Associations between job stress, eating behaviors, and body mass index among healthcare professionals at King Faisal Medical Complex, Taif, Saudi Arabia

Abstract

Background

Healthcare professionals are frequently exposed to occupational stress due to the demanding nature of their work environment. Such stress may influence eating behaviors and potentially contribute to weight-related health outcomes. This study aimed to examine the association between job stress, eating behaviors, and body mass index (BMI) among healthcare professionals working at King Faisal Medical Complex, Taif, Saudi Arabia.

Methods

A cross-sectional study was conducted among 323 healthcare professionals aged 25–60 years at King Faisal Medical Complex, Taif, Saudi Arabia. Participants completed a self-administered online questionnaire comprising of three sections: sociodemographic and lifestyle characteristics, the Brief Job Stress Questionnaire (BJSQ), and the Dutch Eating Behavior Questionnaire (DEBQ). BMI was calculated based on self-reported height and weight. Descriptive statistics, group comparisons, and correlation analyses were performed.

Results

High job stress was reported by 46.4% of participants. Moderate levels of restrained eating (52.3%) and external eating (65.6%) were common, whereas emotional eating was less prevalent, with 37.5% reporting moderate levels and only 9.0% reporting high levels. Weak but statistically significant correlations were observed between job stressors and emotional eating (r = 0.11, p = 0.049) and stress response and external eating (r = 0.14, p = 0.014). Social support was weakly and inversely correlated with external eating (r =  − 0.15, p = 0.006). Restrained and emotional eating behaviors were significantly higher among overweight and obese participants compared with normal-weight individuals (p < 0.05). However, no significant association was observed between overall job stress and BMI.

Conclusions

Job stress is highly prevalent among healthcare professionals and is modestly associated with certain eating behaviors. Although job stress was not directly associated with BMI, maladaptive eating behaviors—particularly restrained and emotional eating––were significantly related to higher BMI. These findings highlight the importance of workplace strategies that address both stress management and healthy eating behaviors to support the well-being of healthcare professionals.

This study is based on a cross-sectional design and is classified as level of evidence 4.

Introduction

The National Institute for Occupational Safety and Health (NIOSH) defines job stress as negative physical and emotional reactions that occur when job demands exceed a worker’s skills, resources, or needs [1]. Globally, job stress represents a major occupational health concern, affecting approximately one in three workers and ranking as the fifth most significant occupational hazard [2, 3]. Surveys have reported that 30–52.5% of workers experience job stress, with a study from the United Kingdom indicating that up to 62% of employees feel stressed at work [4, 5].

Prolonged exposure to job stress has been increasingly linked to adverse psychological outcomes, particularly burnout, anxiety, and depressive symptoms [6, 7]. In Saudi Arabia, available evidence suggests a substantial burden of such psychological symptoms among employees, which have been reported in the literature to be associated with occupational stress [8]. A 2022 report by the National Center for Mental Health Promotion (NCMH) showed that 81% of employees experienced at least one mental health symptom, most commonly burnout, anxiety, nervous tension, and depression [9].

Healthcare professionals appear to be especially vulnerable to severe job stress compared with workers in other occupations [10]. This heightened vulnerability is largely attributed to the demanding nature of healthcare work, which involves high workloads, emotional labor, time pressure, and frequent exposure to critical and stressful patient care situations [10–12]. In addition, healthcare systems are undergoing major financial and structural changes that further intensify occupational stress. These include increasing workload expectations, pressure to maintain income levels, growing clinical complexity, expanded treatment options, electronic monitoring of productivity, and reductions in health and retirement benefits [13–15].

Workplace stress does not remain confined to psychological symptoms but may extend to behavioral and physical health outcomes. The workplace is a key determinant of health, as working conditions influence employees’ health behaviors. Job stress may manifest through emotional reactions (e.g., anxiety, depression, irritability, and exhaustion), behavioral changes (e.g., withdrawal, aggression, and reduced motivation), cognitive difficulties (e.g., impaired concentration and problem-solving), and physical symptoms (e.g., palpitations, nausea, and headaches). Moreover, work-related stress has been shown to adversely affect eating behaviors and other lifestyle patterns, thereby contributing to poorer overall health outcomes [16].

Eating behavior encompasses a wide range of patterns, including food preferences, dieting practices, and disordered eating conditions such as anorexia nervosa and bulimia nervosa [17]. Up to 5% of individuals suffer from eating disorders, most often emerging in adolescence or early adulthood [18]. Eating disorders and obesity are interconnected, each capable of exacerbating the other, and both are linked to serious physical and psychological consequences [19]. Saudi Arabia ranks among the countries with the highest obesity prevalence, with body mass index (BMI) levels increasing from below 10% in 1980 to between 29 and 58% in recent years [20].

Three psychological models describe overeating behaviors related to disordered eating:

1. Restriction theory—conscious control of food intake to manage weight (restrained eating),

2. Emotional theory—eating in response to negative emotions (emotional eating),

3. Externality theory—eating triggered by external cues such as the sight, smell, or taste of food (external eating) [21, 22].

Eating behaviors result from complex physiological, psychological, and social interactions influencing meal timing, portion sizes, and food choices [23, 24]. In healthcare settings, stressful working conditions may alter eating behaviors and contribute to overweight and obesity [25]. Although numerous studies have examined the relationship between job stress and eating behaviors among healthcare professionals internationally [26–28], empirical evidence from Saudi Arabia remains scarce. In particular, little is known about how occupational stress may influence eating behaviors among healthcare professionals in healthcare settings.

Therefore, this study aimed to investigate the association between job stress and eating behaviors with BMI among healthcare professionals at King Faisal Medical Complex in Taif, Saudi Arabia. In addition, it sought to assess the prevalence of job stress and eating behavior patterns and to examine their relationships with sociodemographic characteristics and BMI. Understanding these relationships may inform the development of targeted workplace interventions to promote healthier coping strategies, improve employee well-being, and reduce obesity-related health risks among healthcare professionals.

Methodology

Study design and setting

This study employed a cross-sectional design and was conducted among healthcare professionals at King Faisal Medical Complex in Taif, Saudi Arabia, between August and November 2023.

Study population and sampling

The study population included Saudi and non-Saudi male and female professionals aged 25–60 years, working in both clinical and non-clinical roles. A convenience sampling method was used, whereby participants were recruited through the hospital’s Internal Communication Department, which disseminated the study invitation and survey link electronically.

Data collection procedure

Data were collected using a self-administered online questionnaire created through Google Forms. The questionnaire link was distributed electronically to healthcare professionals at King Faisal Medical Complex through institutional communication channels. Participation was voluntary, and participants were informed about the purpose of the study before completing the survey. Electronic informed consent was obtained before completing the questionnaire, and responses were collected anonymously to ensure confidentiality.

Inclusion and exclusion criteria

Healthcare professionals employed at King Faisal Medical Complex who were aged 25 years or older and provided electronic informed consent were eligible to participate. Pregnant and lactating women were excluded from the study because physiological and hormonal changes during pregnancy and lactation may influence appetite, eating behaviors, and body weight, potentially confounding the association between job stress and eating behaviors. Questionnaires with incomplete responses were excluded from the final analysis.

Sample size calculation

The sample size was calculated based on the primary outcome, namely the prevalence of high job stress among healthcare professionals. A standard single-proportion sample size formula for cross-sectional studies was applied with finite population correction, given the total healthcare workforce at King Faisal Medical Complex (N = 1612). Assuming a 95% confidence level (Z = 1.96), a 5% margin of error (d = 0.05), and a conservative expected proportion (p = 0.50), the minimum required sample size was 311 participants [29]. To account for non-response and incomplete questionnaires, 323 participants were recruited and included in the final analysis.

Study variables

• Sociodemographic and lifestyle characteristics: Information was collected on gender, age, nationality, marital status, educational level, monthly income, occupation, and years of work experience. Participants also reported their height and weight, from which body mass index (BMI) was calculated as weight (kg) divided by height squared (m²). BMI was classified according to World Health Organization (WHO) criteria as underweight (< 18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), and obese (≥ 30.0 kg/m²) [30].

• Job stress assessment: Job stress was assessed using the Brief Job Stress Questionnaire (BJSQ), which consists of 57 items rated on a 4-point Likert scale (1 = strongly disagree to 4 = strongly agree). The instrument measures three domains: job stressors, stress response, and social support. According to established criteria, participants were classified as experiencing high job stress if they met either of the following conditions: (A) a high stress response score (≥ 77), or (B) a moderate stress response score (≥ 63) combined with high job stressors or low social support (≥ 76) [31–33].

• Eating behaviors assessment: Eating behaviors were assessed using the Dutch Eating Behavior Questionnaire (DEBQ), validated for the Saudi population, consisting of 33 items measuring three domains: restrained eating (10 items), emotional eating (13 items), and external eating (10 items). Responses were recorded on a 5-point Likert scale ranging from 1 (never) to 5 (very often) [34].

To categorize eating behavior levels, mean scores were calculated using the following equation:

$$\text{Eating behaviors}=\frac{\text{Highest}\text{possible}\text{score}-\text{Lowest}\text{possible}\text{score}}{\text{Possible}\text{score}}=\frac{5-1}{3}=\frac{4}{3}=1.33$$

and classified into three categories based on Likert scale intervals: low (1.00–2.33), moderate (2.34–3.67), and high (3.68–5.00) [35].

Pilot testing and validation

Content validity was assessed through expert review. A pilot study involving 10 healthcare professionals, who were excluded from the final analysis, was conducted to assess the clarity, comprehensibility, and feasibility of the questionnaire. The pilot study also allowed estimation of the average time required to complete the questionnaire, which was approximately 15–20 min. Feedback obtained from the pilot participants was incorporated into the final version of the questionnaire.

Ethical considerations

Ethical approval was obtained from the Research Ethics Committee of the Faculty of Medicine, King Abdulaziz University (No. 2023-B-35), and from the Research Ethics Committee of King Faisal Medical Complex (No. 2023-B-35).

Statistical analysis

Data were analyzed using IBM SPSS Statistics version 28. Data normality was assessed using the Shapiro–Wilk test. Descriptive statistics were used to summarize participants’ characteristics and study variables. Categorical variables were presented as frequencies and percentages, while continuous variables were expressed as means and standard deviations.

Independent samples t-tests and one-way analysis of variance (ANOVA) were used to examine differences in job stress and eating behavior scores across sociodemographic characteristics and body mass index (BMI) categories. When ANOVA result was significant, post hoc pairwise comparisons were performed using the least significant difference (LSD) test. The LSD test was selected due to its suitability for pairwise comparisons following a significant ANOVA and its ability to maintain adequate statistical power when the number of comparison groups is limited.

Pearson’s correlation coefficients were calculated to assess associations between job stress dimensions and eating behavior domains. In addition, multivariable linear regression analyses were conducted to examine the associations between job stress variables and eating behavior outcomes while adjusting for potential confounding variables, including age, gender, BMI, monthly income, and occupation. All statistical tests were two-tailed, and statistical significance was set at p < 0.05.

Reliability analysis

The internal consistency of the study instruments was evaluated using Cronbach’s alpha coefficients. The Brief Job Stress Questionnaire (BJSQ) demonstrated good internal consistency with a Cronbach’s alpha of 0.965, while the Dutch Eating Behavior Questionnaire (DEBQ) showed excellent reliability with a Cronbach’s alpha of 0.993, indicating that both instruments had acceptable reliability for use in the present study.

Results

A total of 323 healthcare professionals were included in the analysis. Saudi nationals comprised 227 participants (70.3%), and 205 participants were female (63.5%). Participants aged 30–39 years accounted for 133 (41.2%), followed by those aged 25–29 years (129, 39.9%). Married participants numbered 165 (51.1%).

A bachelor’s degree was reported by 187 participants (57.9%), while 81 (25.0%) held a master’s degree or board certification. Monthly income ranged between 5,000 and 9,999 SAR in 125 participants (38.7%) and 10,000 and 19,999 SAR in 119 participants (36.8%). Nurses represented 120 participants (37.2%), and 127 participants (39.3%) reported more than 5 years of work experience.

Regarding body mass index, 142 participants (44.0%) had normal weight, 119 (36.8%) were overweight, and 44 (13.6%) were obese. Detailed sociodemographic and clinical characteristics are presented in Table 1

Table 1.

Sociodemographic characteristics and BMI of the study participants (N = 323)

Sociodemographic characteristics	N = 323	Percentages
Nationality
Saudi	227	70.3
Non-Saudi	96	29.7
Gender
Female	205	63.5
Male	118	36.5
Age
25–29 years	129	39.9
30–39 years	133	41.2
40–49 years	43	13.3
≥ 50 years	18	5.6
Marital status
Single	145	44.9
Married	165	51.1
Divorced/widow	13	4.0
Educational qualification
Diploma	38	11.8
B achelors	187	57.9
Master’s or Board	81	25.0
PhD	17	5.3
Monthly income
< 5000 SR	45	13.9
5,000–9,999 SR	125	38.7
10,000–19,999 SR	119	36.8
≥ 20,000 SR	34	10.6
Occupation
Nurse	120	37.2
Doctor	64	19.8
Technician	53	16.4
Health assistant	30	9.3
Specialist	56	17.3
Work experience
< 1 year	103	31.9
1–5 years	93	28.8
> 5 years	127	39.3
Body mass index
Underweight	18	5.6
Normal	142	44.0
Overweight	119	36.8
Obese	44	13.6

Data are presented as numbers (N) and percentages (%)

As shown in Fig. 1, high job stress was reported by 150/323 participants (46.44%), whereas 173/323 participants (53.56%) did not report high job stress based on the Brief Job Stress Questionnaire.

Fig. 1.

Job stress levels among the study participants.

As shown in Fig. 2, moderate levels of restrained eating were reported by 169/323 participants (52.32%) and moderate external eating by 212/323 participants (65.6%). Low levels of emotional eating were reported by 173/323 participants (53.6%).

Fig. 2.

Eating behavior levels among the study participants.

Significant differences in total job stress scores (BJSQ) were observed according to nationality (p = 0.007), monthly income (p = 0.047), and work experience (p = 0.016). Higher mean stress scores were reported among Saudi participants compared with non-Saudis. Participants with a monthly income of 10,000–19,999 SAR and those with 1–5 years of work experience exhibited the highest stress scores within their respective categories (Table 2).

Table 2.

Total job stress scores across sociodemographic characteristics

Sociodemographic characterization	N	Mean ± SD	P value
Gender
Female	205	155.07 ± 16.51	0.156
Male	118	152.38 ± 16.05
Age
23–29 years	129	155.69 ± 16.29	0.230
30–39 years	133	153.20 ± 15.81
40–49 years	43	154.65 ± 18.44
≥ 50 years	18	147.83 ± 15.09
Nationality
Saudi	227	155.67 ± 17.04	0.007*
Non-Saudi	96	150.33 ± 14.05
Marital status
Single	145	154.76 ± 16.70	0.734
Married	165	153.39 ± 16.30
Divorced/widowed	13	155.38 ± 14.13
Educational qualification
Diploma	38	156.05 ± 19.75	0.377
Bachelors	187	154.90 ± 16.36
Master's or Board	81	152.06 ± 15.23
PhD	17	150.41 ± 12.98
Monthly income
< 5000 SR	45	151.96 ± 16.28	0.047*
5,000–9,999 SR	125	153.75 ± 14.76
10,000–19,999 SR	119	156.81 ± 17.64
≥ 20,000 SR	34	148.62 ± 16.32
Occupation
Nurse	120	155.93 ± 16.48	0.067
Doctor	64	151.67 ± 14.49
Technician	53	157.43 ± 18.94
Health assistant	30	153.73 ± 12.58
Specialist	56	149.93 ± 16.61
Work experience
< 1 year	103	151.63 ± 14.86	0.016*
1–5 years	93	158.07 ± 15.71
> 5 years	127	153.16 ± 17.56

t-test, one-way analysis of variance (ANOVA) were employed to evaluate differences between groups. *p-value is significant at the 0.05 level

Significant differences in total DEBQ scores were observed according to gender and monthly income (p < 0.05), with higher mean scores among male participants and those with monthly incomes of 5,000–9,999 SAR and 10,000–19,999 SAR (Table 3).

Table 3.

Total DEBQ scores across sociodemographic characteristics

Sociodemographic characterization	N	Mean ± SD	P value
Gender
Female	205	84.56 ± 18.72	0.001*
Male	118	93.54 ± 22.28
Age
23–29 years	129	85.41 ± 21.74	0.355
30–39 years	133	89.63 ± 20.69
40–49 years	43	89.86 ± 17.41
≥ 50 years	18	87.22 ± 16.39
Nationality
Saudi	227	88.62 ± 21.10	0.298
Non-Saudi	96	86.01 ± 19.06
Marital status
Single	145	85.57 ± 20.18	0.060
Married	165	90.18 ± 20.62
Divorced/widowed	13	83.54 ± 21.27
Educational qualification
Diploma	38	86.42 ± 23.26	0.665
Bachelors	187	89.01 ± 20.75
Master's or Board	81	86.52 ± 19.47
PhD	17	84.47 ± 16.88
Monthly income
< 5000 SR	45	76.42 ± 18.82	0.001*
5,000–9,999 SR	125	87.01 ± 18.73
10,000–19,999 SR	119	93.33 ± 21.53
≥ 20,000 SR	34	86.82 ± 19.30
Occupation
Nurse	120	84.60 ± 19.56	0.127
Doctor	64	93.00 ± 19.60
Technician	53	87.72 ± 24.50
Health assistant	30	88.73 ± 17.48
Specialist	56	88.54 ± 20.37
Work experience
< 1 year	103	83.90 ± 20.26	0.058
1–5 years	93	89.17 ± 20.30
> 5 years	127	90.06 ± 20.60

t-test, one-way analysis of variance (ANOVA) were employed to evaluate differences between groups

^*p-value is significant at the 0.05 level

Table 4 shows the correlations between the BJSQ sub-dimensions and DEBQ subscales. Weak but statistically significant positive correlations were observed between job stressors and emotional eating (r = 0.11, p = 0.049) as well as total DEBQ scores (r = 0.12, p = 0.029). Stress response was weakly and positively correlated with external eating (r = 0.14, p = 0.014). In contrast, social support showed a weak negative correlation with external eating (r =  − 0.15, p = 0.006). No significant correlation was found between total BJSQ scores and total DEBQ scores.

Table 4.

Correlations between BJSQ sub-dimensions and DEBQ subscales

Variables	Restrained eating		Emotional eating		External eating		Total DEBQ
	Pearson’s correlation	P value	Pearson’s correlation	P value	Pearson’s correlation	P value	Pearson’s correlation	P value
Job stressor	0.10	0.061	0.11	0.049*	0.03	0.618	0.12	0.029*
Stress response	−0.04	0.446	0.04	0.427	0.14	0.014*	0.06	0.291
Social support	0.01	0.818	−0.07	0.239	−0.15	0.006*	−0.09	0.11
Total BJSQ score	−0.01	0.886	0.05	0.352	0.09	0.097	0.06	0.267

^*The mean difference is significant at the 0.05 level

As presented in Table 5, significant differences across BMI categories were observed for restrained eating, emotional eating, and total DEBQ scores (p < 0.05). Post hoc analysis using the least significant difference (LSD) test indicated significant differences in restrained and emotional eating between underweight and normal-weight participants, as well as between overweight and obese participants. Higher mean scores for restrained and emotional eating, as well as total DEBQ scores, were observed among overweight and obese participants compared with those who were underweight or of normal weight. No significant differences across BMI categories were found for job stressors, stress response, social support, or total BJSQ scores.

Table 5.

Eating behaviors and job stress across BMI categories

Variables	BMI
	Underweight Mean ± SD	Normal Mean ± SD	Overweight Mean ± SD	Obese Mean ± SD	p-value
Job stressor	50.44 ± 4.15	49.93 ± 4.42	50.29 ± 4.19	50 ± 4.76	0.692
Stress response	77.38 ± 19.35	76.74 ± 15.34	75.93 ± 13.96	74.57 ± 15.88	0.841
Social support	27.17 ± 5.37	27.99 ± 4.1	27 ± 4.71	28.82 ± 4.71	0.096
Total BJSQ score	155 ± 16.42	154.66 ± 17.08	153.23 ± 14.17	154.18 ± 19.72	0.906
Restrained eating	21.67 ± 11.59	25 ± 9.9	29 ± 6.67	27 ± 8.9	0.000*
Emotional eating	23.39 ± 13.78	28.73 ± 12.2	31 ± 12.51	32.93 ± 12.01	0.019*
External eating	30 ± 9.11	31 ± 8.3	29.38 ± 7.67	29.4 ± 7.67	0.172
Total DEBQ score	74.56 ± 24.22	84.60 ± 22.04	92.17 ± 18.03	92.05 ± 16.12	0.000*

^*The mean difference is significant at the 0.05 level

To study the associations between job stress dimensions and eating behaviors after adjusting for age, gender, BMI, monthly income, and occupation, multivariable linear regression analyses were conducted (Table 6). Results showed that job stressors were significantly associated with higher total DEBQ scores (β = 0.248, p = 0.021) and restrained eating (β = 0.495, p = 0.001). In addition, BMI was positively associated with total DEBQ scores (β = 0.024, p = 0.002), restrained eating (β = 0.041, p = 0.001), and emotional eating (β = 0.026, p = 0.029). Male gender was also associated with higher total DEBQ scores (β = 0.190, p = 0.030). However, the associations between job stress variables and emotional eating and external eating were not statistically significant after adjusting for the covariates.

Table 6.

Multivariable linear regression analysis of factors associated with eating behavior scores

Predictor	Total DEBQ β (p)	Restrained eating β (p)	Emotional eating β (p)	External eating β (p)
Job stressors	0.248 (0.021)*	0.495 (0.001)*	0.102 (0.284)	0.083 (0.351)
Stress response	0.072 (0.198)	− 0.201 (0.024)*	0.088 (0.148)	0.065 (0.231)
Social support	− 0.041 (0.403)	− 0.062 (0.399)	− 0.059 (0.283)	− 0.047 (0.349)
BMI	0.024 (0.002)*	0.041 (0.001)*	0.026 (0.029)*	0.019 (0.061)
Male gender	0.190 (0.030)*	0.112 (0.364)	0.143 (0.171)	0.118 (0.222)

Models adjusted for age, gender, BMI, monthly income, and occupation

^*The mean difference is significant at the 0.05 level

Discussion

This study is among the first in Saudi Arabia to examine the relationship between job stress and eating behaviors among healthcare professionals. The findings reveal a concerning yet expected trend in the healthcare sector: a substantial 46.44% of healthcare professionals experience high job stress. Although a majority 53.56% reported moderate or low stress levels, the near-even distribution highlights the pervasive nature of occupational stress in healthcare settings. The rate of job stress observed in this study is higher than that reported in another study conducted in Saudi Arabia, in which 34.7% of participants experienced job stress, and is consistent with another study reporting that 45.5% of nurses experienced high stress levels [36] Similarly, a study conducted in Japan reported that 54.5% of participants experienced high job stress, while 45.5% reported low job stress, findings that closely align with the present study [37]. In contrast, another study conducted in Saudi Arabia reported that 71% of participants experienced moderate job stress, whereas only 12.2% reported high stress levels [8].

Regarding eating behaviors, most participants reported moderate levels of restrained eating (52.32%) and external eating (65.6%), whereas the majority reported low levels of emotional eating (53.6%). Similar patterns have also been reported in international studies, suggesting that restrained and external eating behaviors are commonly observed among individuals working in high-stress environments [38]. For example, a study conducted in Malaysia found that most participants reported moderate restrained and external eating behaviors (76.1% and 71.4%, respectively), while more than half reported low levels of emotional eating (52.1%) [35]. Another study similarly found that individuals were more prone to external and restrained eating than to emotional eating [39]. However, other studies have reported different patterns, with higher prevalence of emotional and restrained eating compared with external eating [40]. These differences may be explained by variations in eating disorder psychopathology, including differences in body weight concerns, emotional regulation, and the presence or absence of binge eating behaviors [41].

External eating behavior may also be explained by individual differences in responsiveness to environmental food cues. Schachter’s externality theory proposes that some individuals are more responsive to external food-related stimuli, such as the sight, smell, or availability of food, than to internal physiological signals of hunger and satiety [42]. This concept is reflected in the Dutch Eating Behavior Questionnaire (DEBQ), which conceptualizes external eating as eating in response to environmental food cues rather than internal hunger signals [34]. Experimental studies further support this mechanism, demonstrating that exposure to visual and olfactory food cues can increase appetite and food intake [43].

Beyond eating behavior patterns, several demographic and occupational factors were associated with job stress in this study. Saudi nationals reported higher job stress compared with non-Saudi participants, which is consistent with previous local studies [36, 44]. Possible explanations may include higher administrative responsibilities, workplace expectations, and organizational pressures, as well as challenges such as workplace bullying, lack of recognition, and burnout [8]. Participants with mid-range monthly incomes (10,000–19,999 SR) also reported higher stress levels, suggesting that perceived income satisfaction relative to workload may be more influential than absolute income levels, a finding consistent with previous research [45]. In addition, healthcare workers with 1–5 years of experience reported the highest stress levels, possibly reflecting the adjustment period in demanding healthcare environments, whereas more experienced professionals may develop more effective coping strategies over time [46, 47].

Contrary to many previous studies reporting higher eating behavior scores among females [48–50], the present findings showed significantly higher DEBQ scores among males across all eating behavior domains. This observation may indicate under-recognized eating-related difficulties among men, which could be associated with challenges in emotional regulation and cultural factors that discourage help-seeking behaviors among males [51, 52]. These findings highlight the potential need for targeted workplace interventions addressing nutritional awareness and stress management among male healthcare professionals.

Monthly income was also associated with eating behaviors, with higher scores observed among participants earning 5,000–9,999 SR and 10,000–19,999 SR, which is consistent with previous findings [53]. However, the relationship between income and disordered eating remains complex and influenced by multiple psychosocial factors, including body dissatisfaction and stress-related coping strategies [54]. Some international studies have also reported gender differences in eating behaviors, suggesting that men and women may adopt different coping mechanisms in response to occupational stress and emotional regulation challenges [55, 56].

Correlational analysis revealed weak but statistically significant associations between job stressors and emotional eating, as well as between stress response and external eating. In addition, social support showed a weak inverse association with external eating. These findings partially align with previous studies reporting associations between psychological stress and disordered eating behaviors [57, 58], although other studies have reported no significant relationship between stress and eating behaviors [59]. However, after adjusting for potential confounding variables in multivariable regression models, job stressors remained significantly associated only with total eating behavior scores and restrained eating, whereas the associations with emotional eating and external eating were no longer statistically significant. This finding suggests that the relationship between job stress and certain eating behaviors may be partially explained by demographic or lifestyle factors, highlighting the importance of controlling for potential confounders when examining these associations.

Finally, no significant association was observed between job stress and BMI in the present study, which is consistent with several previous reports [60, 61] but contrasts with other studies that have identified a significant relationship between stress and body weight [62, 63]. However, BMI was positively associated with restrained and emotional eating behaviors, with higher scores observed among overweight and obese participants. These findings are consistent with prior research indicating that individuals with higher BMI may be more likely to engage in emotional or restrained eating patterns [56, 64]. Taken together, these results suggest that job stress may influence body weight indirectly through maladaptive coping behaviors, such as emotional or restrained eating, rather than exerting a direct effect on BMI. These findings highlight the importance of workplace strategies aimed at stress reduction and promoting healthy eating behaviors among healthcare professionals.

Conclusion

This study demonstrates that job stress is common among healthcare professionals at King Faisal Medical Complex, with significant differences observed according to nationality, income, and years of professional experience. Although job stress was not directly associated with BMI, it showed associations with certain eating behaviors, particularly restrained eating, suggesting that occupational stress may influence dietary patterns among healthcare workers. In addition, higher BMI was significantly associated with restrained and emotional eating behaviors, particularly among overweight and obese participants. Notably, male healthcare professionals reported higher levels across all eating behavior domains, highlighting a potentially under-recognized at-risk group.

Taken together, these findings suggest that job stress may contribute indirectly to weight-related health outcomes through maladaptive eating behaviors. These results emphasize the importance of implementing integrated workplace strategies that address both occupational stress and unhealthy eating patterns. Such interventions may support healthier coping mechanisms, enhance employee well-being, and help reduce obesity-related health risks among healthcare professionals. Future longitudinal studies are needed to clarify causal pathways and inform the development of targeted prevention and intervention programs.

Strengths and limitations

This study contributes to addressing an important research gap in Saudi Arabia by examining the relationship between job stress and eating behaviors among healthcare professionals, a population known to experience high levels of occupational stress. A key strength of the study is the use of validated instruments, including the Brief Job Stress Questionnaire (BJSQ) and the Dutch Eating Behavior Questionnaire (DEBQ), which enhance the reliability and comparability of the findings.

However, several limitations should be considered when interpreting the results. First, the cross-sectional design limits the ability to establish causal relationships between job stress, eating behaviors, and BMI. Second, data were collected through an online self-administered survey, which may have introduced selection bias and limited participation among individuals with restricted internet access. Third, the sample included a higher proportion of females, nurses, and overweight or obese participants, which may affect the representativeness of the study population. In addition, BMI was calculated using self-reported height and weight, which may be subject to reporting bias. Finally, the study was conducted in a single healthcare institution, which may limit the generalizability of the findings to other healthcare settings or regions.

Abbreviations

NIOSH

National Institute for Occupational Safety and Health

NCMH

National Center for Mental Health Promotion

BJSQ

Brief Job Stress Questionnaire

DEBQ

Dutch Eating Behavior Questionnaire

BMI

Body mass index

Author contributions

W.A.A. and A.A.A. contributed to conceptualization, W.A.A. and A.A.A. contributed to methodology, W.A.A. collected data, W.A.A. ran statistical analysis, A.A.A validated analysis, W.A.A. wrote original draft preparation, A.A.A. wrote review and edited manuscript.

Funding

This project was funded by the KAU Endowment (WAQF) at King Abdulaziz University, Jeddah, Saudi Arabia.

Data availability

The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

King Abdulaziz University Research Ethical Committee gave its approval to the study (No. 382-23). King Faisal Medical Complex Research Ethical Committee gave its approval to the study (No. 2023-B-35). Before completing the questionnaire, the workers were required to review the objectives of the study and provide written informed consent for participation.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.