If it seems your employees are getting heavier — and less healthy — it’s probably not your imagination. And you’re not alone. Though adults in North Carolina smoke less and get a little more exercise than in years past, obesity is on the rise — from 59% of Tar Heel adults in 2002 to 63% now. So says a report by NC Prevention Partners, a Chapel Hill nonprofit. Meg Molloy is executive director.

BNC: Are we worse off than people in other states?

Molloy: Yes. We’re high in stroke. We’re high in diabetes. We’re high in heart disease. Cancer just surpassed heart disease and stroke as our leading killer. We still see people in North Carolina having higher tobacco use. So we do have a bigger problem than the rest of the country, even though the rest of the country isn’t exactly perfect.

Why should employers care?

Poor health from overeating, tobacco use and inactivity is expensive — about $5,700 per employee per year in North Carolina. People are out of work far more frequently when they’re not healthy. And even before they get to the diabetes or heart-disease stage — when they’re just overweight and using tobacco, maybe have high blood pressure — you see far more sick days. You see people who are at work but not as productive. You see higher workers’ comp claims. You see higher medical and disability claims.

What can employers do?

Keep people healthy. Once people get into that unhealthy category, it’s much more expensive to deal with and difficult to turn around.

How do you keep people healthy?

The first thing is to make the work site 100% tobacco-free. That protects every employee from second-hand smoke. We recommend that the whole campus be 100% tobacco-free. That is huge in encouraging people to quit. People who have been thinking about quitting for years will say, ‘OK, well, now I’m just going to have to do this.’

It’s that simple?

Smart employers are not going to roll out that policy without any communication. They’re going to be talking about it a year in advance, rolling out benefit programs at least six months in advance, offering subsidized or no-cost tobacco-cessation medication through their health plan. They’re going to offer counseling, and they’re going to give work time to help people go get quit-smoking assistance.

What about overweight workers?

Make sure that your work site gives people access to healthy foods. Make sure there are healthy options on the cafeteria line and make more than half of your vending items healthy choices. In our office, we stock the break room with fresh fruit, juices and bottled water. We don’t encourage people to bring in brownies, cupcakes and leftover Halloween candy.

How can employers encourage more physical activity?

Many have a wellness committee map out a half-mile or mile route near the facility or even, in larger work places, within the facility. They give people incentives to use their 15-minute breaks for walking instead of eating a doughnut or smoking. If you log a certain amount of miles, you might be eligible for a small incentive — a gift card or water bottle. Some employers are offering stronger incentives — extra days off or waived or reduced co-pays and premiums.

Wouldn’t extra vacation days offset a benefit of having healthy workers — that they show up more often?

An employer has to balance how many days off it would offer. But if you see somebody lose 15 or 20 pounds and he or she gets a day off, you’re going to save a lot of money.

Are any CEOs leading morning calisthenics?

Several hospital CEOs have told me that until they got involved, where they actually got out there and walked or did whatever the activities were, a lot of the staff didn’t think it was em- braced fully. If CEOs walk the walk and not just talk about it, you have much better buy-in and better participation from management on down.

What about something like the TV show Celebrity Fit Club, where you have teams competing to lose the most weight?

Competitions can be effective if they’re done well. Many people do better when they’re working as part of a group. A lot of people need support to change their behavior.

What are the hallmarks of a good health-insurance program?

Tobacco-cessation benefits should cover counseling and medications. On the healthy-weight side, it should include medical nutrition therapy with a registered dietitian — not just for diseases but to maintain healthy weight. Many plans in our state offer obesity-prevention and -management benefits for kids and adults, be- cause dependent costs are high for employers

What’s the outlook?

Most scientists predict we’re going to see weight trends continue to rise for the next 20 years. That means more of the work force will struggle with high blood pressure, diabetes and other health issues. If employers don’t do anything, we’ll see our health get worse, and our costs are going to continue to go up.