8279515 Obesity negatively impacts work participation amongst older workers

<h3>Objectives</h3> Obesity is a growing public health burden associated with increasing healthcare costs. However, there is also evidence that obesity impacts work ability and reduces work productivity and participation, thereby increasing indirect costs. This longitudinal study investigated the impact of obesity on work participation amongst middle-aged adults and explored the mechanisms for these impacts. <h3>Material and Methods</h3> Data came from the Health and Employment After Fifty (HEAF) cohort study of adults aged 50-64 years at baseline. We used Cox proportional hazard models to explore the longitudinal effect of body mass index (BMI) on the risk of work exit because of health (HRJL). To test whether the association between BMI and HRJL was partly explained by depression and/or walking speed, we further adjusted estimates for these factors. <h3>Results</h3> Amongst 5086 participants in paid work at baseline, 40% were overweight and 23.7% obese. Obesity and overweight showed a socio-economic gradient. After adjustment for sex, proximity to retirement, finances, educational attainment, smoking and physical activity, obesity and overweight were associated with increased risk of work exit on health grounds (HR 1.35, 95%CI 1.11-1.64 and HR 1.54, 95%CI 1.25-1.89 respectively). Depression and slow walking speed were independent risk factors for work exit which, when combined in the models with obesity, explained most of the effects. <h3>Discussion</h3> Obesity and overweight importantly impact work ability at older ages. However, most of their impact can be explained by depression and/or slow walking speed. Prompt diagnosis and treatment for depression, accompanied by mid-life recognition of functional impact on walking speed could facilitate prolonged working at older ages, resulting in economic benefits for individuals, employers and societies with reduced healthcare and indirect costs.