We all know America has a problem with obesity, but what's becoming starkly clearer is just how expensive the country's love affair with super-sized portions and sedentary lifestyles is proving to be.
A study by the Conference Board has calculated that obesity rates in the U.S have doubled in the past 30 years and that more than a third of Americans now fit the definition of "obese".
And the cost to the economy in lost working days and extra healthcare costs is a staggering $45bn a year, it found.
Obesity, it reported, was responsible for a 36 per cent increase in spending on healthcare services, more than smoking or problem drinking.
More than four out of 10 U.S. companies had implemented obesity-reduction programmes, and a quarter said they planned to do so this year.
Estimates on the average return-on-investment for wellness programmes ranged from zero to $5 for every dollar invested, it also found.
But such programmes could give companies an edge when it came to recruiting and retaining key employees, it argued.
However, some employers were also coming to the conclusion that awarding cash and prizes for weight loss could be just as effective as spending on long-term wellness programmes.
Employers had to tread a fine line between being seen as being too intrusive in managing obese employees and failing to manage them properly.
There was evidence that, as weight went up, wages went down, the Conference Board study also suggested.
Employers therefore needed to be fully aware of any potential discrimination risk before addressing employees' weight, whether for the employee's own good or that of the company.
And the jury was still very much out on the costs and benefits of paying for weight-loss surgery for employees.
While obese employees medically eligible for such surgery (about 9 per cent of the workforce) had sharply higher obesity-related medical costs and absenteeism, some employers felt they were unlikely to recoup their surgery costs before such workers left for other jobs.
How employers communicated a wellness or weight-loss programme was as important as how they designed it, the survey suggested.
Companies needed to involve employees in planning health initiatives, rather than working from the top-down, and also needed to ensure that personal privacy was protected, it recommended.
"Employers need to realize that obesity is not solely a health and wellness issue," said labour economist Linda Barrington, research director of The Conference Board Management Excellence Program and co-author of the report.
"Employees' obesity-related health problems in the United States are costing companies billions of dollars each year in medical coverage and absenteeism. Employers need to pay attention to their workers' weights, for the good of the bottom line, as well as the good of the employees and of society," she added.