The Indiana Court of Appeals has ruled that a pizza shop must pay for weight-loss surgery for an obese employee to ensure the success of another operation for a back injury he suffered at work.

The decision is raising concern among businesses bracing for more such claims.

Boston's The Gourmet Pizza cook Adam Childers of Schererville weighed 340 pounds when he was injured by a freezer door. Doctors said he needed back surgery, but it wouldn't be successful unless he had weight-loss surgery first.

Boston's argued it shouldn't have to pay because Childers' weight was a pre-existing condition.

But a workers' compensation board and the court said the company had to pay because his weight and the accident created a single injury.