Operating costs are heavily influenced not only by

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Operating costs are heavily influenced not only by features of the physical facili ty but by the decision regard· ing support staff. For those companies choosing not to emplo y support personnel, costs have been estimated at around $150 per participant per year. Co mpanies that have their ow n supp o rting staff and a facility opened 10 to 14 hours per day can expect to incur costs of between $500 and $1,000 per participant per year. Th e ra nge is probably 912 even gr eater at the high end if standardized definitions were used for act ive company partir;ip ation. Weight Reduction Bo~~ l ! ~tua fiai ane e:)idemiologic studi es ff~lating body build, weight and fT ! ol tality h ave demon stra ted that the greater the weigh'< (fOi a give n height) the greater the chance of death· o . sl Tht influence of obesity is largely mediat ed (reversibly) through increases in blood pre ss ure, higher total cholesterol, and bl ood glucose.s 2 Obesity that is greater than 20% of id ea l body weight affects 25% to 45 % of Americans over 30 years of age. Of workers, 13.6% of males and 2UY '1o of females arc esti· mated to be overweight defined as 20% or mor e over desired weigh!." Prevalence of obesity differs by socio· eco nomi c status and by cultural and ethnic group. A cross- sectional study of 1,660 persons in a portion of Manhattan with diverse socioecono mic groups founei a strong inverse relationship between prev alence of obesity and socioecon- omic status. 53 Men of lower soc io economic status had 32% prevalence of obesity compared with upp er class men with 16%. Women show ed even gr ea ter variati o ns with 30% of lower socioeconomic sta tus obese compared with 16 % of those in the middle stat us and 5% in '~e upp er statu s group. Ethnicity was also a strong predictor of obesity with a 6: 1 ratio of prevalence between low er- and upper-status groups. S imilar r esul ts hav e been obtain ed in other studi es, such as the Framingham Study. Whil e control of obesity can be expected to reduce known risk indicators for cardiovascular disease and diabe- tes, prolonged weight control in populations of obe se incli- viduals has been difficult to ach ieve. Only in the last 15 years can it be claimed that significant weight reductions have been achieved without fasting or enforcing consump· tion of unusual nutri ent forms ~uch as "liquid protein. " The most successful programs have utili ze d various be- havioral therapies. A numb er of behavioral approaches have been empl oyed to help individual s gain more control over their eati ng habits. Primary among t hem is record keeping and main - tainin g a diary of what foods are eate n, in what quantities, at what times and und er what circumstances. This provides a more ob jective view of what is consum ed while simul- taneously underscoring that the ind ividu al can be effective in self-monitoring. A second approach is altering th e environmental stimuli to eating. Shopping from a predeter- mined list, not buying calorie·dense foods, eating only in one room and not eating con curre ntly with other activities such as watc hing television or reading all decrease the chance of ove rez.ting.
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  • Spring '12
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