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Obesity costs American companies $56 billion in lost productivity caused by disability, illness and death, according to the Centers for Disease Control and Prevention. Considering the high toll, some employers are more than willing to pay for a healthier crew.

46% of the nation’s largest employers offer incentives to employees who exercise and have healthy lifestyles. The Supreme Court of the United States that it is not discriminationtooffer incentives.

Weight is a sensitive issue, so programs should be sure to encourage progress, not punish the overweight. In Michigan, it’s illegal to discriminate on the basis of weight.

It’s also important to encourage overall healthy living and wellness, not just pounds lost. Programs that focus on one health aspect won’t have a significant impact on overall health care costs, said A. Mark Fendrick, co-director of the University of Michigan’s Center for Value-Based Insurance Design.

For Kym Jackson, exercise is a way of life now. Two years of a rigorous regimen have literally transformed her.

But Jackson changed because she had little choice.

Her employer, the Benton County, Ark., government, told her and every other out-of shape worker to get healthy or lose their health coverage, because the cost of providing health care was getting out of hand.

“I have to tell you, when our plan was hemorrhaging, it was about a bottom-line issue,” said Benton County’s human resources director Barbara Ludwig. “But it was an employee’s bottom-line.”

The county built an incentive into the plan enabling county workers to cut their annual deductible to as low as $500 if they were able to pass yearly fitness tests: cholesterol lower than 160; glucose lower than 126; blood pressure 140 over 90 and no nicotine.

But many employers were offended – initially.

A prison guard, Andy Bowman, said his first reaction was: “didn’t like it.” Why not?

“I didn’t want no one telling me I’m out of shape,” Bowman said. “No one wants to have it in their face.”

Another guard, Mark, said: “I think at first you’re a little skeptical, picking on me because I’m fat.”

So Reynolds asked the HR manager, “You’re forcing a lifestyle on your workers?”

But Benton County isn’t the only employer forcing employees to get healthy. IBM offers it’s employees bonuses if they exercise, lose weight, stop smoking, or get rid of unhealthy behavior.