Perception of Obesity related stress at workplace among health care workers to reduce absenteeism

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Health care
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Table of Contents
Literature review..............................................................................................................................1
Methodology:...................................................................................................................................6
Results and analysis:........................................................................................................................7
Conclusion:....................................................................................................................................12
References:....................................................................................................................................13
Appendices:...................................................................................................................................18

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Title: Perception of Obesity related stress at workplace among health care workers to reduce
absenteeism
Literature review
The main purpose of literature review is to present background information on the topic
and increase understanding regarding the correlation between obesity, stress and absenteeism.
Prevalence of obesity related stress at workplace
Obesity is a medical condition associated with accumulation of body fat and any
individual with a body mass index (BMI) of 30 or more are termed as obese. The current global
standard for diagnosing obesity is BMI over 30 kg/m2 (American Diabetes Association, 2018).
Obesity is linked to high risk of many chronic diseases like diabetes, cancer and heart disease. In
New Zealand, BMI is measured using height and weight compared to some other countries
which rely on self-reported values (Stats NZ, 2015). According to the Ministry of Health survey
in 2017, about 34% of the adults are obese in the country. As per the most recent statistics for the
year 2018/2019, around 1 in 3 adults were obese and adults living socioeconomically deprived
areas where most likely to be obese compared to those living i n least deprived areas (Ministry of
Health NZ, 2019). Obesity has become a major public health burden in New Zealand as it has
increased health care and lost productivity cost. According to a study by Lal, Moodie, Ashton,
Siahpush and Swinburn (2012) done to estimate the cost of health care productivity and lost
productivity due to obesity in New Zealand, it was found that obesity resulted in expenditure of
NZ$686 million in the year 2006. A systematic review by Goettler, Grosse and Sonntag (2017)
suggested substantial cost due to lost productivity among workers with obesity. This indirect cost
increased due to losses from decreased productivity due to inability to work. The severity of the

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issue in New Zealand is evidenced by obesity rate of 65% among minority groups like Pacific,
47% in Maori and 32% in rest of New Zealand citizens. These evidences clearly suggest the need
for policies and interventions to reduce the rate of obesity and decrease the productivity losses at
workplace.
Correlation between obesity related stress and absenteeism
Development of obesity related stress has become a common phenomenon in workplace
which is linked to increase in incidence of body shaming and discrimination at workplace.
Various research studies have examined the incidence of discrimination in the workplace and
these studies mainly explain how stereotypes about obese employees contribute to discriminatory
behaviours. Flint et al. (2016) gave the evidence regarding high stress in obese workers because
of discrimination at the hiring stage. Managers were less likely to call obese people for an
interview as they held negative automatic stereotypes. However, obesity alone was not the cause
of discrimination. It occurred because of gender as well as requirement of the job. The results
from a longitudinal study by Reber, König and Hajek (2018) revealed that overweight and obese
women are often subjected to weight stigmatization and prejudice which leads to increased
feelings of stress and increased job strain. Such situation leads to poor coping strategies which
results in withdrawal behaviours such as sick leave. Thus, the relation between excess weight,
absenteeism and stress has been established from past research evidences too.
Apart from discrimination and obesity related stereotypes, obesity is one of the cause
behind high absenteeism rate at workplace too. Fitzgerald, Kirby, Murphy and Geaney (2016)
gave evidence regarding central obesity to be a strong predictor of sick leave. The researcher
argues regarding paying attention to the workplace for obesity prevention as employees spend

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longer time in their work environment and workplace culture can create a balance between
organizational targets and workers health. There are various evidence of high rate of absenteeism
due to obesity. VanWormer, Linde, Harnack, Stovitz & Jeffery (2012) reported that obese
employees are more prone to high workplace absenteeism rate as employees with BMI ≥ 30
kg/m2 had 25% higher odds of falling sick. Similarly, the study by Asay, Roy, Lang, Payne &
Howard (2016) revealed absenteeism rate of 30% for obesity. The study also showed high rate of
employee absenteeism due to other factors like smoking, physical activity, hypertension and
diabetes. However, the major gap found in all the studies were that it did not explored about the
issues from the perspective of workers. Evaluating their opinion is important to understand their
expectation at workplace and implement policy changes in workplace so that obese individual
gets equal rights and recognition at work.
Prevalence of obesity related absenteeism in health care setting:
There are many reasons to investigate about the prevalence of obesity related absenteeism
in health care settings. According to Amani and Gill (2013), accurate assessment among health
care professional is important because obesity increased the incidence of muscular disorders and
mental health conditions which is the leading cause of work-related illness. In addition, obesity
increased risk of chronic disease and the associated sickness absence rates which affect the
capacity of healthcare workforce and lead to patient safety issues. Hence, evaluating obesity rate
in health care professional group is important to identify possible contribution of adverse
workplace factors on obesity and consider health promotion efforts of health care professionals
to make positive changes to behaviour of workers in health setting. The study by Kyle et al.
(2017) reported about the prevalence of obesity among health care professionals in England.

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Obesity rate was found to be high in all groups and the odds of being obese were high for nurses
compared to other groups. However, as the reason for high rate of obesity among nurses was
missing, this study suggested the need to better understand the reason for the same through future
research work.
The study by Sharma, Anand, Kishore, Dey and Infgle, (2013) investigating about
obesity and stress among health professionals in a rural hospital of Delhi confirmed that three-
fourth of the overweight and obese workers had stress at their job compared to professionals who
were underweight or with normal weight. The findings related to coping strategies used by each
workers revealed that majority of workers adapted positive strategies to deal with stress. 47% of
them reported talking to family members to deal with stress. However, one limitation of the
study was that it did not gave objective definition of stress. Despite this, the study points out to
the need health promotion programs at workplace so that the problem of obesity related among
this cadre of workers are effectively managed. Averett (2014) also argues regarding the need to
pay attention to the issues of obese individuals considering evidences of discriminatory hiring for
obese people and low wages for obese people. The above discussion clearly shows the effect of
obesity on labour market outcomes. Hence, evaluating perceptions of health workers could open
the possibility of considering programs that could enhance the motivation of people affected by
obesity and improve attitude towards obesity among co-workers at workplace. Such initiative in
New Zealand would lead to savings in the health cost expenditure and as well as a productivity
concerns due to high absenteeism rates.
Discussion from the review of literature: