Top-down buy in is consistently listed as a key component of wellness program success by health and productivity experts. Advocating healthy decisions is a culture change and a challenge. So, anytime an adviser or employer can work shoulder-to-shoulder with employees engaged in wellness programs, they have a better opportunity to inspire, influence and steer behavior.

Bill Germanakos was able to do this because his personal journey to health was well publicized at work - and nationally. Last year, Germanakos, a medical sales representative for Quest Diagnostics, won top prize on "The Biggest Loser." He lost 164 pounds - 49.1% of his body weight - in 34 weeks, dramatically improving his health. In April, Quest Diagnostics appointed Germanakos, who had previously led a sales team selling new technologies, as its director of employer wellness initiatives.

"It seems like a natural fit for me to join the company's health and wellness management team," he says.

Leading by example

Germanakos clearly has the New Jersey-based company following in his healthy footsteps. Quest Diagnostics was named a Gold Award winner among the 2008 Best Employers for Healthy Lifestyles - making a case for the strength of a message sent by HR execs and advisers who practice what they preach.

The company's HealthyQuest employee wellness program, has resulted in more than 70% of participants achieving an assessment rating that indicates a low risk of developing major health problems, compared to 60% when the program began.

Programs include physical fitness, weight, and stress management resources, tobacco cessation counseling and efforts to improve the healthful quality of food choices at onsite cafeterias and vending machines. The company is beginning to see a positive ROI from the programs and employees appreciate the changes in their lifestyle, says Fred R. Williams, director of health benefits management at Quest Diagnostics.

A large part of the program's success can be attributed to Germanakos.

"[It was] a no-brainer to have him join our team. He is a wonderful example of what can happen when you are faced with many high-risk health factors, and you are able to put mind over matter to make changes in your lifestyle," Williams says.

Having Germanakos share his wellness story encourages others to share their own, which gives wellness participants confidence that they can make a change as dramatic as his, whether it's quitting smoking or losing weight, notes Williams, adding that improving health is a metric that the company tracks.

Unexpected payoff

Thom Mangan, president of the benefits division of Hub International, Northeast, has found that making his personal commitment to health and wellness public has helped make the wellness conversation with clients more meaningful. While he's whittling down his waistline, he's helping to broaden his firm's bottom line.

Mangan, whose goal is to lose 30 pounds, has been steadfast in his wellness approach. He is waking up more than an hour earlier to workout. He's also ordering salmon, rather than steak, and often skipping the cocktails when he's out and about with clients and prospects.

"I'm going through it. I know it can be done. And it's not easy," says Mangan.

But all his hard work could be paying off as numbers other than his blood pressure could improve, too. He points out that it's easy to be sheepish about focusing on wellness with clients and prospects, when the broker is anything but the picture of health. Now, Mangan has the opportunity to frame his wellness services differently and push clients a little more forcefully than he has in the past.

Neil Simons, president of Rockville, Md.-based Independent Benefit Services also thinks wellness is a crucial element to lowering premiums and developing a happier, more productive workforce. He attributes his advisory firm's success with implementing wellness programs for clients to IBS' internal wellness advocacy.

"I don't know if [participating in wellness] is critical to your success in business, but I do know it helps if you are practicing what you preach. That's one of the reasons we went to consumer-driven health care four years ago, because we wanted to be the guinea pigs and see how it works. So, as wellness has developed we've tried to develop more internally what we're doing with it," says Simons.

Although Simons doesn't believe there's a one-size-fits-all approach to wellness programs, his company implements many of the best practices they have passed on to clients. The employees take health risk assessments, work with a health coach and even participate in competitions.

"We have a fitness guru on retainer that we bring in to talk to our clients. And he comes in to our office every Monday and takes everybody's blood pressure every week. He claims that's the most important number in your life. And he keeps everybody moving and thinking about fitness," says Simons.

This year the firm launched an eight-week internal fitness challenge. Independent Benefit Services broke the budget on the prizes because so many people made significant differences in their health. With 35 employees they had 100% participation.

When advisers and employers share in employees' wellness journey there is also the opportunity to share additional tips and tactics on how to accomplish health goals.

"I am making public appearances and letting people know what I have accomplished," Germanakos says. "I am trying to spread the word and educate people about health and wellness ... If I was able to do it, then they can do the same. By no means was it easy, but it's a worthwhile endeavor."

Even before going on "The Biggest Loser," Germanakos had participated in some of the health and wellness programs offered by Quest Diagnostics.

"I had a good understanding of what my biometrics levels were before I arrived at the show's training facility, but I need a little bit more motivation. That is why I signed up for the show," he says.

The hard work has more than paid off - personally and professionally - not only for Germanakos, but also for the Quest colleagues he now leads and inspires.

EBA Managing Editor Molly Bernhart contributed to this story.

Achieving and maintaining behavior change

Motivating participants is a major challenge facing worksite wellness. But maintaining the healthy behaviors participants learn to embrace through the plan is even more difficult. Here are some tips for overcoming obstacles that could cause employees to fall back on bad behaviors once the honeymoon is over:

Meet people where they are.

The smoking cessation strategy for a 50-year-old who smokes three packs of cigarettes a day should differ significantly from the treatment plan for a 21-year-old who consumes just three cigarettes every other day.

Personalize the experience.

Employers need to actively involve workers in determining what will work best for their own situation. Lifestyle coaching programs can be an effective way to help people create an individualized strategy, as coaches can assess each individual's specific needs, develop a customized action plan, solve problems and prevent setbacks. They also can help identify the emotional triggers of unhealthy habits.

Measure success.

Someone who loses 12 pounds with an eight-week weight loss program may appear successful, but does he or she have the skills needed for long-term weight management? Participants need to feel motivated to continue making progress, which may include having increased confidence, experiencing psychological mood changes and finding the right support network.

Matthew M. Clark is a clinical psychologist with the Department of Psychiatry and Psychology at Mayo Clinic in Rochester, Minn., and a medical director for Mayo Clinic.