Technical Paper 1:
Obesity in Australia: a need for urgent action

4.6.3 - The workplace setting

|TOC|next page

Table of contents

As a setting of particular importance in obesity prevention, the workplace represents an arena for social leadership and peer support in tackling behavioural change, while work and employment policies and practices can enable or inhibit positive change.

A recent review of the effectiveness of workplace weight loss programs concluded that outcomes show modest short-term improvements in body weight, but that there is a paucity of long-term health and economic data.[108] Common factors of worksite health promotion programs with successful outcomes (such as small decreases in BMI) include regular participation, intervention intensity, the inclusion of dietary advice, supervised physical activity, support for physical activity outside the workplace, counselling and plant reorganisation.[109]

A review of workplace-based interventions targeting dietary behaviours through various education and environmental initiatives that were focused around the work canteen found positive but modest changes in diet and food purchases or no impact.[110]

Reviews of workplace initiatives promoting physical activity (interventions included health checks, motivational prompts and physical activity programs) have found inconsistent or inconclusive evidence,[111, 112] with some strong evidence for increased physical activity behaviour but inconsistent or no evidence for improvements in cardiovascular outcomes, body weight or general health.[112] More comprehensive interventions, incorporating individual approaches and changes in workplace culture and organisational structure, were more successful.[111]

‘WorkHealth’ is an initiative of the Victorian Government which began in July 2008.10 It is a five-year, $218 million program aimed at improving the health and wellbeing of Victorian workers through workplace-based health checks and providing access to advice and education programs to help workers reduce their risk of chronic disease. The aims are to reduce absenteeism, improve productivity, reduce injuries and reduce the burden of chronic disease on the Victorian health system. The voluntary initiative uses the workplace as an opportunity for health promotion and disease prevention; partnerships between government, employers and workers to develop effective health solutions; and links to existing health initiatives and services. Through the initiative, every Victorian workplace (involving up to 2.6 million workers across the state) will be given the opportunity to participate in staff health programs. All workers will be provided with information on how to improve their health and will initially be offered two types of free on-site screening tests. These include a self-assessment chronic disease test to identify physiological and lifestyle issues contributing to their level of risk of developing a chronic disease; and the collection of physical and biomedical measurements, such as height, weight, cholesterol, blood pressure and blood sugar. The health provider will assess the information collected, provide the worker with individualised information and advice, and, where appropriate, provide the worker with recommendations for a general practitioner (GP) follow-up. The initiative also involves co-contribution grants for larger workplaces for screening, and for the expansion of existing or new health and wellbeing programs.
Top of Page

These programs will provide information and advice, and facilitate free on-site screening services for chronic disease. A chronic diseases prevention program will also be developed through the initiative; those workers identified as most at risk and those newly diagnosed with chronic diseases such as type 2 diabetes will be provided with access to services such as a free lifestyle change program to help them adopt healthier eating and physical activity behaviours, and information and education programs.

These kinds of programs and opportunities could be provided to Australian employees more broadly as a standard condition of employment. For example, workplaces could offer risk assessment and risk modification programs, nutritional education for workers and families, and physical activity embedded in or in association with regular daily work practice. In addition, incentives could be provided to employers to reduce the chronic disease risk profile of their employees.

Sedentary behaviour in the workplace

The workplace represents an ideal opportunity to reduce sedentary behaviour among the population. Prolonged inactivity such as sitting is now common during working, domestic and recreational time, and typically comprises over half of waking time activity.[113, 114] Over one-quarter of Australians (26%) report sitting for eight or more hours during a typical day.[43]

Recent Australian research has demonstrated the benefits of avoiding prolonged uninterrupted periods of sedentary (mainly sitting) time,[114] interspersing periods of inactivity with breaks, and substituting (at minimum) light-intensity activity for sedentary time.[113, 114] These benefits include improved weight and metabolic outcomes. For example, the amount of sedentary time, time spent in light-intensity physical activity and time spent in mean activity intensity were found to be significantly associated with waist circumference and metabolic risk factors, independent of time spent in moderate-to- vigorous-intensity activity. On average, each 10% increase in sedentary time was associated with a 3.1cm larger waist circumference.[113] Evidence also indicated that people who took more breaks in sedentary time had significantly lower measures of obesity (waist circumference and BMI), and improved blood triglyceride and glucose levels, regardless of total sedentary time and moderate-vigorous physical activity. Those in the group who had the most breaks had a waist circumference on average 5.95cm smaller than those in the group who took the least breaks.[114]

While it is important to continue to promote the significant health benefits of regular moderate-vigorous physical activity, this research indicates that extended periods of sedentary time (as are common among office workers) may undo the benefits of such activity. The results suggest that simple interventions that can be implemented in the workplace and domestically to decrease passive sitting time and increase the number of breaks can also lead to substantial health improvements. The evidence highlights behaviours that may be more appealing and feasible for some people to undertake, which can still result in improved weight and metabolic effects; for example, the importance of lower-intensity activity throughout the day (including incidental activity such as standing) rather than a focus on more purposeful moderate- to vigorous-activity such as going to the gym or jogging. Simple and sustainable strategies include:
  • Standing up while on the telephone or watching television
  • Using a telephone headset at the office to keep moving during phone calls
  • Holding walking or standing meetings when appropriate
  • Arranging regular (for example, half-hourly) short breaks during sit-down meetings.

Employers and workplaces (both large and small) develop comprehensive programs that support healthy eating and physical activity. Evidence-based guidelines recommend ensuring policies and building design encourage healthy eating and physical activity, such as travel expenses promoting walking or cycling to work; improved stairwells to encourage use; and the provision of shower and bike parking facilities.[1] Incentive schemes to encourage healthy behaviours and weight management include contributions to gym memberships, including active travel in expense policies, and the availability and promotion of competitively priced healthy food choices on-site (including vending machines).

10See www.workhealth.vic.gov.au/wps/wcm/connect/WorkHealth/Home


|TOC|next page