating existing health disparities. Second, the integration of emerging technologies offers promising opportunities for personalization, ongoing engagement, and precise evaluation, though ethical considerations regarding privacy and potential discrimination require careful attention. Third, policy development at organizational, industry, and governmental levels can create supportive environments that extend beyond individual workplaces to address systemic factors influencing employee health behaviors. Finally, implementation research must continue identifying effective strategies for scaling evidence-based interventions across diverse workplace contexts while maintaining fidelity to core principles.
Employers are uniquely positioned to influence population health through workplace obesity prevention initiatives that reach adults who might otherwise have limited engagement with health promotion efforts. By implementing comprehensive, evidence-based approaches tailored to their specific organizational contexts, employers can simultaneously advance public health objectives and strengthen organizational performance. The substantial evidence base, implementation frameworks, and economic rationale reviewed in this article provide a compelling roadmap for organizations seeking to address obesity prevention as a strategic priority aligned with both health and business objectives.
References
- Tremmel M, Gerdtham UG, Nilsson PM, Saha S. Economic burden of obesity: A systematic literature review. Int J Environ Res Public Health. 2017;14(4):435.
- Anderson LM, Quinn TA, Glanz K, et al. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: A systematic review. Am J Prev Med. 2009;37(4):340-357.
- Proper KI, van Oostrom SH. The effectiveness of workplace health promotion interventions on physical and mental health outcomes – a systematic review of reviews. Scand J Work Environ Health. 2019;45(6):546-559.
- Goetzel RZ, Henke RM, Tabrizi M, et al. Do workplace health promotion (wellness) programs work? J Occup Environ Med. 2014;56(9):927-934.
- Milani RV, Lavie CJ. Impact of worksite wellness intervention on cardiac risk factors and one-year health care costs. Am J Cardiol. 2009 Nov 15;104(10):1389-92. doi: 10.1016/j.amjcard.2009.07.007. Epub 2009 Sep 26. PMID: 19892055.
