Eating, Activity, and Weight-related Problems From Adolescence to Adulthood

Introduction

Determining the population-based scope and stability of eating, activity, and weight-related problems is critical to inform interventions. This study examines: (1) the prevalence of eating, activity, and weight-related problems likely to influence health; and (2) the trajectories for having at least one of these problems during the transition from adolescence to adulthood.

Methods

Project EAT I-IV (Eating and Activity in Teens and Young Adults) collected longitudinal survey data from 858 females and 597 males at four waves, approximately every 5 years, from 1998 to 2016, during the transition from adolescence to adulthood. Analyses were conducted in 2017–2018. Measures included high fast-food intake (≥3 times/week), low physical activity (<150 minutes/week), unhealthy weight control, body dissatisfaction, and obesity status.

Results

Among females, the prevalence of having at least one eating, activity, or weight-related problems was 78.1% at Wave 1 (adolescence) and 82.3% at Wave 4 (adulthood); in males, the prevalence was 60.1% at Wave 1 and 69.2% at Wave 4. Of all outcomes assessed, unhealthy weight control behaviors had the highest prevalence in both genders. The stability of having at least one problem was high; 60.2% of females and 34.1% of males had at least one problematic outcome at all four waves.

Conclusions

The majority of young people have some type of eating, activity, or weight-related problem at all stages from adolescence to adulthood. Findings indicate a need for wide-reaching interventions that address a broad spectrum of eating, activity, and weight-related problems prior to and throughout this developmental period.

Introduction

The high prevalence of eating, activity, and weight-related problems during adolescence is of great public health concern, given that adolescence is a period of rapid growth and development,1, 2, 3, 4, 5, 6 and behavioral patterns established during this time may set the stage for adulthood.⁷ If eating, activity, and other weight-related problems persist from adolescence into early adulthood, then young adults, and the future generations they influence as parents, will be at increased risk for developing chronic health outcomes. To inform the content and timing of interventions, it is important to understand the scope and stability of eating, activity, and weight-related problems throughout the critical period from adolescence to adulthood.

The current study examines the prevalence and stability of a broad spectrum of eating, activity, and weight-related factors that have been linked to adverse health consequences. Examining a broad spectrum of eating, activity, and weight-related problems concurrently is valuable for learning about the scope of various problems that may be interrelated and have cumulative impacts on health. The current study thus includes indicator variables from within the domains of eating, physical activity, weight control practices, body image, and weight status that have been found to be associated with adverse health outcomes: high fast-food intake,8, 9 low levels of moderate to vigorous physical activity (MVPA),10, 11, 12 unhealthy weight control practices,¹³ body dissatisfaction,14, 15, 16, 17 and obesity.¹⁸ For example, eating fast food more than twice a week is associated with excess weight gain and increased insulin resistance 15 years later.⁹ Low MVPA predicts elevated all-cause mortality and cardiovascular risk 20 years later.¹⁹ Unhealthy weight control behaviors (e.g., skipping meals, taking diet pills) predict greater weight gain over time¹³ and low body satisfaction is linked to higher rates of binge eating, smoking,¹⁶ depression, and poor self-esteem.²⁰

Research questions to be addressed include: (1) How does the prevalence of eating, activity, and weight-related problems change over time among females and males during the transition from adolescence to early adulthood? And (2) what are the individual trajectories over time for having at least one eating, activity, or weight-related problem in females and males? Examining prevalence over time provides information about the scope of the problems, whereas examining individual trajectories provides information about the stability or consistency of having at least one problematic outcome. Findings will inform the field’s understanding of the scope, timing, and patterns of eating, activity, and weight-related problems across key developmental periods of the life cycle and thus provide important information to guide policies, community- and school-based interventions, and clinical practices.