CVS Drugstore Chain Unveils New Employee Diet Plan: Fat-Shaming and a $600 Fine

Menacing CVS logo

Workplace wellness incentive programs are not a new phenomenon, but the Internet is in turmoil today over a recent announcement by the national drugstore chain CVS. Beginning in May, CVS will require employees on the company's insurance plan to undergo health testing—including body mass indexing and blood glucose testing—or face a $600 annual penalty.  

The company's rationale? Coercing employees to submit to health testing will provide incentive for workers to get—and stay—in shape. Employees' health information will not be accessible to the company itself, but rather to a third party responsible for administering company insurance benefits. Reportedly, with the advent of Obamacare and rising healthcare costs, practices like this threaten to become more commonplace in the corporate environment. 

Attention everyone, everywhere. If you've been struggling for years to get in shape, whatever that means to you, you can just quit whatever it is you're doing right now because CVS has got it all figured out. It turns out whatever silliness you were attempting, you just didn't have the proper incentive. Except, as it happens, this regimen already exists and it's called humiliation and fat-shaming. Have someone tell you you're overweight, or pay a major fine.

Then there's the next major issue. CVS, which really should by keyed in to the latest, or at the very least some, health news, ought to know Body Mass Index (BMI) is by no means an accurate indicator of health. As Keith Devlin over at NPR pointed out back in 2009, there are at least 10 good reasons BMI is entirely bogus, not the least of which is it hinges on the notion of the "average man."

According to the Centers for Disease Control and Prevention, BMI may have some minute health relevance, but correlation varies widely based on sex, race and age. For instance, at an equivalent BMI, women tend to have more body fat than men. Additionally, a BMI which shows up as within the ideal target range can actually be a smokescreen for serious underlying health factors. The complexity of BMI as an indicator of health presents something of a double-edged sword for these employee health profiles: the more in-depth and contextual the profiles are about their patients, the more accurate they are… but being in-depth requires being considerably more invasive.

Further, what happens if this incentivizing fails? There are laws against discriminatory hiring and firing practices, but our society is far from perfect. What's to say what goes through the mind of a CVS hiring manager, however unconsciously, who knows a fitter-looking workplace equates to better insurance benefits? What's to say companies like CVS won't subtly modify their hiring profile to lower their insurance costs and score better benefits? Perhaps most realistically and devastatingly, who's to say what goes through the mind of an overweight employee who worries his job security is threatened by his health status or appearance? 

Obesity is more prevalent in low-income workers, due to a variety of factors, including workplace stress and purported diminished accessibility to healthy food. The economists will side with CVS and agree when it comes to incentives, money goes a long way. It's great to promote health and wellness initiatives in the workplace, but CVS, which is being blatantly reactive, and even "bullying" according to some sources, seems to be going about it all wrong.

Once the doctor hands an employee the "overweight" card, who's going to be there to counsel him on the best fitness, diet and mental health practices for his personal lifestyle? If this is not the company's responsibility, as many will argue, why make him pay emotionally to find out he's unhealthy in the first place? 


Photo from NBC's coverage of CVS's program.

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11 Comments Have Been Posted

Bitch Media says, "Don't tell me if I'm sick!"

Arguing against blood glucose testing as fat shaming is akin to arguing against HIV testing as slut shaming. Mere "head in the sand" thinking dressed up as freedom. Pretty shitty.

That you chose to focus on BMI alone when it is clearly being paired with THE real test for diabetes risk is also shitty. That's REAL informed choice -- to know what's happening in our bodies at its most basic processing level is the kind of knowledge we should embrace. Far better than BMI alone, arbitrary clothing sizes, and "how so you feel when you look in the mirror" woo woo.

Points to applaud: BMI with blood glucose testing, not alone; testing with costs, but not as condition of employment; required for all employees, not based on "apparent" need.

Seriously, with diabetes the number three killer, what's your next plan -- arguing against safety belts and helmets??

Freedom of Choice now a bad thing

You're with the company aren't you?

My takeaway from this piece

My takeaway from this piece is NOT that blood glucose testing is fat shaming. My take away was that blood glucose testing is about as good an incentive to "get healthy" as your mother telling you that you'll never meet a nice boy if you dont' slim down. I don't know how you came to the conclusion that anybody was trying to dissuade anyone from having their blood glucose levels tested. Just saying as a member of the peanut case you are legitimately worried this piece would have a negative impact on the likelihood that I would seek information about my body and isn't because no one is suggesting it should. Sleep soundly knowing I'm not an idiot.

penalty for overweight

Not long ago I was in perfect shape. I worked at least eighty hours and ran three miles a day. The doctors then diagnosed me with a genetic disorder. The meds the doctor gave me made me gain considerable weight. CVS knows that there are many precriptions and illnesses that cause overweight. Gladly I dont work there but my pecriptions are about four thousand dollars a month. When these meds become due next month i will change to a small independant pharmacy. CVS can go to hell.

CVS, how about $600.00 for Being Healthy?

The CVS leadership group believes by fining employees $600.00 for being unhealthy it is going to suddenly create a healthier workforce, wow! They obviously have no clue about successful lifestyle management change and frankly isn't really interested in developing a healthier employee. This is just a head in the sand, old school problem solving mindset in play here. I don't like their future profit generating capabilities, here is why.

How about partnering with employees and creating incentives for being healthy, yes, pay employees for good health?

How about creating a corporate culture that supports health promoting behaviors like physical activity, eating well and stress management?

Think of it this way for a moment, the following is an excerpt from Wellbeing: The Five Essential Elements. New York: Gallup Press Harter, J., Rath, T., (2010).

"When leaders embrace the opportunity to improve employees’ wellbeing, they create more engaging places to work and greater returns for the organization. Conversely, when leaders opt to ignore employees’ wellbeing, they erode the confidence of those who follow them and limit their organization’s growth.

The benefits of improving the wellbeing in organizations:
• Improved performance
• Higher quality work
• Fewer employee sick days
• Less employee turnover
• Fewer on the job injuries

This all adds up to a more efficient and higher performing organization.

Furthermore, the most progressive leaders use this knowledge to recruit and retain employees. They know it is easier to attract top talent if they can show a prospective employee how working for the organization will translate into better relationships, more financial security, improved physical health, and more involvement in the community.

Just as the most successful organizations have worked systemically to optimize their levels of employee engagement, they are now turning their attention to employee wellbeing as a way to gain an emotional, financial and competitive advantage."

Just some common sense, don't you think?


Neo-liberalism at its finest

"CVS will require employees on the company’s insurance plan to undergo health testing—including body mass indexing and blood glucose testing—or face a $600 annual penalty."

I read this not as CVS fining employees for being unhealthy, but rather fining employees that don't partake in the test. Even 'healthy' employees may not want to take part in the test as a matter of principle.

Regardless, there are obvious ethical problems with this. We can relate the need for 'healthy' bodies as the company's desire to increase profits. Healthy bodies = productive bodies = profit.

This article examines the

This article examines the issue of corporations invading personal lifestyle and sociological behaviours for their better profit bottom-line. It still makes me want to go out and eat a burger.

Same situation.

My company just did the same thing when switching over to a new health insurance plan. It was framed as "do this health measurement initiative and get $400 off your health insurance premium!"

Well, surprise -- they are now offering the $400 savings for next year's premium if you improve your health scores by next round of testing.

It infuriates me because it is myopic, punitive, and completely arbitrary. Not to mention, discriminatory towards people who are unable to improve their numbers for any variety of reasons (ex: genetic predisposition towards high cholesterol, weight gain due to medication side effects) OR numbers are improved through unhealthy means (ex: weight loss due to eating disordered behavior.)

Most build the incentive

Most build the incentive plans to permit alternative forms of paricipation or programs for those who are medically unable to participate (and is actually legally is supposed to be). A company cannot provide a wellness incentive built into their insurance premiums if they are not voluntary and do not provide an alternative to those who medically cannot participate in the program, otherwise it does open up potential discrimination claims.

In this case, I believe that CVS built the wellness incentive into their medical premiums between employee and employer contributions. It is meant promote healthier choices, better knowledge behind ones health (know your numbers campaigns) and potentially reduce utilization costs that cause insurance premium increases to employers (and ultimately to the employee to offset employer increases). It is a means to help cost savings for both the employer and employee.

Also, due to protections of private health information, the employer cannot know details to what someones numbers are, they are confidential. Most choose to apply the incentive discounting to benefit premiums upon participation in the program (completely voluntary, no sharing of BMI, etc.) and if they link improvements in subsequent years to additional discounting, it is performed by a third party who is not affliated with the employer or insurer or handles premiums and claims processing. In the case of Health Risk Assessments, they may require details of glucose levels, BMI, blood pressure,etc. just to give a readout of your healthscore and again are confidential and are not given to the employer or the insurance company. It is to the benefit of the individual participant and how they want to use those numbers and data.

"Good Health?"

What exactly is "good health?" Who determines it? It's subjective, a sociological construct. The definition we give it today is different from 20 years ago and will be different 20 years from now.

Not so long ago, a BMI of 28 was considered "overweight," until certain "doctors" who sit on the Weight Watchers Board determined it should be lowered three points to 25. Now you are overweight if your Body Mass Index is a 25. Why do you think they lowered it? More people being considered "overweight," more people spend money to "get in shape," possibly via Weight Watchers, which these doctors profit from. A mere example, perhaps, or more indicative of the entire industry?

Question why this is all happening! The life expectancy rate doubled in the 20th century; if diabetes kills people in their 70s, better than women dying in child birth, people succumbing to tuberculosis and polio. Sure, there are more strides to be made. I'm not saying eat 3 Big Macs a day (or allow children to do so and drink tons of soda and candy) - but use common sense. Don't sit around watching t.v. all the time, get out and move. However don't let an industry predicated on money and artificial constructs rob you blind.

What's next? A public scale and shaming ceremony? A community lottery each year, sacrificing the ugliest and fattest (as determined by the Media) to keep the rest of society in "good health?"

It's only in our best interest, for our health, right?

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