Health promotion is associated with the acquisition of healthy life behaviors. Healthcare workers can provide counseling services such as healthy nutrition and physical activity in the acquisition of healthy life behaviors and can be role models for the society. In this study, we evaluated dietary self-efficacy, physical activity level and the concept of obesogenic environment in healthcare workers.

Health perception and satisfaction are subjective markers that can be used to evaluate the health of individuals [28]. In our study, approximately half of the participants paid attention to being healthy most of the time and 59.3% of them evaluated their health as good or very good. In a study in the literature, the self-perception of health of employees in a university hospital was evaluated and 60.8% of the participants were reported to be satisfied with their own health, similar to our study [29].

Regular physical activity is extremely beneficial for mental and physical health. According to WHO data, 31.0% of adults do not meet the recommended physical activity level [30]. In our study, when the physical activity levels of the participants were classified, approximately half (56.8%) were minimally active, 29.7% were inactive and 13.5% were very active. The fact that almost one out of 3 healthcare workers in our study was inactive emphasizes the need to determine the barriers to physical activity in healthcare workers and to develop interventions to encourage physical activity in healthcare workers.

Recently, the prevalence of obesity has been increasing and overweight and obesity pose a threat for health problems. The rates of overweight and obesity in adults worldwide are reported to be 43.0% and 16.0%, respectively, according to the WHO [3]. In our country, the prevalence of overweight and obesity in individuals aged 15 years and older has been reported as 55.8% [31]. In our study, 56.2% of the participants were overweight or obese, similar to the general population. In a study conducted in hospital workers in South Africa, 73% of healthcare workers were reported to be overweight or obese [32]. The higher rate of overweight and obese in hospital workers compared to primary healthcare workers may be thought to be due to the negative effects of conditions such as shifts on eating patterns and physical activity [22]. At the same time, the prevalence of overweight and obesity may vary in different societies [3].

Smoking and alcohol use are health-related behaviors. In the literature, high rates of tobacco use have been reported in healthcare workers compared to the general population [33]. For this reason, smoking and alcohol use rates were also evaluated in our study and found to be 23.9% and 15.2%, respectively. In a systematic review in the literature, similar to our study, tobacco use in healthcare workers was reported as 22.0% [34]. In a study conducted in our country, the prevalence of alcohol consumption was reported as 15.4% in physicians and 8.9% in nurses [35]. In our study, the rates of smoking and alcohol use were found to be similar to the literature. Considering that healthcare professionals are role models for the society and recommend healthy lifestyle behaviors to their patients, it is important to control the prevalence of smoking and alcohol use in healthcare professionals.

A healthy diet is essential for the protection and promotion of health. In the litarture, the diet quality was not good, and nutrient intakes were insufficient among healthcare workers [36] In our study, dietary self-efficacy of the participants was evaluated because it may be related to healthy eating behaviors of individuals. The median value of the total score of the participants was 32.0 (11.0–55.0). The highest score was obtained from Social and Intrinsic Factors and the lowest score was obtained from Negative Emotional Events subscale. In a study conducted in university students in our country, the highest score was obtained from ‘social and intrinsic factors’ and the lowest score was obtained from the ‘negative emotional events’ subscale [23]. According to the results, in line with the literature, social or intrinsic factors may make it less difficult to resist eating, whereas negative emotional events such as having had an upsetting argument with a partner may make it more difficult to resist eating.

Participants’ characteristics related to their DSES scores were evaluated. Those who were minimally physically active and very physically active had significantly higher DSES scores than those who were inactive. Accordingly, we can think that healthy lifestyle behaviors such as physical activity and healthy eating positively affect each other. In our study, participants who were underweight and normal weight had significantly higher diet self-efficacy than those who were overweight and obese. According to this result, we may think that low dietary self-efficacy may increase the risk of obesity. Since our study has a cross-sectional design, prospective studies should be conducted to better interpret the causal relationship. Those who rated their health as good and very good also had higher dietary self-efficacy than those who rated their health as poor and fair. The positive effect of self-perception of health on dietary self-efficacy emphasizes the positive effect of improving individuals’ health, including physical and mental health, on nutrition.

By evaluating the effects of the factors constituting the obesogenic environment on healthcare professionals, healthcare professionals will be able to both guide the society in terms of these obesogenic concepts and direct their own lifestyles in order to prevent obesity. There is evidence in the literature that individual-based workplace-based interventions can provide modest weight loss [37]. Participants received the highest score in the Factors regarding physical environment and opportunities subgroup of the AOES scale. According to our results, there is a need to organize factors related to the physical environment, such as walking areas, gyms, and areas where access to healthy foods in the work environment will be increased. Moreover, the integration of advanced technologies like ChatGPT in personalized obesity management may offer innovative approaches to addressing obesogenic environments and diet self-efficacy [38].

Participants’ characteristics related to their AOES scores were evaluated. Those who were physically inactive had significantly higher AOES scores than those who were minimally active and very active. Those who were overweight and obese had significantly higher scores than those who were underweight and normal. According to the literature, obesogenic environment increases the obesity risk of individuals and the society, and creates limitations in access to sustainable healthy food with accessible wages and in the provision of safe and easy physical activity [13]. According to our results, although we can interpret that obesogenic environment creates a barrier to physical activity and poses a risk for obesity, prospective studies are needed to evaluate causality.

The relationship between participants’ dietary self-efficacy and obesogenic environment characteristics was evaluated. A significant negative correlation was observed between the DSES scale and the AOES (r=-0.263, p < 0.001). According to our results, it can be concluded that decreasing the effects of obesogenic environments may increase dietary self-efficacy. This finding highlights the importance of dealing with external environmental factors to enhance people’s confidence in maintaining healthy dietary habits. Addressing obesogenic environmental factors in workplace could play a crucial role in improving dietary self-efficacy among healthcare workers. The findings on obesogenic environments suggest a need for holistic approaches and workplace interventions such as creating walking areas, providing access to gyms, offering healthy food options, implementing regular wellness programs, and promoting active commuting initiatives.