“The Relationship among Registered Nurses’ Personality Type, Weight Status, Weight Loss Motivating Factors, Weight Loss Regimens, and Successful or Unsuccessful Weight Loss”
Purpose of the Study
The purpose of the study was to determine the relationship among Registered Nurses' personality type utilizing the Myers-Briggs Type Indicator (MBTI) and their weight status. Although Registered Nurses of all weights participated in this study, the focus was on examining the responses of Registered Nurses who had been overweight or obese and attempted to lose weight within the past five years. Specific areas of interest included motivating factors and weight loss regimens. Each participant also completed a demographic survey that asked relevant questions regarding age, Body Mass Index (BMI), gender, race/ethnicity, education and disability status, work hours, and prescription medication use.
Research Questions
Research question one
How do RNs report their personality type and weight status?
Research question two
For RNs who have attempted to lose weight, what are the relationships among their personality type, weight loss motivating factors, weight loss regimens as well as their age, gender, BMI, race/ethnicity, education status, work hours, physical ability, and prescription medication use in their successful or unsuccessful attempts at losing weight?
Research question three
How do RNs who are successful or unsuccessful in their weight loss attempts compare in their personality type, weight loss motivating factors, and weight loss regimens?
Research question four
To what extent do personality type, age, gender, BMI, race/ethnicity, education status, work hours, physical ability, and prescription medication use predict successful or unsuccessful weight loss in RNs?
Research question five
To what extent do personality type, weight loss motivating factors, weight loss regimens, age, gender, BMI, race/ethnicity, education status, work hours, physical ability, and prescription medication use predict successful or unsuccessful weight loss in RNs?
Background / Significance
The obesity epidemic is increasing in the United States as well as the world and there are a multitude of weight loss programs and diets for consumers to choose from (Federal Trade Commission, 1997). There are 85 clinical studies listed by the U.S. National Institutes of Health recruiting participants that focus on obesity (Clinical Trials, 2006). Personality type is not listed among the current research in the NIH clinical trial listing. It is clear that there is a need to educate RNs on appropriate weight loss programs that may benefit themselves as well as their patients, families and friends.
The significance of the study relates to the obesity epidemic in the United States and the world. Obesity leads to increased morbidity and mortality while often decreasing the quality of life in these same individuals. The costs of obesity to both the individual and society are staggering with regard to treatment and workdays lost. Effective measures need to be developed towards the prevention of weight gain as well as weight loss treatments. The notion that “one size fits all” does not work concerning obesity and weight loss.
The United States Government has set goals for improvement in nutrition and weight loss for the population through a multitude of objectives found in their publication "Healthy People 2010." Three important objectives found in "Healthy People 2010" that pertain to the focus of this study include 1) increasing the proportion of adults who are at a healthy weight; 2) reducing the proportion of adults who are obese; and 3) increasing the proportion of physician office visits made by patients with a diagnosis of cardiovascular disease, diabetes, or hyperlipidemia that include education related to diet and nutrition. Since Registered Nurses are part of the health care system and provide nursing care, diagnose, educate and treat individuals in their perspective roles either as Registered Nurses or as Nurse Practitioners, they should set an example of good health which includes being within the normal BMI range. Personality may play a role in providing guidance in treating obesity by investigating those Registered Nurses who have already successfully or unsuccessfully lost weight. If there are relationships among weight status, weight loss motivating factors, weight loss regimens and Registered Nurses' personality type, then guidance can be given to those of the same personality type for assistance in successfully losing weight.
Registered Nurses have been part of some research in weight gain and obesity as well as a myriad of other research studies in both the Nurses’ Health Study I (1976 to present) and Nurses’ Health Study II (1989 to present) developed through the Harvard Medical School. After the completion of the study it is the hope of this researcher that the MBTI may be utilized in health care offices, both primary care and family medicine, to assist individuals in their ability to lose weight through appropriate weight loss regimens. The purpose of utilizing Registered Nurses for the study is to be able to transfer the information obtained from the Registered Nurses to the general population in the same way that much of the data and knowledge obtained through the Harvard designed Nurses’ Health Studies have been able to be generalized to the public at large.
Methodology
Registered Nurses either received a letter in the mail, an e-mail invitation or were asked to participate in person in this anonymous research at various nursing functions or conferences. Those individuals who received the letter or e-mail and agreed to participate in this research were given a web site address where they were able to complete the demographic survey and the MBTI. Those individuals who agreed to participate while at nursing functions or conferences received a hard copy of the demographic survey form as well as the Myers-Briggs Type Indicator to fill out and hand in to the investigator anonymously. In order to maintain anonymity, each participant chose a random combination of two letters and three numbers to place on both survey form and MBTI in order for the researcher to know which survey corresponded to each MBTI. The Myers-Briggs Type Inventory was a "self report questionnaire" that required the individual filling out the Inventory to answer ninety-three questions regarding personality preferences they had. The participant chose between two dichotomous answers.
Results
The current obesity epidemic in the United States as well as in the world requires that successful treatment measures be developed in order to assist those who are motivated to lose weight to achieve their goal. This is not only imperative because of the epidemic itself, but also because of the large number of chronic illnesses that have become associated with and caused by being overweight or obese. The cost to the individuals who are obese or overweight is not only in the emotional and physical realms, but also in financial costs to both the individuals themselves and to society. These costs include but are not limited to the direct treatment costs as well as the indirect costs of lost productivity and earnings (Colditz, 1999). Thus, successful treatment and the ability to guide RNs as well as others to successful treatment methods must be the focus of the health care profession, the government, and those in the field of obesity research.
Personality Type, BMI, and Registered Nurses
Briggs Myers et al (1998) discussed the “occupational trends of the 16 types” and provided a table of the most common occupations within each type. Besides health care, which was found most commonly in four of the types, other occupations listed were education, management, administration, law enforcement, accounting, religion, arts as well as scientific fields to name a few. Health care workers were most likely found to be Introverted Sensing Feeling Judging (ISFJ), Introverted Sensing Feeling Perceiving (ISFP), Extraverted Sensing Feeling Perceiving (ESFP), and Extraverted Sensing Feeling Judging (ESFJ). In the current study, RNs were found to have personalities within all sixteen MBTI types. However, the majority of the RNs were found in the following MBTI types: Introverted Sensing Thinking Judging (ISTJ), Introverted Sensing Feeling Judging (ISFJ), Extraverted Intuitive Feeling Perceiving (ENFP), and Extraverted Sensing Feeling Judging (ESFJ). Thus, two of the personality types (ISFJ and ESFJ) correlated to those types found more commonly in the health care profession. Additionally, previous research (Hildebrandt, 1982; Harris, 1985; Levine, 1985; Guyer, 1987; and Drabek-Enty, 1992) using the MBTI in relation to weight loss or maintenance found that the populations who participated in their research had a limited number of types represented. Thus, it was interesting to find that RNs were found in all sixteen personality types in this study and not limited to those found in the four health care occupations listed above.
Another interesting fact was that those most likely to be in the occupation of health care were Sensing Feeling (SF) types. The RNs who were of the Sensing Feeling function were found to be the majority of RNs: Sensing Feeling (251 / 34.8 percent), Sensing Thinking (202 / 28.0 percent), Intuition Feeling (197 / 27.3 percent), and Intuition Thinking (71 / 9.9 percent). Thus, in this study the majority of RNs were oriented to sensing (453 / 62.9 percent) type as compared to intuition (268 / 37.1 percent). In addition, both extraverted (382) and introverted (339) attitudes were found equally in the RN population and the attitudes of judging (429 / 59.6 percent) and perceiving (292 / 40.4 percent) revealed a greater number in the former attitude.
According to the statistics related to overweight and obesity published by the National Institute of Health (2007) and taken from the National Health and Nutrition Examination Survey (NHANES) 2001 to 2004 data, 133.6 million (66 percent) of all adults age 20 years or older were overweight or obese (p. 4). Compared to this research study there were 411 RNs who were overweight or obese (57 percent). This is just below the national average as seen above. NHANES also revealed that more specifically 63.3 million (31.4 percent) were obese. Again, compared to the current study, 195 RNs or 27 percent were obese. This is also just below the national average. The NHANES data also revealed that 65.4 million (32.3 percent) of adults 20 years of age or older were at a healthy weight. This is compared to the number of RNs were at a healthy weight (302 / 41.9 percent) in this study. Thus, it appears that RNs in this study were more healthy compared to the national statistics.
Lastly, it was noted that participants in this study who reported their personality type being Introverted Intuitive Feeling Perceiving (INFP) had 50 percent of their personality type within the overweight body weight category. This personality type had the largest percentage of any type in either the overweight or obese categories. Although RNs of every personality type were found in each overweight and obese category, the majority were less than forty percent. Those personality types which had forty percent or greater of their personality type in overweight not including Introvert Intuitive Feeling Perceiving which was just noted above included Extraverted Intuitive Feeling Judging (ENFJ) at 42.6 percent. Introverted Sensing Thinking Perceiving (ISTP) type was 42.9 percent and Extraverted Intuitive Thinking Perceiving (ENTP) type was 40.0 percent in the obese category. There were no other unique patterns in the overweight and obese categories with regard to the other personality types.
Personality Type and Weight Loss Regimens
The current study examined diet, exercise, social interaction, and pharmacotherapy as weight loss regimens utilized by the RNs in their attempt to lose weight in relation to specific aspects of the MBTI personality type. Participants in the current study revealed no preference between weight loss regimens chosen regardless of the personality attitude of intuition versus sensing. Additionally, introverts or extraverts showed no particular preference for the weight loss regimen chosen. Thus unlike the results in Levine’s study (1985), no specific preference towards weight loss regimens were found among intuitives, introverts or sensing personality types.
This study revealed no specific preference among regimens utilized by intuitive / thinking personality types unlike Drabek Enty (1992). No research was performed in the current study specifically on sensing / perceiving personality types.
Thus, in the two scholarly research studies related to MBTI personality type and weight loss regimen / techniques utilized to lose weight, similar results were not found in the current study, which had a significant greater number of participants compared to the two studies discussed above.
Motivation and Weight Loss
This study found no significant statistical relationships between motivating factors and successful or unsuccessful weight loss in participants with the MBTI attitudes of introversion and extraversion, the functions of perceiving and judging, or sensing and thinking.
Personality Type and Weight Loss
Although there was no statistical significance between successful weight loss and personality type in this study, it was noted that RNs who were of the personality type Extraverted Sensing Feeling Perceiving (ESFP) appeared to have a higher percentage of participants who successfully lost weight, and Introverted Sensing Feeling Judging (ISFJ) had a higher percentage of participants who were unsuccessful with their weight loss attempts. All other personality types split evenly between being successful and unsuccessful in their weight loss attempts. Thus, unlike Hildebrandt who found successful weight loss in individuals who were in either the thinking or feeling preferences, the current research did not tend to lean in this direction. Additionally, examination of successful weight loss in relation to the attitudes of introversion and extraversion as well as the functions of sensing and intuition was evaluated. There were no significant relationships in either attitudes or functions with regard to successful weight loss. Several of the previous doctoral dissertations and master’s thesis using the MBTI suggested that their studies be replicated using a larger population. However, even though this research study had 721 participants, and it was the largest study on personality type and weight loss using the MBTI, there were no definitive or statistically significant relationships found between MBTI personality types and successful weight loss.
Weight Loss Regimens and Weight Loss
Several different weight loss regimens were examined in this study including diet, exercise, social interaction, and pharmacotherapy. Significance was noted in both the dietary and exercise regimen categories. There were no significant relationships among participants in the study using social interaction or medication use and successful weight loss.
Diet Regimen and Weight Loss Success
Interestingly, the significance found regarding dietary regimen use revealed that participants in the study who did not use a dietary regimen were more likely to be successful in their weight loss attempts than those who chose to use a dietary regimen. This may appear on the surface to not make sense with current national and international research on weight loss and dietary influence; however, those participants in this research study who lost weight when they did not utilize a diet regimen may have chosen a more common sense approach to their respective diets by watching what they ate instead of using a specific “diet regimen.” Maybe successful weight loss is not in the “how,” but in the adherence and consistency of the behavioral change that the individual who attempts weight loss undertakes.
Exercise Regimen and Weight Loss Success
The other significant finding was between exercise and successful weight loss. Findings suggest that RNs who exercise had a lower BMI level than those who did not exercise.
Weight Loss Demographics and Weight Loss
Several different weight loss demographics were examined in this study including age, gender, ethnicity, education level, shift work hours, disability, and prescription medication use. Statistical significance was noted in the categories of Body Mass Index (BMI), age, disability, and prescription medication use. There were no significant relationships among participants in the study according to their gender, ethnicity, education level, shift work hours, and successful weight loss.
BMI and Weight Loss Success
According to this study, the participants who were most successful in losing and maintaining weight loss were those participants who originally had a lower BMI. They were more likely to lose weight if they were in the BMI category of overweight (BMI 25kg/m2 to 29.9kg/m2) than if they were in the obese category (BMI ≥30kg/m2). Thus, the lower the initial BMI when attempting to lose weight, the more successful according to the current results.
Age and Weight Loss Success
Age showed a statistical significance with motivation as a contributing factor. This study found that those RNs who were of a younger age were more motivated to lose weight than older RNs.
Disability and Weight Loss Success
This study revealed a statistical significant relationship between BMI and disability in relation to successful weight loss. Thos RNs who had a physical disability had a tendency to have a higher BMI in the current research study. Thus, individuals who are disabled appear to have a greater chance of gaining weight as seen in Pain and Wiles (2006).
Prescription Medication Use and Weight Loss Success
Lastly, the other statistical significant relationship found in this study was that of prescription medication use and unsuccessful weight loss. Those participants who took prescription medication, which could cause weight gain while they were attempting to lose weight, were less successful than those participants who did not take prescription medications that could cause weight gain.