Obesity Court

Morgan O'Rourke


November 1, 2009

In July, a Centers for Disease Control and Prevention study found that the costs of treating obesity-related disease may have climbed as high as $147 billion in 2008-almost 10% of all total U.S. medical costs. The study found that costs had nearly doubled in only 10 years, and with the prevalence of obesity increasing 37% between 1998 and 2006, costs are only expected to rise.

For some companies, these costs are manifesting themselves in unanticipated ways. Two recent court decisions have found employers to be responsible for paying for weight-loss surgeries in addition to the medical expenses related to a workplace injury. In Indiana, after Adam Childers, a 340-pound cook at Boston's Gourmet Pizza, suffered a back injury from being struck by a freezer door, doctors determined that he would need lap-band surgery in order to lose weight before undergoing a back operation. His employer balked at having to pay for the $25,000 surgery since Childers' obesity was a pre-existing condition. But courts ruled that his weight and the accident combined to create a single injury and, therefore, the employer had to pick up the tab.

According to Childers' attorney, this case was not without precedent. Courts in Ohio, California, Oregon, Florida and South Dakota reached similar verdicts as far back as 1983. And a few weeks after Childers' case, the Oregon Supreme Court ruled on another case concerning obesity and surgery, determining that state workers compensation insurance had to cover Edward Sprague's gastric bypass operation in order to aid his recovery from knee-replacement surgery. Sprague, who weighed 320 pounds, first injured his knee in 1976 while working as a mechanic and again in 1999 after a work-related accident in a bakery.

Critics are concerned that the rulings encourage discrimination because employers will become reluctant to hire obese workers-or anyone else with a pre-existing medical problem for that matter-because of the possibility of increased medical costs down the road. While laws in all 50 states prevent discrimination for a pre-existing condition such as obesity, employers would have an incentive to quietly search for other reasons to choose a different candidate-a practice that could mean that those most in need of health insurance would find it increasingly difficult to receive employer-aided care.

Morgan O’Rourke is editor in chief of Risk Management and director of publications for the Risk & Insurance Management Society, Inc. (RIMS)