肥満と減量療法のジャーナル

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The Focal Point of Overweight and Obesity Control among Healthcare Workers: Lifestyle Behavior Intervention or Psychological Stress Reduction?

Shaoqing Gong1, Xiangyang Tian2*

Obesity has become a significant public health concern over the world. The Healthcare Workers (HCWs) have a high incidence of overweight and obesity, even higher than those within other occupation categories and general population. Physicians and nursing staff have to be on duty around the clock with frequent shift work, long working hours, and excessive emotional engagement. Intensive work makes them more prone to excessive psychological stress, as well as anxiety and depressed mood caused by stress management disorders. Excessive psychological stress, anxiety and depression often lead to sleep disorders, sedentary lifestyles and physical inactivity, and emotional eating in HCWs, resulting in overweight and obesity. Despite decades of research, strategies centered on lifestyle modification to tackle obesity are often unsuccessful. Although intervention studies in health care settings demonstrated improved weight outcomes, by employing methods involving nutrition education and healthy lifestyles, physical activity, and diet, an effective and sustainable solution for tackling overweight and obesity among HCWs has yet to be identified. All obesity related lifestyle behaviors, physiological and biochemical changes are originated from psychological stress through three mechanisms: Directly lead to unhealthy behaviors; activate the HPA axis with glucocorticoids release; promote the imbalance in appetite hormones including insulin, ghrelin and leptin, etc. HCWs are considered to experience a heavier psychological stress, which makes them more susceptible to the risk of overweight and obesity. Up to now, several intervention studies have achieved inspiring results in stress reduction among HCWs. Psychological stress reduction should be the focal point for overweight and obesity intervention among HCWs in the future.