Weight changes in young adults: a mixed-methods study (original) (raw)

Clinical Studies and Practice

International Journal of Obesity volume 39, pages 508–513 (2015)Cite this article

Subjects

Abstract

Objective:

In both the United States and United Kingdom, countries with high prevalence of obesity, weight gain is particularly rapid in young adulthood and especially identified among first-year students.

Design:

A triangulation protocol was used, incorporating quantitative and qualitative research methods. A 27-question online survey was sent to all first-year undergraduates twice, with a 9-month interval. An online focus group was conducted at the end of the year, analysed by content and thematically. Self-reported weights and heights were validated against objectively measured data.

Results:

From a total of 3010 first-year students, 1440 (female=734) responded at baseline mean (s.d.) age 20 (3.6) years, body mass index 22.3 (4.6) kg m−2, 17% smokers and 80% alcohol drinkers. At follow-up, 1275 students reported a mean weight change of 1.8 (s.d. 2.6) kg over the 9-month period. Self-reported data correlated strongly with measured weights (_r_=0.999, P<0.001) and heights (_r_=0.998, P<0.001). Predictors of weight gain were baseline weight (P<0.001). Dairy products consumption was associated with less weight gain (P<0.001). Fruit and vegetable consumption, and time spent on physical activity or sleeping were associated with neither weight gain nor weight loss. Focus group content analysis revealed weight gain as a major concern, reported by half the participants, and increased alcohol consumption was considered the most common lifestyle change behind weight gain. Thematic analysis identified three main themes as barriers to or facilitators of healthy lifestyles and weight; budget, peer influence and time management.

Conclusions:

Rapid weight gain is of concern to young adults. Students living away from home are at particular risk, owing to specific obesogenic behaviours. Consumption of fruit and vegetables, and physical activity, despite popular beliefs, were not associated with protection against weight gain.

This is a preview of subscription content, access via your institution

Access options

Subscribe to this journal

Receive 12 print issues and online access

$259.00 per year

only $21.58 per issue

Buy this article

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Additional access options:

Similar content being viewed by others

References

  1. Lobstein T, Leach R . International comparisons of obesity trends, determinants and responses. Evidence Review. Foresight Tackling Obesities: Future Choices 2007. http://www.foresight.gov.uk.
  2. Vlassopoulos A, Combet E, Lean ME Changing distributions of body size and adiposity with age. Int J Obes (Lond) 2013; 38: 857–864.
    Article Google Scholar
  3. Lean ME, Katsarou C, McLoone P, Morrison DS Changes in BMI and waist circumference in Scottish adults: use of repeated cross-sectional surveys to explore multiple age groups and birth-cohorts. Int J Obes (Lond) 2013; 37: 800–808.
    Article CAS Google Scholar
  4. Scottish Health Survey 2011 http://www.scotland.gov.uk/Publications/2011/10/1138/0 (last assessed 27 January 2013).
  5. Nikolaou CK, Lean MEJ, Hankey CR Weight and lifestyle changes in first year students in Scotland: the heal pilot study. Obes Rev 2011; 12: 63–279.
    Article Google Scholar
  6. Pope C, Mays N Qualitative research: reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ 1995; 311: 42.
    Article CAS PubMed PubMed Central Google Scholar
  7. O’Cathain A, Murphy E, Nicholl J Three techniques for integrating data in mixed methods studies. BMJ 2010; 341: C4587.
    Article PubMed Google Scholar
  8. Braun V, Clarke V Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77–101.
    Article Google Scholar
  9. Mihalopoulos NL, Auinger P, Klein J The freshman 15: is it real? J Am Coll Health 2008; 56: 531–533.
    Article PubMed PubMed Central Google Scholar
  10. Provencher V, Polivy J, Wintre MG, Pratt MW, Pancer SM, Birnie-Lefcovitch S et al. Who gains or who loses weight? Psychosocial factors among first-year university students. Physiol Behav 2009; 96: 135–141.
    Article CAS PubMed Google Scholar
  11. Anderson DA, Shapiro JR, Lundgren JD The freshman year of college as a critical period for weight gain: an initial evaluation. Eat Behav 2003; 4: 363–367.
    Article PubMed Google Scholar
  12. Delinsky SS, Wilson GT . Weight gain, dietary restraint and disordered eating in the freshman year of college. Eat Behav 2008; 9: 82–90.
    Article PubMed Google Scholar
  13. Cluskey & Grobe. College weight gain and behavior transitions: male and female differences. J Am Diet Assoc 2009; 109: 325–329.
    Article PubMed Google Scholar
  14. Pliner P, Saunders T . Vulnerability to freshman weight gain as a function of dietary restraint and residence. Physiol Behav 2008; 93: 76–82.
    Article CAS PubMed Google Scholar
  15. Lowe MR, Annunziato RA, Didie E, Bellace DL, Ridell L, Maille C et al. Multiple types of dieting prospectively predict weight gain during the freshman year of college. Appetite 2006; 47: 83–90.
    Article PubMed Google Scholar
  16. Yakusheva O, Kapinos K, Weiss M Peer effects and the freshman 15: evidence from a natural experiment. Econ Hum Biol 2011; 9: 119–132.
    Article PubMed Google Scholar
  17. Kapinos KA, Yakusheva O . Environmental Influences on Young Adult weight gain Evidence From a Natural Experiment. J Adolesc Health 2011; 48: 52–58.
    Article PubMed Google Scholar
  18. Jung ME, Bray SR, Martin Ginis KA Behaviour change and the freshman 15: tracking physical activity and dietary patterns in 1st-year university women. J Am Coll Health 2008; 56: 523–530.
    Article PubMed Google Scholar
  19. Butler SM, Black DR, Blue CL, Gretebeck RJ Change in diet, physical activity, and body weight in female college freshman. Am J Health Behav 2004; 28: 24–32.
    Article PubMed Google Scholar
  20. Economos CD, Hildebrandt ML, Hyatt RR College freshman stress and weight change: Differences by gender. Am J Health Behav 2008; 32: 16–25.
    Article PubMed Google Scholar
  21. Levitsky DA, Halbmaier CA, Mrdjenovic G The freshman weight gain: a model for the study of the epidemic of obesity. Int J Obes 2004; 28: 1435–1442.
    Article CAS Google Scholar
  22. Morrow ML, Heesch KC, Dinger MK, Hull HR, Kneehans AW, Fields DA Freshman 15: fact or fiction. Obesity 2006; 14: 8.
    Article Google Scholar
  23. Vella-Zarb RA, Elgar FJ The ‘freshman 5’: a meta-analysis of weight gain in the freshman year of college. J Am Coll Health 2009; 58: 161–166.
    Article PubMed Google Scholar
  24. Serlahious A, Hamer M, Wardle J Stress and weight change in university students in the United Kingdom. Physiol Behav 2007; 92: 548–553.
    Article Google Scholar
  25. Lewis CE, Jacobs DR, McCreath H, Kiefe CI, Schreiner PJ, Smith DE et al. Weight gain continues in the 1990s: 10-year trend in weight and overweight from the CARDIA study. Am J Epidem 2000; 151: 1172–1181.
    Article CAS Google Scholar
  26. Kratz M, Baars T, Guyenet S The relationship between high-fat dairy consumption and obesity, cardiovascular, and metabolic disease. Eur J Nutr 2012; 52: 1–24.
    Article PubMed Google Scholar
  27. Greaney ML, Less FD, White AA, Dayton SF, Riebe D, Blissmer B et al. College students’ barriers and enablers for healthful weight management: a qualitative study. J Nutr Educ Behav 2009; 41: 281–286.
    Article PubMed Google Scholar
  28. Greenbaum TL Internet focus groups: an oxymoron. Market News 1997; 31: 35–36.
    Google Scholar
  29. Eysenbach G, Wyatt J Using the internet for surveys and health research. J Med Internet Res 2002; 4: e13.
    Article PubMed PubMed Central Google Scholar
  30. Wright KB . Researching internet-based populations: Advantages and disadvantages of online survey research, online questionnaire authoring software packages, and web survey services. J Comput Mediat Commun 2005; 10: 3.
    Google Scholar
  31. Hilton S, Patterson C, Teyhan A Escalating coverage of obesity in UK Newspapers: the evolution and framing of the “obesity epidemic” from 1996 to 2010. Obesity 2012; 20: 1688–1695.
    Article PubMed Google Scholar

Download references

Author information

Authors and Affiliations

  1. Human Nutrition Department, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
    C K Nikolaou, C R Hankey & M E J Lean

Authors

  1. C K Nikolaou
  2. C R Hankey
  3. M E J Lean

Corresponding author

Correspondence toC K Nikolaou.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

About this article

Cite this article

Nikolaou, C., Hankey, C. & Lean, M. Weight changes in young adults: a mixed-methods study.Int J Obes 39, 508–513 (2015). https://doi.org/10.1038/ijo.2014.160

Download citation

This article is cited by