Fat nurses, fat America?

Unless you’ve been hiding under a rock for the last couple of years—or in nursing school, which amounts to the same thing—you’re aware that there’s an epidemic of overweight and obesity in America these days.

About a third of Americans have a BMI (Body Mass Index) of over 30, which is considered obese. A little more than half of nurses, according to one study, have a BMI of over 30, making us one of the “fatter” professions in this country.

Is it a nursing problem or a general American problem?

My hypothesis is that it’s a general American problem combined with the way BMI is calculated.

Nurses, like the general population, are aging. People over the age of 40 tend to have higher BMIs than people under 40. Nurses also tend to work swing shifts or nights more often than your average cubicle resident, and people who have rotating schedules or work at night are more prone to obesity (and other health problems, like cancer). Finally, nurses—especially in rural areas—tend to have both longer workdays and longer commutes, which cuts down on the time available for things like exercise and sleep, both prophylactics against getting fat.

All of these factors can be found in other professions; factory workers and janitorial staff, for example, often work second- or third-shift jobs. More and more people are falling into the category of “supercommuters,” meaning they spend more than 90 minutes on the road to get to or from work. And, of course, our population as a whole is aging—and age, unless you’re actively trying to do something about it—means a loss of lean muscle mass and a gain in fat percentage. All of this means that nurses as a profession aren’t doing anything outside the curve of the general American population (i.e., aging and getting fatter).

Still, I don’t know that there’s cause for panic. In a highly unscientific survey of my own critical care unit, I found that all but one of the nurses I work with on a regular basis would be considered “overweight” or “obese” if BMI were the only measurement used. The nurses I work with are, on average, a physically active bunch. Carrying a lot of muscle bumps you up on the BMI scale, which was originally intended to measure only sedentary individuals. The nurses on my unit are also mostly under 35, which means that we skew, as a group, more toward an “overweight” BMI than a more mixed-age group of people (see age and muscle loss, above). A couple of us are fat, several of us are fat-but-strong and one of us is perfectly fine according to BMI, but unable to lift patients.

I’d be interested to see a breakdown of the Nurses’ Health Study by things like cholesterol levels, preponderance of heart disease and stroke, cancer rates, and—most importantly—functional status of the people studied. I would bet that nurses, on the whole, are as good as or better than the average American in terms of overall health, and much better than the average American in terms of subjectively perceived health. After all, we have one of the most physically active jobs out there. We tend to be stronger and more mobile longer than people who sit in front of computers all day, despite the prevalence of donuts in the breakroom. We may ache at the end of the day, but our day is a whole lot more challenging, physically, than that of the average office worker.

What do you say?