Financial implications of New York City's weight management initiative.

PurposeTo estimate potential annual savings in medical expenditures from a subsidized weight management program from the NYC Government perspective.DesignLongitudinal observational study.SettingEmployees of New York City (NYC) government and enrolled dependents.Sample14,946 participants with overweight and obesity.InterventionWW (formerly Weight Watchers®) 'Workshop' and 'Digital' programs.MeasuresParticipation rate, enrollment duration, weight change, and predicted gross and net total and per capita medical expenditure savings and return on investment (ROI).AnalysisParticipation rate, enrollment duration, weight change, and program costs are based on direct observation. Predicted savings are simulated based on published data relating weight loss to medical expenditure reductions.ResultsIn total, 47% of participating employees and 50% of participating dependents lost weight during the enrollment period. Mean (median) enrollment duration for employees was 7.1 months (7.0) and for dependents was 6.9 months (6.0). Mean (median) weight losses for the employees in 'Workshops' and 'Digital' was 6.6 lbs (2.80) and 6.3 lbs (0.0). For dependents, weight losses were 7.4 lbs (3.59) and 11.6 lbs (2.0). Per capita and total predicted net savings to NYC Government from employees was estimated to be $120 and$1,486,102 for an ROI of 143%. Including dependents, predicted net savings increases to $1,963,431 for an ROI of 189%. Over 80% of savings came from participants in the Obese III category.ConclusionAn evidence-based weight management program has the potential to generate a positive ROI for employers. Future studies should validate these estimates using actual data and more rigorous designs

Employee and Customer Reactions to a Healthy In-Store Marketing Intervention in Supermarkets

Abstract Supermarkets are a primary source of food for American households, and increased presence in low-income, high-minority neighborhoods present opportunities to increase access to healthy foods. It is important to assess store manager and customer reactions to in-store marketing interventions. The objective was to evaluate manager and customer reactions to stealth, low-cost, sustainable in-store marketing strategies to promote healthier purchases in five product categories and gain insight into shopping habits and willingness to change behaviors. Surveys were collected as part of the evaluation of a cluster-randomized controlled trial conducted from 2011-2012 in eight urban supermarkets in low-income, high-minority neighborhoods. Store manager (n=16) and customer intercept surveys (n=100) were administered at intervention stores in May-July 2012 and August 2012, respectively. Demographics, shopping habits, and impact were calculated using frequency distributions, cross-tabulation, and analyses of variance. Correlations were calculated using Pearson's R or one-sided Fisher's Exact Test. Most managers reported the project had a positive impact on stocking, ordering, staffing, and interaction with other employees. Most customers did not notice new marketing strategies, although they were intentionally stealth. A large number of customers reported making impulse purchases regularly. Opportunities to positively affect purchasing may exist