On average, the rate of obesity increases throughout life. In young adults age 20-39 years old, the rate of obesity is 34%, which is roughly double that of pre-adolescence.¹ Weight gain often continues between young adulthood and middle age, averaging 0.5 to 1.0 kg per year.² Young adults have the highest rate of high weight gain, defined as 45 pounds or more, of any age group.

Many young adults are already overweight or obese and even more middle aged adults fall in this category. Currently, 60.3% of young adults aged 20–39-years old are overweight or obese while 75.3% of middle aged adults are either overweight or obese.³ The prevalence of extreme (grade 3) obesity in young adults is already at 5.6% and increases to 7.7% by middle age.

Poor diet choices and low physical activity levels are the main reasons for the high rate of overweight and obesity in young adults. Research has shown that young adults who recently transitioned to independent living to have poor diet quality on average. For example, in a study of over 1300 young adults age 18-25 years, only 40% self-reported that they eat the recommended amount of vegetables and nearly a third (32%) engage in unhealthy snacking.⁴ Another study of 738 college students found that the majority (over 69%) did not meet recommended levels (5 servings) of fruits and vegetables and over 67% did not meet the recommended amount of dietary fiber (20 g) per day.⁵

Young adults (19-39 years old) also have the highest intake of soft drinks compared to other age groups.⁶ During the 15 year change from childhood to adulthood, the Bogalusa Heart study found that on average fruits and milk consumption decreased and sweetened beverages, salty snacks, and beef consumption increased.⁷ The change to independent living in this age group is also often accompanied by an increase in alcohol use, which is associated with weight gain.⁸ Putting all this data together creates a picture that shows that young adults, on average, need to develop skills associated with assessing nutrient-value and selecting health promoting foods.

Making a major lifestyle change to healthier eating, together with a healthy level of physical activity, would prevent the weight gain typically seen by middle age along with significant associated health concerns.

What Are The Health-Related Concerns?

Excess weight and poor diet are among the major risk factors for cardiovascular disease. Young adults have a very low prevalence of meeting criteria for cardiovascular health. Only 0.5% of 196 young adults in one study met the criteria for ideal cardiovascular health and this was attributed to poor dietary habits more than the other cardiovascular health factors⁹ and only 4.1% of young adults met the criteria for an American Heart Association ideal health diet score. Therefore, it seems likely that many young adults would benefit from improving their dietary habits that affect cardiovascular risk factors.

Another illness that is associated with excess weight is type 2 diabetes. Preventing the development of this disease also is best started at a young age. The rate of diagnosed diabetes goes from 0.24% of the population under age 20 years up to 2.6% of those ages 18-44 years old.¹⁰ Many more cases of diabetes go undiagnosed and untreated with devastating eventual health effects. While a small minority of younger adults already have diabetes, a much larger group will develop it later in life if a healthy weight is not achieved and maintained.

Many other health problems are associated with long term obesity, such as a higher rate of certain forms of cancer, gall bladder disease, and osteoarthritis.¹¹ Furthermore, obesity itself is a disease associated with self-perpetuating changes in metabolism: The longer you are obese, the more difficult it is to lose weight. Other health effects of obesity are more immediate, such as higher rates of depression, sleep apnea, and negative social impact. As obesity increases, so does physical discomfort with not fitting physically in an environment designed for people of a healthier weight.

Obesity is best prevented or treated by adopting a healthy lifestyle that includes a healthy diet along with sufficient physical activity and starting in young adulthood is not too early. Clearly there is a critical need for lifestyle change for the average young adult, whether to address existing obesity or prevent future obesity and its consequences.

References

1. Zheng Yan, Manson JoAnn E, Yuan Changzheng, et al. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life. JAMA. 2017;318(3):255-269. doi:10.1001/jama.2017.7092.
2. Hutfless Susan, Maruthur Nisa M, Wilson Renee F, et al. Strategies to Prevent Weight Gain Among Adults. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013.
3. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012.. JAMA. 2014;311:806-814. doi:doi:10.1001/jama.2014.732.
4. Poobalan Amudha S, Aucott Lorna S, Clarke Amanda, Smith William Cairns S. Diet behaviour among young people in transition to adulthood (18–25 year olds): a mixed method study. Health Psychol Behav Med. 2014;2(1):909-928. doi:10.1080/21642850.2014.931232.
5. Huang Terry TK, Harris Kari Jo, Lee Rebecca E, Nazir Niaman, Born Wendi, Kaur Harsohena. Assessing Overweight, Obesity, Diet, and Physical Activity in College Students. J Am Coll Health J ACH. 2003;52(2):83-86. doi:10.1080/07448480309595728.
6. Nielsen Samara Joy, Popkin Barry M. Changes in Beverage Intake between 1977 and 2001. Am J Prev Med. 2004;27(3):205-210. doi:10.1016/j.amepre.2004.05.005.
7. Demory-Luce Debby, Morales Miriam, Nicklas Theresa, Baranowski Tom, Zakeri Issa, Berenson Gerald. Changes in Food Group Consumption Patterns from Childhood to Young Adulthood: The Bogalusa Heart Study. J Am Diet Assoc. 2004;104(11):1684-1691. doi:10.1016/j.jada.2004.07.026.
8. Butler Scott M, Black David R, Blue Carolyn L, Gretebeck Randall J. Change in Diet, Physical Activity, and Body Weight in Female College Freshman. Am J Health Behav. 2004;28(1):24-32.
9. Forget Geneviève, Doyon Myriam, Lacerte Guillaume, et al. Adoption of American Heart Association 2020 Ideal Healthy Diet Recommendations Prevents Weight Gain in Young Adults. J Acad Nutr Diet. 2013;113(11):1517-1522. doi:10.1016/j.jand.2013.06.346.
10. CDC. National Diabetes Statistics Report, 2017. 2017.
11. Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol. 2010;316(2):104-108.