Obesity and work: HEAF study of older workers, a 6-year follow-up

Obesity impacts work ability. Previous longitudinal research in the Health and Employment After Fifty (HEAF) cohort found that obesity reduced work participation to older ages, with effects only partially explained by comorbidities.

To test the hypothesis that obesity impacts working to older ages through either depressive symptoms and/or function, this study was conducted using 6-year prospective data.

HEAF is a population-based cohort study of 8000+ adults aged 50-64 years recruited 2013-14. Six-year data from HEAF were used to construct 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 explore whether the association between obesity/overweight and HRJL was partly explained by depressive symptoms (mental health) and/or walking speed (proxy for function), additional analyses were adjusted for these factors.

Amongst 5086 participants in paid work at baseline, 40% were overweight and 24% obese. After adjustment for sex, proximity to retirement, finances, education, smoking and physical activity, obesity/overweight were associated with increased risk of HRJL (HR 1.35, 95% CI 1.11-1.64 and HR 1.54, 95% CI 1.25-1.89 respectively). Self-reported symptoms of depression and slow walking speed were independent risk factors explaining most of the effects.

Obesity/overweight restricts work ability at older ages. Most work loss can be explained by depressive symptoms and/or slow walking speed. Prompt diagnosis and treatment for depression, alongside identification of slow walking speed could facilitate prolonged working to older ages, with potential economic benefits for individuals, employers and societies.