Characteristics of a Favorable Weight Status Change From Adolescence to Young Adulthood

To explore 10-year longitudinal predictors (personal, psychological, behavioral, and socioenvironmental) of exiting obesity from adolescence to young adulthood.

Data were collected from a population-based cohort of adolescents (n = 2,287) attending middle/high schools in Minneapolis-St. Paul in 1998-1999 (mean age = 14.9) and again in 2008-2009 (mean age = 25.3) participating in Project Eating and Activity Among Teens and Young Adults. Self-reported height and weight were used to calculate weight status change between adolescence and young adulthood, among participants with obesity at baseline (n = 175). Questionnaires assessed personal, psychological, behavioral, and socioenvironmental factors hypothesized to play a role in obesity. Modified Poisson regressions estimated adjusted relative risks (RRs) for exiting obesity as a function of each baseline and 10-year change in predictor, controlling for relevant covariates.

Thirty-two percent of adolescents exited obesity in young adulthood. Reductions in fast food intake (RR = .73, 95% confidence interval [CI] = .61-.87) and screen time (RR = .98, 95% CI = .96-.99), and increases in fruit/vegetable intake (RR = 1.06, 95% CI 1.01-1.12), moderate-to-vigorous physical activity (RR = 1.06, 95% CI = 1.00-1.12), home fruit/vegetable availability (RR = 1.58, 95% CI = 1.19-2.09), family meals (RR = 1.12, 95% CI = 1.03-1.22), and serving vegetables at dinner (RR = 1.45, 95% CI = 1.10-1.92) were associated with exiting obesity. Not dieting as an adolescent and improvements in body satisfaction, depressive symptoms, self-esteem, and weight teasing were also associated with exiting obesity.

Promoting healthy eating and activity, and improving the healthfulness of home food environments may be promising intervention targets for promoting healthier weights in adolescents and young adults with obesity. Addressing dieting behavior and the psychosocial health of adolescents with obesity may also be needed throughout the transition to young adulthood.