Abstract
It is estimated that American employers spend more than $900 billion annually on health care and that obesity-attributable health care expenditures total $75 billion. The authors discuss a yearlong health promotion research project aimed at obesity and involving eight small manufacturing companies. Three hundred forty-one employees randomly selected at the intervention and control worksites were followed at baseline and at 3, 6, and 12 months for anthropometric measures, lifestyle behaviors, absences, and work performance. The authors conclude that although the worksite offers unique opportunities to develop health promotion programs, these efforts are not without challenges due to the tensions regarding the need to protect and promote health for the population, the increasing concerns over health care costs and access, and the priority to maintain individuals' rights and privacy.