Overweight and Obesity Among Nursing Professionals: Prevalence and Reasons for Poor Eating Habits

Healthcare organizations can play a key role in promoting healthy lifestyles by providing healthier food options in the workplace, offering workplace wellness programs, and addressing the root causes of stress and emotional eating.

Part 1

Background of the topic

Obesity is a major health crisis among nurses.  According to Kyle, Neall, and Atherton (2016), 69.1% of nurses in Scotland are overweight or obese which means that they are at a high risk of developing T2D. In particular, Kyle, Neall, and Atherton (2016) noted that the prevalence of obesity among nurses is higher than prevalence levels among other health professionals (51.3%), unqualified care staff (68.5%). The increased prevalence of obesity reflects the nature of a global pandemic. Since nurses are the largest occupational group within the health care system, they are important in promoting health and addressing obesity and T2D. However, nurses continue to adopt poor health behaviours which lead to obesity and T2D. Gupta and Gaur (2016) argue that the health behaviours of nurses influence the level at which they can engage in health promotion while also influencing public confidence in the advice they provide. Therefore, it is important to focus on the factors contributing to the development of obesity and T2D among nurses so that proper measures can be taken. Gupta and Gaur (2016) add that one of the leading causes of obesity and T2D among nurses relates to poor eating habits and sedentary lifestyles.

Nurses work in a highly demanding environment. Monakali et al. (2018) noted that based on the high levels of stress related to their work, nurses are forced to alter their eating practices thereby contributing to poor dietary intakes as well as altered nutritional status. Urbanetto et al. (2019) add that because of several work roles, nurses are a risk of developing obesity which is associated with the development of chronic conditions such as diabetes. Nurses play a critical role in public health care with an increased need to play a critical role in health promotion among patients. Nurses are in contact with patients and when they adopt healthy living lifestyles, the patient can be influenced to adopt healthy choices as well (Goon, Seekoe, & Owolabi, 2018). Therefore, the objective of any nurse is to improve the lives of patients. Nurses become effective when they make informed choices on healthy living as an important aspect since it influences the care they provide for other people (Urbanetto et al., 2019). However, nurses experience stress related to their work that affects their ability to engage in exercises as well as adopt and maintain healthy eating habits. Gupta and Gaur (2016) noted that physical activity among nurses is very low with several nurses not meeting the recommended 30 minutes of exercise within five days a week. The inability to find time outside their busy schedule is a major challenge in adopting a healthy lifestyle such as exercise. The lack of time also means that nurses cannot find an ideal opportunity to prepare meals. As a result, they depend on poor dietary measures such as eating snacks. In the end, nurses are affected by increased levels of obesity and the development of T2D.

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Poor diet and lack of physical exercise are risk factors for T2D and obesity. According to Kyle et al, 2017, qualified nurses in the United Kingdom adopt poor health behaviours. Stephens, Cobiac, and Veerman (2014) noted that in England, about 45% of nurses do not exercise while 58% have poor eating habits such as not eating five portions of fruits or vegetables daily. Furthermore, 36% of nurses eat food high in fat and sugar regularly (Kyle et al, 2017). In this sense, the behaviour of nurses relating to exercise and eating habits contribute to high levels of obesity and T2D. Kyle, Neall, and Atherton (2016) noted that in Scotland, obesity is a major health crisis among nurses with over two-thirds of nurses being obese or overweight. In particular, nurses are affected by overweight and obesity more than other health professionals. The implication is that nurses are at a high risk of developing T2D and cardiovascular diseases as well as cancer.  The high levels of obesity and T2D among nurses are related to poor health behaviours as well as the nature of work. Miller et al. (2008) argue that occupation factors such as high levels of work and inability to access healthy food contribute to obesity and T2D. Zitkus (2011) adds that nurses often complain that they lack the necessary time to prepare healthy meals because of the long working hours as well as stress and strain at work. Within the hospital environment, nurses also fail to obtain healthy food. In most cases, nurses are served unhealthy foods within the South African context (Monakali et al, 2018). Gupta and Gaur (2016) also argued that the nature of the nursing profession also means that nurses consume food with high levels of fat and sugar since they lack time outside their nursing practice.  Therefore, it is evident that obesity and T2D are related to poor eating habits. 

The rationale

The increased prevalence of obesity is a concern since it is linked to T2D and other chronic health conditions which contribute to increased budgets related to health care (Monakali et al, 2018). Besides, nurses as important care providers lose the time needed to care for patients. When nurses adopt poor eating habits leading to obesity, they also influence patients negatively into adopting these poor health behaviours (Huang et al, 2016). Huang et al (2016) add that Nurses have a lower risk of developing T2D than non-nurses. Nurses are more knowledgeable than non-nurses on how to manage their lifestyles. Among nurses with T2D, poor eating habits and lack of exercise contributed to the risk of T2D through obesity and overweight. Therefore, it would be important to understand the factors that make nurses engage in poor eating habits as well as possible measures that can be adopted to enhance the nutrition of nurses. According to Kyle, Neall, and Atherton (2016), obesity is highly costly to the National Health Service (NHS) with over £6 billion being spent as well as further projections on increased spending. Based on the health and financial implications of obesity and overweight within the United Kingdom, it is important to understand measures that can be taken to address poor eating habits among nurses to avoid high levels of obesity and T2D. Besides, focus on nurses highlights their contribution to the management of obesity and T2D as a key public health objective.

Nurses play a crucial role in public health. Nursing Midwifery Council (NMC) (2008) noted that apart from their role of taking care of patients, they have a regulatory requirement of ensuring that they promote healthy living among patients.  In particular, nurses are required to promote positive behaviour change among patients by taking time from their routine to teach patients healthy behaviours. Since nurses are the largest health professionals within public health, they are crucial in addressing the high level of obesity and T2D within society. Múnera-Gaviria et al. (2017) argue that nurses should ensure that they provide advice and education on how to prevent the development of obesity and T2D. However, this is not possible when nurses engage in poor eating habits as well as lack of exercise. In this sense, this study needs to examine how nurses can engage in behaviour change relating to their sedentary lifestyles so that they influence positive behaviour change among other patients.  A nurse cannot provide advice to the patient on exercise when they lack time to exercise. Besides, the nurse cannot provide advice on healthy nutrition when they adopt poor eating habits based on foods high in sugar and fat. Personal experience influences care provided when interacting with patients (Kelly & Wills, 2018). Since there is a potential negative impact on nurses' health and behaviours on engagement in health education, understanding strategies to enhance the lifestyles of nurses is important in reducing the prevalence of obesity and T2D. The study is important in understanding the ability of nurses to influence education relating to healthy living in the management of obesity and T2D.

Research Aim

The study aims to explore the extent and reasons for overweight and obesity among nurses.

Research Objectives

1. To understand the role of work conditions in influencing poor eating and lifestyle habits among nurses
2. To identify measures and initiatives that have been undertaken to improve eating and lifestyle habits among nurses
3. To assess the effectiveness of these measures and initiatives

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Process of literature searching

The study adopts a systematic approach to searching for literature. In particular, the focus is on reviewing and analysing literature so that the researcher can appraise existing evidence on factors contributing to poor eating habits among nurses leading to overweight and obesity. The review aims to answer the question relating to which intervention measures have been used to address poor eating habits that lead to obesity among nurses. The review focuses on evaluating the circumstances under which poor eating habits emerge among nurses and the intervention measure which can be effective for the affected nurses. The researcher looks for evidence within primary articles with practice-based evidence. In this sense, the study looks into published peer-reviewed primary research on poor eating habits among nurses leading to obesity in any country. The literature search will be conducted using the following databases: CINAHL, SCOPUS, PUBMED, MEDLINE, Psych INFO, and British Nursing Index. The inclusion and exclusion criteria are defined in table 1 below.

Table 1: Inclusion and exclusion criteria

References

Gupta, S., & Gaur, S. (2016). Lifestyle patterns, eating practices, and obesity among nurses: A review. International Journal of Health Sciences and Research, 6(11), 258-266.

Huang, H. L., Pan, C. C., Wang, S. M., Kung, P. T., Chou, W. Y., & Tsai, W. C. (2016). The incidence risk of type 2 diabetes mellitus in female nurses: a nationwide matched cohort study. BMC public health, 16(1), 443.

Kelly, M., & Wills, J. (2018). Systematic review: What works to address obesity in nurses? Occupational Medicine, 68(4), 228-238.

Kyle, R. G., Neall, R. A., & Atherton, I. M. (2016). Prevalence of overweight and obesity among nurses in Scotland: A cross-sectional study using the Scottish Health Survey. International Journal of Nursing Studies, 53, 126-133.

Kyle, R. G., Wills, J., Mahoney, C., Hoyle, L., Kelly, M., & Atherton, I. M. (2017). Obesity prevalence among healthcare professionals in England: a cross-sectional study using the Health Survey for England. BMJ Open, 7(12).

Bogossian, F. E., Hepworth, J., Leong, G. M., Flaws, D. F., Gibbons, K. S., Benefer, C. A., & Turner, C. T. (2012). A cross-sectional analysis of patterns of obesity in a cohort of working nurses and midwives in Australia, New Zealand, and the United Kingdom. International journal of nursing studies, 49(6), 727-738.

Monakali, S., Ter Goon, D., Seekoe, E., & Owolabi, E. O. (2018). Prevalence and factors associated with abdominal obesity among primary health care professional nurses in Eastern Cape, South Africa. South African Family Practice, 60(5), 146-150.

Múnera-Gaviria, H. A., Salazar-Blandón, D. A., Pastor-Durango, M. D. P., & Alzate-Yepes, T. (2017). Overweight and obesity conditions: Prevalence and associated risk factors in nursing students in a public university in Medellín, Colombia. Investigacion y educacion en enfermeria, 35(2), 191-196.

Nursing Midwifery Council (NMC), (2018). The Code: Standards of Conduct, Performance, and Ethics for Nurses and Midwives. NMC, London.

Stephens, S. K., Cobiac, L. J., & Veerman, J. L. (2014). Improving diet and physical activity to reduce the population prevalence of overweight and obesity: An overview of current evidence. Preventive medicine, 62, 167-178.

Urbanetto, J. D. S., Rocha, P. S. D., Dutra, R. C., Maciel, M. C., Bandeira, A. G., & Magnago, T. S. B. D. S. (2019). Stress and overweight/obesity among nursing students. Revista Latino-Americana de enfermagem, 27.

Zitkus, B. S. (2011). The relationship among registered nurses' weight status, weight-loss regimens, and successful or unsuccessful weight loss. Journal of the American Academy of Nurse Practitioners, 23(2), 110-116.

Goon, D. T., Maputle, M. S., Olukoga, A., Lebese, R., Khoza, L. B., & Ayanwu, F. C. (2013). Overweight, obesity and underweight in nurses in Vhembe and Capricorn districts, Limpopo. South African Journal of Clinical Nutrition, 26(3), 147-149.