Comment

Obesity in nursing: why fat-shaming helps no one

Thin nurse does not equal better nurse, but obesity is a risk factor we need to address

Thin nurse does not equal better nurse, but obesity is a risk factor we need to address

Obesity among health and social care workers mirrors rates in the general population Picture: iStock

Following the publication of the governments obesity strategy, the Daily Telegraph published an article by journalist Charles Moore that asks: If we must be slim, why are so many nurses fat?

Something of a Twitter storm followed, with many people accusing Mr Moore of fat-shaming nurses, the very professionals who just months ago were being lauded as NHS heroes.

Obesity among nurses does not jeopardise health promotion

Research by London South Bank and Edinburgh Napier universities has shown that about a quarter of nurses in England are obese, which is about the same

...

Thin nurse does not equal better nurse, but obesity is a risk factor we need to address

Obesity among health and social care workers mirrors rates in the general population Picture: iStock

Following the publication of the government’s obesity strategy, the Daily Telegraph published an article by journalist Charles Moore that asks: ‘If we must be slim, why are so many nurses fat?’

Something of a Twitter storm followed, with many people accusing Mr Moore of fat-shaming nurses, the very professionals who just months ago were being lauded as ‘NHS heroes’.

Obesity among nurses does not jeopardise health promotion

Research by London South Bank and Edinburgh Napier universities has shown that about a quarter of nurses in England are obese, which is about the same level as the general population.

Indeed, we found that the prevalence of obesity among health and social care workers mirrors the inequalities and opportunities of general society. In other words, the poorest of the workforce – care workers – are three times more likely to be obese than doctors.

Mr Moore poses his question ‘why are so many nurses fat?’ because it is seen as surprising that the nursing workforce, which is the largest group in health and social care, ‘doesn’t know better’ than to get fat. There is an unspoken expectation that having a healthy lifestyle is part of professional duty.

The article suggests that the visibility of fat nurses makes it less likely that the general public will attempt to do something about their own weight.

There is very little evidence to support this point of view. While the public – and the staff themselves – expect nurses to be role models for healthier living, there is as yet no evidence that less credence is given to the advice of nurses who happen to be obese.

Indeed, nurses argue that any struggles they may have with their weight make them more able to empathise, support, and communicate with patients or members of the public experiencing the same thing.

Realities of nursing can present barriers to a healthy lifestyle

Our research provided four key explanations of why nurses may have difficulty maintaining a healthy weight. First, many nurses work shifts. Shift patterns disrupt metabolism and make it more difficult to eat regularly.

Second, those in the acute sector and in the community all report the difficulties of accessing healthy food while on duty, on the road or at night. It took the pandemic to highlight how important nutritious food is to NHS workers, as numerous organisations set out to deliver meals to hospitals.

Despite attempts to improve the food offered to patients, the food available to staff in canteens rarely meets the criteria for a healthy meal.

Third, nursing is a stressful job – even before the pandemic’s additional burdens. In our research, many nurses describe how the emotional labour and focus on others precludes them from giving attention to their own lifestyle.

Last, managing one’s weight costs. It costs money to buy fresh fruit and vegetables, to avoid waste when families are not used to consuming fresh food, and it costs precious time to cook and to exercise.

‘While the public – and staff themselves – expect nurses to be role models for healthier living, there is as yet, no evidence that less credence is given to the advice or nurses who happen to be obese’

In our research, most nurses who are obese know they are obese and are motivated to lose weight. The Healthy Weight Initiative for nurses, a project that was supported by the RCN, was very popular, but advice and support is not enough.

Evidence from several studies shows that nurses’ working lives present specific barriers to leading a healthy lifestyle.

The support nurses need at work to lead healthier lives

Nurses need regular and long enough breaks to eat a meal, they need somewhere to store food and prepare it at work, they need cheap and healthy meals in canteens where they do not have to queue, they need on-site exercise facilities, and they need the permission and support to look after themselves.

Much of the commentary on social media following the Charles Moore article reflected outrage that the question should even be asked, and yet raising this issue isn’t about blame or shaming.

Of course, being a thin(ner) nurse doesn’t make someone a better nurse. But obesity matters. It matters because obesity is harmful to individuals and, as we have seen in the pandemic, is a risk factor for more severe COVID-19 infection.


Jane Wills is director of research and enterprise/director of Centre for Applied Research in Improvement and Innovation, School of Health and Social Care, London South Bank University


Further reading

Want to read more?

Subscribe for unlimited access

Enjoy 1 month's access for £1 and get:

  • Full access to nursing standard.com and the Nursing Standard app
  • Monthly digital edition
  • RCNi Portfolio and interactive CPD quizzes
  • RCNi Learning with 200+ evidence-based modules
  • 10 articles a month from any other RCNi journal

This article is not available as part of an institutional subscription. Why is this?

Jobs