BACKGROUND:
The transition to university life is a critical period for shaping long-term health behaviours. For nursing students, future health professionals, this period is often marked by academic pressure, time constraints and disrupted lifestyles. In low- and middle-income settings, limited institutional support may further increase vulnerability to overweight and obesity, raising concerns for both student wellbeing and future health workforce sustainability.

METHODS:
A cross-sectional quantitative study was conducted among 135 undergraduate nursing students at a South African higher education institution. Body mass index (BMI) was calculated using measured height and weight. Lifestyle behaviours, including physical activity and dietary practices, were self-reported, while academic-related stress was assessed using a validated multidimensional stress scale. Descriptive statistics and chi-square or Fisher’s exact tests were used to examine associations between BMI, lifestyle behaviours and stress.

RESULTS:
Almost one in two students was classified as overweight or obese (48.2%). Unhealthy lifestyle patterns were common, with over three-quarters of participants replacing meals with snacks (78.5%, p<0.001) and most reporting inconsistent physical activity (61.5%, p<0.001). Although overall stress levels were generally low, time-related stress particularly limited time spent with family was significantly associated with higher BMI (Fisher’s exact=19.18, p=0.010), with obese students reporting the highest stress levels.

CONCLUSIONS:
Obesity among nursing students reflects more than individual choices; it is shaped by time pressure, lifestyle disruption and broader structural constraints. Integrating equity-focused health promotion, time management support and healthy campus environments is essential to protect student wellbeing and strengthen a sustainable health workforce.