Purpose: While previous research suggests that obesity contributes to the onset of many chronic diseases, its association with labor supply is less well known. Here we examine the impact of body mass index (BMI) on workforce participation in a U.S., working-age population.

Methods: Using prospective data from the Panel Study of Income Dynamics, we estimated the effect of obesity in 1986 on labor force participation in 1999 among men (n=1899) and women (n=2395). The sample was restricted to household heads and spouses who were >17 years in 1986 and < 65 years in 1999, and who were interviewed at both times. BMI was calculated from self-reported height and weight. Individuals were classified into the following weight categories: underweight (BMI <18.5), normal weight (BMI ≥18.5 but <25), overweight (BMI ≥25 but <30) and obese (BMI ≥30). We estimated the effect of obesity on probability of not working using three multivariable logistic models, which controlled for socio-demographic (SD) characteristics (model 1); smoking status and SD characteristics (model 2); and smoking status, exercise, and SD characteristics (model 3). We stratified analyses by sex.

Results: In the unadjusted analysis, persons who were obese in 1986 were approximately twice as likely not to be working in 1999 when compared to normal weight individuals (men: odds ratio [OR] 2.20, 95% confidence interval [CI] 1.52 - 3.17; women: OR 1.81, 95% CI 1.38 - 2.37). After adjusting for socio-demographic characteristics the relationship between obesity in 1986 and not working in 1999 remained statistically significant (men: adjusted OR [aOR] 1.52, 95% CI 0.99 - 2.31; women: aOR 1.40, 95% CI 1.03 - 1.91). Further adjusting for smoking status and exercise did not substantively affect these results. The Cochran-Armitage linear trend test supported the hypothesis that the proportion of individuals not working in 1999 rose with increasing baseline weight categories (P < 0.01).

Conclusion: This study suggests that obesity has long-term effects on employment. Therefore, in addition to disease morbidity and mortality, obesity appears to result in productivity losses through reduced workforce participation.