Relationship between some psychosocial factors, eating attitudes and overweight/obesity among hospital employees: a case–control study
This case–control study of hospital employees in Türkiye reveals that disordered eating attitudes, age, lower education levels, larger household sizes, and non-healthcare occupational roles are significantly associated with overweight and obesity, suggesting a need for comprehensive health screening and early clinical assessment beyond standard health education.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Weight is rarely just about calories in versus calories out. It is a complex outcome shaped by the world we live in, the stress we carry, and the way we relate to food. Scientists call these non-medical influences "social determinants of health." They include everything from our jobs and income to our family life and how supported we feel by others. When people face high stress or lack social support, their eating habits often change. Some eat more to cope with difficult emotions, while others eat less. This relationship between the mind, the environment, and the plate is a major focus of modern health research, especially for people who work in high-pressure environments like hospitals. Healthcare workers are often seen as role models for healthy living, yet they face unique challenges, including long shifts, emotional strain, and irregular schedules, which can make maintaining a healthy weight difficult.
A recent study conducted in a public hospital in Ankara, Turkey, set out to understand exactly how these factors play out among hospital staff. The researchers wanted to know if specific psychological traits—such as how a person perceives their stress, how much support they feel from family and friends, and their attitudes toward eating—were linked to being overweight or obese. They also looked at how job type, age, and family size influenced these outcomes. To do this, they gathered data from nearly 600 hospital employees who had participated in a routine health screening. The team measured each person's height and weight to calculate their body mass index, a standard way to categorize weight. They then divided the participants into three groups: those with a healthy weight, those who were overweight, and those who were obese. Everyone in the study also filled out detailed questionnaires about their daily lives, their feelings of stress, their social connections, and their relationship with food.
The results revealed a clear picture of who was struggling with weight and why. Age turned out to be a significant factor. Employees in their thirties were much more likely to be obese than those in their twenties. As people moved into their forties and beyond, the likelihood of obesity remained high, suggesting that weight gain accumulates as people age, perhaps due to natural changes in how the body uses energy. Family life also played a major role. The study found that the more people living in a household, the higher the odds of obesity. For every additional person in the home, the risk increased noticeably. This suggests that the dynamics of a household, such as shared meals or financial pressures, might influence eating habits in ways that lead to weight gain.
Perhaps the most striking finding concerned the psychological relationship with food. The researchers used a standard test to identify "disordered eating attitudes," which include behaviors like strict dieting, feeling guilty after eating, or obsessing over food. They found that employees who were obese were significantly more likely to have these troubled attitudes toward eating compared to those with a healthy weight. This link remained strong even after the researchers accounted for age, job type, and stress levels. It suggests that for those who are obese, the issue is not just about willpower or simple hunger, but involves a deeper, more complex struggle with how they view and handle food. Interestingly, the study did not find a strong link between these eating attitudes and being merely overweight; the connection appeared specifically with obesity.
Surprisingly, the study did not find that high stress levels directly caused weight gain in this group. While stress is often blamed for unhealthy eating, the data showed that employees who reported feeling more stressed were actually slightly less likely to be obese. The researchers noted this was a counterintuitive result and suggested it might be because the hospital staff generally reported only moderate levels of stress, or perhaps because those under extreme stress did not participate in the study. Similarly, while social support is usually seen as a buffer against health problems, the study did not find a direct link between feeling supported and having a healthy weight. However, they did observe that in groups with higher obesity, those who felt more supported tended to feel less stressed, hinting at a complex web of relationships between these factors.
The type of job a person held also mattered. Employees who worked in non-medical roles, such as administration or maintenance, were much more likely to be overweight or obese than the doctors and nurses. Those with lower levels of education also faced higher risks of being overweight. These findings point to the idea that the hospital environment itself, or the specific demands of medical versus non-medical roles, creates different conditions for health. Despite these challenges, many of the employees with excess weight were aware of the problem. A large portion of the overweight and obese staff had tried to lose weight before and expressed a desire to do so again. Yet, many also reported feeling tired, in pain, or short of breath, symptoms that often accompany obesity and can make daily work difficult.
The study concludes that helping hospital staff manage their weight requires more than just telling them to eat better or exercise more. Because disordered eating attitudes are a major concern for those who are obese, health programs need to address the psychological aspects of eating. The researchers suggest that hospitals should include regular weight monitoring in their annual health checks and offer deeper assessments for employees who are obese to catch other health risks early. By understanding that weight is influenced by age, family size, job type, and how a person relates to food, hospitals can create better support systems. Protecting the health of the workforce is essential, not just for the employees themselves, but for the quality of care they provide to patients.
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