By Catherine Macpherson, senior product manager, Ceridian LifeWorks

If you pick up a newspaper, listen to the news or browse the Internet, you can easily find stories on the health threat of obesity in America -- with a $123 billion annual price tag in associated health care costs (Centers for Disease Control). Most of us are familiar with the dangers associated with obesity, including hypertension, diabetes, sleep apnea, stroke, high cholesterol, some cancers and reproductive problems, just to name a few. But there's another condition that we don't always think about: The stigma associated with obesity and its psychological and social effects.

Obesity is one of the last forms of "acceptable discrimination." We have all probably been witness to people who find themselves the target of jokes or discrimination in a variety of settings, such as employment, health care or education. TV shows have even conducted experiments with models wearing "fat suits," attempting entry to trendy clubs in New York City, unsuccessfully I might add. I have my own story on obesity discrimination.

During a visit with my sister and her family, we went shopping with my 14-year old niece, who is overweight. We went into a clothing store where she chose a few shirts to try on. A saleswoman approached my sister and I while my niece was in the dressing room. She told us there was nothing in the store for my niece -- that the clothes simply would not fit her -- and implied that the clothes may be damaged if she tried them on, even though the knit T-shirts she chose were "one size fits all."

Unfortunately, my niece heard the saleswoman's comments and was brought to tears. Needless to say, my sister and I let the salesperson, and later the manager, know that her remarks were insensitive, rude, discriminatory and hurtful to a young person's self-esteem.

Just like this story, multiple forms of weight stigmatization happen in employment, education, health care and social settings. The Obesity Action Coalition, an obesity advocacy group, reports that bias results in many forms of inequity, including hiring preferences, promotions, wages, college admissions, bullying, quality of health care and social interaction.

With examples such as these, it's no surprise that those who are obese may also suffer from depression, anxiety, low self-esteem and poor body image. A 2006 study of more than 9,000 adults by Group Health Cooperative in Seattle found that mood and anxiety disorders, including depression, were about 25 percent more common for the obese studied than in those who were not obese. Given how prevalent and acceptable weight stigma is in our society, the problem of discrimination requires a shift in public attitudes toward obesity, including understanding its causes and recognizing our own biases.

Weighing the causes of obesity
When my family vacationed in Denmark last summer, I was amazed at the bike traffic. Bike lanes were filled with professionals, students, parents and children on bicycles pedaling to where they needed to go. My curiosity about it led me to research a Danish Web site, where I discovered that a quarter of the Danish population use their bikes daily for transportation, and every Dane over the age of 10 travels 400 kilometers a year on a bike. You can imagine that the rate of obesity in Denmark is in stark contrast to what's happening in the United States. Although the CDC reports that obesity levels among U.S. adults finally look like they are leveling off, we've seen three decades of increasing weight in America.

While increased physical activity helps, the root causes of obesity are complex. Some people may think it's simply a matter of willpower or self-control with food, but there are also genetic, environmental and excess food factors complicating the problem. Consider today's lifestyles. Children spend an average of almost six hours a day sitting in front of a TV or computer screen. And the typical adult leads a much more sedentary lifestyle than our predecessors and we are bombarded with convenience foods and ever-growing portion sizes. Not to mention that research shows that lack of sleep and stress -- which go hand in hand with today's typical American lifestyle -- encourage weight gain. Particularly around the waistline, which carries the most health risks.

But the causes of obesity go even deeper than the convenience food, high-stress lifestyles and the environment that Americans share. More research is showing that obesity is an issue not just for a person, but for a social network. Recent research shows that when your friends gain weight, you do too. Other research offers that obese people tend to pair up. This societal, peer-network power can move the needle in the other direction as well. When you start to slim down, others around you might, too.

Tip the scales in their favor
Although weight loss is more challenging for some than others, obesity is a preventable condition. Just as overweight can be considered a consequence of long-term energy imbalance, people should not expect a quick fix for losing weight. The keys to successful weight loss include:

• A step-by-step approach
• Learning new habits
• Coping with stress
• Changing the environment
• Coaching for support and encouragement
• Help for depression or anxiety if present

No health problem exists without an emotional, financial or legal component. Ceridian LifeWorks can help your employees face the challenges of obesity. Our dedicated health coaches provide a holistic approach with one-on-one guidance to help employees put healthy lifestyle habits into place. We truly support the individual looking to make personal changes by also providing employee assistance counseling (EAP) for help with emotional and other issues -- including weight-related bias.

Like my shopping experience with my niece, it's important to show acceptance of your employees, whatever their size, and to approach obese workers in a nonjudgmental and supportive way. And you can help your employees make a positive change in their lives by giving them access to a one-on-one coaching program and EAP services. Chances are they'll be happier, healthier and more productive.

Catherine Macpherson is a senior product manager at Ceridian. She oversees health and wellness product development including development of all health coaching programs and materials. She has a master's degree in nutrition, is a registered dietitian, and has worked as a product manager, project manager, content writer and editor for 14 years.