title: Knowledge and perceptions among overweight and obese employees about lifestyle-related health benefit changes.
abstract: BACKGROUND
  We investigated perceptions among overweight and obese state employees about changes to health insurance that were designed to reduce the scope of health benefits for employees who are obese or who smoke.
  
  
  METHODS
  Before implementation of health benefit plan changes, 658 state employees who were overweight (ie, those with a body mass index [BMI] of 25-29.9) or obese (ie, those with a BMI of > or = 30) enrolled in a weight-loss intervention study were asked about their attitudes and beliefs concerning the new benefit plan changes.
  
  
  RESULTS
  Thirty-one percent of employees with a measured BMI of 40 or greater self-reported a BMI of less than 40, suggesting they were unaware that their current BMI would place them in a higher-risk benefit plan. More than half of all respondents reported that the new benefit changes would motivate them to make behavioral changes, but fewer than half felt confident in their ability to make changes. Respondents with a BMI of 40 or greater were more likely than respondents in lower BMI categories to oppose the new changes focused on obesity (P < .001). Current smokers were more likely than former smokers and nonsmokers to oppose the new benefit changes focused on tobacco use (P < .01).
  
  
  CONCLUSIONS
  Participants represented a sample of employees enrolled in a weight-loss study, limiting generalizability to the larger population of state employees.
  
  
  CONCLUSIONS
  Benefit plan changes that require employees who are obese and smoke to pay more for health care may motivate some, but not all, individuals to change their behaviors. Since confidence to lose weight was lowest among individuals in the highest BMI categories, more-intense intervention options may be needed to achieve desired health behavior changes.
authors: Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, CB 7440, Chapel Hill, NC 27599-7440, USA. jiangli@email.unc.edu
authors: Jiang
authors: J
authors: Li
authors: Laura
authors: L
authors: Linnan
authors: Eric A
authors: EA
authors: Finkelstein
authors: Deborah F
authors: DF
authors: Tate
authors: Carolyn
authors: C
authors: Naseer
authors: Kelly R
authors: KR
authors: Evenson
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016009:Chi-Square Distribution; D005260:Female; D006264:Health Benefit Plans, Employee; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology*; D050177:Overweight / Q000517:prevention & control* / Q000523:psychology*; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D014495:Universities; D015431:Weight Loss