• Jonathan Chu, Kyle T Ganson, Eric Vittinghoff, Deborah Mitchison, Phillipa Hay, Jennifer Tabler, Rachel F Rodgers, Stuart B Murray, and Jason M Nagata.
• Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
• J Gen Intern Med. 2021 Sep 1; 36 (9): 2622-2630.

BackgroundCommunity sample data indicate that weight control efforts in young adulthood may have associations with greater increases in body mass index (BMI) over time.ObjectiveTo determine the prospective associations between weight goals and behaviors in young adults and BMI trajectories over 15-year follow-up using a nationally representative sample.DesignLongitudinal cohort data collected from 2001 to 2018 of the National Longitudinal Study of Adolescent to Adult Health.ParticipantsYoung adults aged 18-26 years old at baseline stratified by gender and BMI category.Main MeasuresPredictors: weight goals, any weight loss/maintenance behaviors, dieting, exercise, disordered eating behaviors.OutcomesBMI at 7- and 15-year follow-up.Key ResultsOf the 12,155 young adults in the sample (54% female, 32% non-White), 33.2% reported a goal to lose weight, 15.7% to gain weight, and 14.6% to maintain weight. In unadjusted models, all groups have higher mean BMI at 7- and 15-year follow-up. In mixed effect models, goals to lose weight in men with BMI < 18.5 (5.94 kg/m2; 95% CI 2.58, 9.30) and goals to maintain weight in men with BMI ≥ 25 (0.44; 95% CI 0.15, 0.72) were associated with greater BMI increase compared to no weight goal. Engaging in disordered eating behaviors was associated with greater BMI increase in men with BMI < 18.5 (5.91; 2.96, 8.86) and women with 18.5 ≤ BMI < 25 (0.40; 0.16, 0.63). Dieting (- 0.24; - 0.41, - 0.06) and exercise (- 0.31; - 0.45, - 0.17) were associated with lower BMI increase in women with 18.5 ≤ BMI < 25. In women with BMI < 18.5, dieting was associated with greater BMI increase (1.35; 0.33, 2.37).ConclusionsWeight control efforts may have variable effects on BMI over time by gender and BMI category. These findings underscore the need to counsel patients on the effectiveness of weight control efforts and long-term weight management.© 2021. The Author(s).

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