Carrot or Stick?

Which produces better results?

Positive reinforcement or punishment?

It's the age-old question which now is being applied in the workplace. Some employers are willing to reward employees who make lifestyle changes such as losing weight or stop smoking while others choose to punish non-compliant workers with a higher share of the premiums.

A few states are surcharging smokers. Now Alabama will be doing likewise for overweight workers.

Obese workers must be prepared to pay a $25 per month "fine" if they are not ship shape.

The State Employees' Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don't have free health screenings.

If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program, or take steps on their own to improve their health. If they show progress in a follow-up screening, they won't be charged. But if they don't, they must pay starting in January 2011.

Seems fair enough.

Not all state employees see it that way.

"It's terrible," said health department employee Chequla Motley. "Some people come into this world big."

Computer technician Tim Colley already pays $24 a month for being a smoker and doesn't like the idea of another charge.

That's a new one on me. "I came into this world big and I am going to continue to get bigger."

You really can't control what happens in utero, but you are responsible if you feel a need to super-size every meal after that.

E-K. Daufin of Montgomery, a college professor and founder of Love Your Body, Love Yourself, which holds body acceptance workshops, said the new policy will be stressful for people like her.

People like to make excuses for coming in extra large sizes. Why can't they just admit they have a problem?

"I'm big and beautiful and doing my best to keep my stress levels down so I can stay healthy," Daufin said. "That's big, not lazy, not a glutton and certainly not deserving of the pompous, poisonous disrespect served up daily to those of us with more bounce to the ounce."

I have never met or heard of a person who lost weight and regretted it.

research shows someone with a body mass index of 35 to 39 generates $1,748 more in annual medical expenses than someone with a BMI less than 25, considered normal.

So the extra $600 doesn't even compensate for the additional cost of insuring the obese.

Carrot cake anyone?