nature publishing group
commentaries
Emerging Adulthood and College-
aged Youth: An Overlooked Age
for Weight-related Behavior
Change
Melissa C. Nelson1, Mary Story1, Nicole I. Larson1,
Dianne Neumark-Sztainer1 and Leslie A. Lytle1
Obesity (2008) 16, 2205–2211. doi:10.1038/oby.2008.365
Obesity is a major public health con-
cern, and effective population-wide
intervention strategies aimed at reduc-
ing obesity are needed. Although a
growing body of literature has explored
modifiable determinants of excess
weight gain in adults and, to a lesser
extent, in children, other important
ages have been understudied. Though
once considered to be an age of optimal
health and well-being, the transition
from adolescence to young adulthood
is gaining recognition as an important
time for health promotion and disease
prevention. Not only is the presence of
obesity and unhealthy lifestyle char-
acteristics at this life stage associated
with increased chronic disease risk, but
this also may be a critical time during
which young people establish indepen-
dence and adopt lasting health behavior
patterns. The objectives of this article
are to: (i) describe emerging adulthood
as a developmentally unique life stage,
(ii) highlight epidemiologic evidence
documenting adverse changes in diet,
physical activity, and weight during
this stage, (iii) discuss the influence of
food and beverage marketing targeting
emerging adults, and (iv) illustrate the
need for health promotion and inter-
vention efforts that could target young
adults through settings such as postsec-
ondary institutions.
1
Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA. Correspondence: Melissa C. Nelson
(nels5024@epi.umn.edu)
Received 14 February 2008; accepted 8 May 2008. doi:10.1038/oby.2008.365
obesity | VOLUME 16 NUMBER 10 | OCTOBER 2008
Emerging adulthood: a unique
developmental stage
Over the past 50 years, major popula-
tion-level demographic shifts including
increases in postsecondary education
and delays in marriage and childbearing
have occurred. These shifts have opened
the door for a period of “emerging
adulthood,” typically defined as 18–25
years of age (1). This period is marked
by important transitions such as leav-
ing home and increasing autonomy in
decision-making; however at the same
time, adult responsibilities such as finan-
cial independence and residential and
employment stability are still in flux.
This period of emerging adulthood may
be an important, yet overlooked, age for
establishing long-term health behav-
ior patterns. Several factors differenti-
ate emerging adulthood from other life
stages and have specific relevance to the
formation of health behavior patterns,
including identity development and
shifting interpersonal influences.
One defining characteristic of this
life stage is the development of a self
identity. Emerging adulthood is a time
for the exploration of new ideologies
and behaviors which allow individu-
als to express their individuality. Given
­previous research showing that iden-
tity (e.g., incorporating healthy lifestyle
characteristics in the concept of one’s
perspectives
self) is an important indicator of lasting
health behavior change, emerging adult-
hood may be a particularly important
time for establishing and intervening on
long-term health behavior patterns (2,3).
In addition, other psychosocial attri-
butes associated with beneficial health
behaviors (e.g., self-efficacy) develop or
become established during this period
of emerging adulthood (4), providing
support for the unique importance of
this life stage in long-term behavioral
patterning.
Emerging adulthood may also be
a time for changing support systems
and shifting interpersonal influences.
Although the influence of parents
and family is well established in the
­literature on childhood and, to a lesser
extent, adolescent diet and physical
activity patterns, little research has
examined these issues among young
adults. Young adults spend more lei-
sure time alone compared to other age
group (except retirees ≥55 years) (5)
and are often assumed to be more dis-
connected from their family. However,
some research suggests that closer rela-
tionships with parents (6,7) and sib-
lings (8) may evolve as youth transition
into college and adulthood (9,10). As
youth become more independent, fam-
ily and social network influences begin
to shift and may serve different roles, as
compared to that which they served in
childhood and adolescence. Much addi-
tional research is needed to understand
the evolving social influences in the
emerging adult years and the extent to
which this may influence health behav-
ior patterns. Given the overall paucity
of research in this area, more work is
needed to understand better how the
unique characteristics of emerging
adulthood may contribute to establish-
ing long-term behavioral patterns and
the possible vulnerability of this life
stage to various influences.
2205
perspectives
commentaries
The transition from adolescence to
young adulthood: weight-related
behaviors and influences
The transition from adolescence to
adulthood and the determinants of eat-
ing and physical activity is understudied.
However, national trend data suggest
that this is a risky period for the devel-
opment of obesity, as well as unhealthy
diet and physical activity practices.
Weight gain. Research from national sur-
veys and longitudinal cohorts has identi-
fied the transition between adolescence
and adulthood as a period of increased
risk for excess weight gain. Nationally
representative cross-sectional survey
data from the Behavioral Risk Factor
Surveillance System indicated that from
1991 to 1998, the greatest magnitude of
increase in obesity prevalence was among
18–29-year olds (increasing from 7.1 to
12.1%)  (11). The prevalence of obesity
among young adults more than doubled
in the past 30 years. The most recent
National Health and Nutrition Exami-
nation Survey (NHANES) data indicate
that the prevalence has continued to
increase since 1999 (ref. 12).Currently,
28.5% of 20–39-year olds are obese and
57.1% are overweight or obese (12).
Nationally representative longitudi-
nal cohort data from the National Lon-
gitudinal Study of Adolescent Health
(Add Health) (13), assessing 9,795 ado-
lescents (baseline age: 13–20 years in
1996), found that the 5-year incidence
of obesity was nearly 13% (follow-up
age: 19–26 years in 2001), whereas
only 1.6% shifted from being obese to
nonobese. In comparison to NHANES
(1971–1974), the Add Health cohort
showed ­substantial secular changes in
the BMI distribution over time, par-
ticularly among individuals aged 19–26
years (13). In addition, findings from
the CARDIA (Coronary Artery Risk
Development in Young Adults) (14,15)
longitudinal cohort illustrate both 5-
and 10-year increases in weight among
individuals 18–30 years of age at base-
line (1985). Five-year weight gain was
greater for men aged 18–24 years com-
pared to men aged 25–30 years (14).
Furthermore, the largest 10-year weight
gains were seen among those in their
2206
early- to mid-twenties, as compared to
those in their thirties (15).
Physical activity. Although longitudinal
data are limited, there is evidence of dra-
matic changes in lifestyle characteristics
during this period. Cohort data from
Add Health indicate that although most
adolescents fail to meet national guide-
lines for physical activity (33.6%), even
fewer meet these guidelines as young
adults (12.7%) (16). In addition, find-
ings from Project EAT (Eating Among
Teens), a 5-year longitudinal cohort
study of Minnesota adolescents, confirm
such adverse changes in activity patterns
during the transition from high school
to young adulthood (17). Findings
showed longitudinal changes in moder-
ate to vigorous physical activity, particu-
larly among girls (decreasing from 5.1
to 3.5 h/week aged from 16 to 20 years),
and leisure time computer use, particu-
larly among boys (increasing from 10.4
to 14.2 h/week aged from 16 to 20 years).
Overall, many changes in physical activ-
ity patterns began during the transition
from junior to senior high school and
continued during the transition from
high school to post–high school. One
notable exception is moderate to vigor-
ous physical activity among boys, which
only began to decline during the transi-
tion after high school.
Furthermore, a recent analysis of
the National Health Interview ­survey
data  (18) indicated that age-related
declines in physical activity are par-
ticularly pronounced between 15 and
18  years of age and continue through
age 21. Physical activity has been shown
to decline even further with specific
life events typically following emerg-
ing adulthood (such as ­moving into a
live-in relationship, getting married, and
becoming a parent), but generally do not
appear to continue to decline with age
after mid-adulthood (30–64 years) (18).
Thus health-promotion efforts to increase
activity during emerging adulthood may
be particularly important.
Dietary intake. Research also suggests
that declines in overall-diet quality may
accompany these unfavorable shifts in
activity patterns during the transition
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to adulthood (19,20). For example, fast
food consumption has been associated
with weight gain over time, and find-
ings from national survey data indicate
that fast food restaurant use is highest
in young adulthood: 52% of 20–39 years
reported eating fast food on one or both
days of the Continuing Survey of Food
Intakes by Individuals (1994–1996,
1998) (21). These data also indicate
that soft drink intake is highest among
19–39-year olds compared to other age
groups (22). In addition, NHANES data
illustrate that a majority of young adults
(aged 20–29 years) consume <1 serving/
day of fruit (males 63%, females 59%)
and vegetables (including potatoes,
males 19%, females 20%) (23). Unfor-
tunately, however, the collapsing of ages
19–39 years does not allow for an exami-
nation of the emerging adult period.
Longitudinal findings from Project
EAT also indicate adverse changes in
dietary intake. For example, total fruit
and vegetable intake decreased sig-
nificantly (by >½ serving/day) during
the 5-year transition period after high
school  (24). Add Health data indicate
that fast food consumption markedly
increased and consumption of break-
fast decreased across a 5-year transition
between adolescence and adulthood (25).
The Bogalusa Heart Study (19), a lon-
gitudinal study of a biracial cohort fol-
lowing children >15 years into young
adulthood, also showed a substantial
decline in diet quality as individuals pro-
gressed through this transition. Findings
indicate that individuals consumed less
fruits/fruit juice and milk (19) and more
sweetened beverages, salty snacks, and
beef as young adults (19–28 years) than
as children.
Several studies have reported that
despite changes in diet quality, there is
substantial tracking in dietary intake
between adolescence and young adult-
hood, as well as into later adulthood
(20,26,27). Weight status also shows a
high degree of tracking over time (28).
Thus setting a “trajectory” for ­beneficial
health behavior patterns and dietary
intake during this time may be an
important step toward initiating ­lasting
healthy behaviors. Furthermore, a grow-
ing number of individuals are now

becoming obese during adolescence and
are exposed to a wide array of precursors
to poor-diet quality and ­inactivity before
the emerging adult years. For example,
secular trends suggest declining rates of
family meals and home food prepara-
tion (29), potentially leaving young adults
without the skills to prepare foods and
plan healthful meals on their own. Thus,
challenges lie in reversing the effects of
adverse adolescent exposures during
the emerging adult years and promoting
healthful long-term behavior patterns in
all segments of the population.
Food and beverage marketing: the
coveted emerging adult market
Dietary intake is influenced by a variety
of factors, including individual, interper-
sonal, institutional, and macro-system
influences. Although many of these influ-
ences are thought to be shared by a wide
range of age groups, food and beverage
marketing may be a particularly potent
macro-level influence for emerging
adults. The food, beverage and restaurant
industries are estimated to have spent
>$11 billion on advertising in 2004 alone
(30). Young adults aged 18–24 years are
a highly desirable market, particularly
among fast food and soft drink compa-
nies. Marketing campaigns geared toward
young adults, particularly males, have
brought increased sales to fast food res-
taurant chains in the past decade (31–34).
These campaigns have been specifically
designed to increase product recogni-
tion, sales and brand loyalty among this
group and have been widely promoted in
young adult media markets. A number of
these successful campaigns have targeted
issues such as fast food late night dining
and value pricing (32,35). For example,
in launching its late night “Fourthmeal”
campaign (with “Fourthmeal” marketed
as “the meal between dinner and break-
fast”), Taco Bell cites industry research
in its press release indicating that nearly
50% of males aged 18–29 years are eat-
ing out after 7 pm (32). Industry research
also suggests that young males spend
well above market averages in these vis-
its, averaging over $7.00 (ref. 36). To
our knowledge, similar peer-reviewed
­evidence in the scientific literature is not
available to confirm these trends.
obesity | VOLUME 16 NUMBER 10 | OCTOBER 2008
A number of these successful industry-
driven campaigns have received recogni-
tion from the marketing and advertising
community, for example, receiving EFFIE
Awards (prestigious annual advertising
awards) for their work in effectively tar-
geting young adults. Honored campaigns
include:
• Hardee’s. In 2001, industr y
research found that among its
target markets Hardee’s was “the
most avoided restaurant in the fast
food category” (31). Launching a
major initiative targeting frequent
fast food consumers, the com-
pany conducted “a segmentation
analysis … to create a landscape
from which we selected a more
meaningful target for Hardee’s.
We called this target ‘Young Hun-
gry Guys.’ This group is defined as
young burger eaters (men 16–34)
who want a more adult-like place
to eat the burgers they love. This
group seeks out big burgers as
their food of choice, has the most
growth potential for Hardee’s and
represent the heaviest usage in the
fast food category” (31). With this,
the Thickburger was introduced
(providing ~850–1,400 calories/
burger). As a result, the company
grew from the lowest to the high-
est ranked leading quick-service
restaurant among young male fast
food consumers (31).
• Burger King. In February 2004 after
significantly declining sales, Burger
King refocused its efforts on its
heaviest users, identified as males
aged 16–34 years (34). To do so, they
introduced the large-sized Angus
Steak Burger. Describing its creative
strategy, the marketing team states
that “since the beginning of time,
men have been ­eating large amounts
of meat cooked over fires. For thou-
sands of years, society has been wired
to associate this kind of indulgence
with power, pleasure and status. The
problem is our culture is on an anti-
indulgence craze the likes of which
we have never seen before. Our strat-
egy was to give our target permission
to indulge in a great tasting burger
perspectives
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commentaries
and not apologize for it. And ­nothing
gives them permission better than
the affordable, deeply satisfying fire-
grilled Angus Steak Burger…” (34).
After ­increasing its market share
among young men, this single-menu
item subsequently accounted for 10%
of sales dollars for Burger King.
• Jack in the Box. After suffering
from the bad publicity of a 1993
Escherichia coli outbreak, Jack in the
Box declared that its aim was to cre-
ate “an emotional bond with the ‘core’
of the fast food audience: young men,
ages 18–24. These were the guys vis-
iting fast food most often” (33). They
began a marketing campaign based
on “irreverent” humor to appeal to
this audience, including the “Meaty
Cheesy Boys” campaign (depicting
a spoof of a pop-culture boy band).
Using media sources targeting males
18–24 years, Jack in the Box sales
more than doubled from 1995 ­levels
(to over $2 billion in 2003) (33).
Soft drink companies have also recog-
nized emerging adults as an important
market segment. For example, Moun-
tain Dew has launched major market-
ing campaigns targeting 18–24-year-old
men, with “Do the Dew” advertisements
featuring extreme sportsmen and well-
known professional athletes (37). In addi-
tion to promoting and advertising their
existing soda products through sports,
soft drink companies have reacted to
the diversification of beverage selections
by introducing new products targeting
this age group, such as sports and energy
drinks (e.g., Red Bull, RockStar).
Thus, in summary, though we have lit-
tle in the way of public health initiatives
to promote weight-related health among
young adults, food and beverage market-
ing campaigns, particularly from the fast
food and soft drink industries, have been
heavily targeting this age group over the
past decade to establish brand loyalty and
ensure a future consumer base.
Targeted settings for reaching
emerging adults: postsecondary
institutions
Nearly half (47%) of Americans aged
17–24 years are enrolled postsecondary
2207
perspectives
commentaries
students (38). In considering the devel-
opment of health-promotion initiatives,
such institutions may be well suited for
addressing emerging adult weight-related
behaviors. However, given that this life
stage has long been an overlooked area
of research, particularly in terms of obe-
sity prevention, scant evidence is avail-
able to evaluate ­specific weight-related
behaviors of college ­students. Below we
have summarized the current literature,
which is primarily drawn from 4-year
colleges/universities. There is a striking
lack of research examining weight-related
behaviors among other types of students,
such as those attending 2-year commu-
nity or technical colleges.
Postsecondary obesity and weight
change. Obesity is a major health con-
cern among college-age students. Data
from the 2006 American College Health
Association’s National College Health
Assessment (ACHA-NCHA), an assess-
ment of primarily 4-year institutions,
indicated that the prevalence of over-
weight was ~31% (BMI ≥25 kg/m2 using
self-reported height/weight), including
30% of these individuals who are obese
(BMI ≥ 30) (39).
Among the lay public, there has
long been recognition of the weight
gain ­associated with college entry (the
­“Freshman 15”); however, little research
has explored this issue and its causal
mechanisms. Several small studies have
shown that college enrollment is followed
by substantial weight gain. During the
first 3–4 months of college, students gain
an average of 1.5–6.8 lb (40–45), with
the proportion of overweight or obese
students as much as doubling by the end
of the first semester (42). In particular,
females who leave home to go to college
have been shown to be three to five times
as likely to gain 15% or more above their
ideal weight compared to females who did
not leave home (43), indicating an impor-
tant influence of some element in the col-
lege experience on campus. Furthermore,
previous research suggests that this first-
semester weight gain is specifically linked
to important changes in body composi-
tion (i.e., increased fat mass, decreased
fat-free mass) (44,46). Although some
students lose weight upon college enroll-
ment, it has been estimated that ~70%
2208
gain weight during their first 2 years (47).
Recent research following students across
4 years of enrollment indicates that this
weight gain is maintained over time, with
females on average gaining 3.8 lb and
males gaining 9.3 lb from freshman to
senior year (48). Although some growth
may be attributed to continued gains in
height, particularly among males, many
college youth may be progressing on a
trajectory of excessive weight gain.
Dietary patterns. College students report
poor dietary practices that are likely to
play an important role in unhealthy
weight change during this period.
ACHA-NCHA data indicate that only
6% of students consume ≥5 daily serv-
ings of  fruits/vegetables (39), a finding
which has been consistent in smaller,
regional studies (49,50). A majority of
students have little variety in intake, eat-
ing “the same foods day after day” (51).
Although diet quality may decrease when
students begin their ­freshman year (44),
there appears to be little improvement
in dietary intake throughout the college
years (52). Levitsky et al. (41) found that
~47% of the variation in first-semester
weight gain (~4 lb) was attributable to
basic measures of eating in “all-you-can-
eat” dining halls, snacking patterns, and
eating high-fat “junk food.”
Physical activity and sedentary ­behavior.
The majority of college students also fail
to meet national recommendations for
physical activity. ACHA-NCHA data
indicate that only 42% of students exer-
cised vigorously for ≥20 min or mod-
erately for ≥30 min on 3 of the past
7 days (39). Other research indicates that
during the transition to college, exercise
(particularly aerobic exercise)  (47) and
fitness levels (44) appear to decrease, and
are unlikely to improve as students age
increases (52). In fact, some research-
suggests that upper-level students
(e.g.,  juniors/seniors) spend substan-
tially less time walking and participat-
ing in vigorous activities, compared to
lower-level students (52,53), reflecting
the potential continued decline in these
behaviors over time. Although sedentary
behaviors may also be important deter-
minants of weight status, little is known
about these behaviors among college stu-
dents. In a study of 493 students enrolled
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in conditioning and activity classes (53),
students reported engaging in strikingly
high levels of sedentary behaviors, ~30 h/
week (11 h watching TV/videos, 13 h
studying, 6 h using the computer). More
research is clearly needed to understand
these lifestyle patterns.
Other risk behaviors. In addition to diet
and activity, there are other risk factors
that are prevalent in emerging adults
which may be linked to weight-related
health.
Substance use: ACHA-NCHA data
indicate that 37% of college students
consumed ≥5 alcoholic beverages at one
sitting during the past 2 weeks (“binge
drinking”) (39). Alcohol intake has been
linked with decreased appetite regula-
tion and increased dietary intake in
controlled feeding trials (54). Although
research indicates that binge drinking
is associated with a range of adverse
dietary patterns, sedentary behavior,
and unhealthy weight control among
college youth (55), additional work is
needed to understand better the means
by which these complex behaviors are
related. Similarly, little research is avail-
able to understand the impact of other
substance use (e.g., marijuana, which
11–16% of college youth report using in
the past month) (39) on meal pattern-
ing and weight gain. These are areas that
warrant further investigation and poten-
tially impact on weight status.
Unhealthy weight practices: College-
aged women are at high risk for body
dissatisfaction and unhealthy weight
control practices (56–58). Little research
has explored these issues among college
males. Recent evidence has suggested
that dieting frequency and unhealthy
weight control may be associated with
weight gain (59) and poor-diet quality
(60). There is a need for a better under-
standing of the links between weight
gain and weight-related attitudes and
practices during this age.
Stress, sleep, and mental health: Many
college students perceive increased levels of
stress, originating from a variety of sources,
such as having to adapt to new environ-
ments, the broadening sense of indepen-
dence and self-reliance, and a wide array
of social and other demands  (61,62).
Though stress has been associated with
 perspectives

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commentaries

poor diets, inactivity and a range of
adverse health behaviors among college
youth  (63), the mechanisms through
which these relationships operate are
not clear. In addition, college students
are also susceptible to risk factors, such
as sleep loss and depression, which are
linked with excess weight gain and obe-
sity (61,64). In 2000, 71% of college stu-
dents reported sleep-related problems, a
nearly threefold increase from 1978 (ref.
65,66) and more than twice the percent of
adults in the general population reporting
sleep-related problems (67). Therefore,
college students are at particularly high
risk for adverse effects of sleep loss/prob-
lems, including weight gain and declines
in emotional and mental well being.
Postsecondary campuses: important
targets for weight-related interventions
Approximately 17 million US students
are officially enrolled in one of over
6,000 postsecondary institutions (68). In
addition, college and university enroll-
ment (69) has steadily increased over the
past two decades. Colleges, universities,
and other postsecondary institutions now
serve a wide range of individuals from a
broad array of socioeconomic and racial/
ethnic backgrounds. Implementing effec-
tive interventions in these settings will
likely to have an important impact on
health behavior among a broad range of
at-risk emerging adult groups.
For many emerging adults, the new-
found independence of campus life is
accompanied by the introduction of a
variety of weight-related risks (e.g., “all-
you-can-eat” dining facilities, high alco-
hol consumption) and is a documented
period of weight gain. As students adopt
new health behavior patterns, often liv-
ing away from home for the first time,
college life may set the stage for estab-
lishing important behavioral patterns
that will impact chronic disease risk.
Four-year postsecondary institutions
are well-suited settings for implement-
ing diet and physical activity–related
interventions. Enrolled students
may largely share residential factors
(e.g., dormitories, sororities/fraterni-
ties),  have limited access to off-campus
areas (e.g.,  less than half of US college
students own automobiles (69)), and are
tied to a common health-care system.
Although 2-year postsecondary institu-
tions likely reach an even larger propor-
tions of at-risk groups (e.g., groups of
lower socioeconomic status), virtually
no work to date has documented the
prevalence of weight-related behaviors
on these campuses and the related life-
styles of these students. Although some
of the aforementioned factors (e.g.,
dormitories) may not be applicable to
2-year educational institutions, both 2-
and 4-years settings offer shared eating
environments on campus and learning
and skills-building opportunities in the
classroom for interventions. Despite
the need in this area, researchers have
largely not begun to work with these
institutions to develop, implement and
evaluate nutrition and physical activity
interventions.
In general, large-scale obesity preven-
tion and healthy weight maintenance–
oriented interventions are challenging to
design and implement. To be successful,
such strategies should be evidence-based
and appropriately tailored to suit the
individual needs of the expected target
audience. Although there is a paucity of
epidemiologic research allowing us to
understand the most potent modifiable
determinants of excess weight gain dur-
ing the emerging adult years, we are able
to use the little evidence that is available
to propose important areas for future
research in this area (Table 1). Given the
multiple levels of influence on weight-
related health behavior, as highlighted
by the widely recognized socio-eco-
logical framework, important areas for
future epidemiologic and intervention
research span a range of influences, from
­macro-level to individual-level factors.

Table 1  Targets for future obesity prevention research among emerging adults, across socio-ecological levels of influence
Level of influence Examples of target research areas
Macro-level environments Explore mechanisms through which health-promotion efforts may counterbalance the adverse impact of fast food
and soft drink marketing specifically targeting emerging adults, for example, through media education initiatives or
industry partnerships to promote the sales of more healthful products
Institutional environments Examine how weight-related behaviors and influences differ among students enrolled at various postsecondary
institutions (e.g., 4-year universities vs. 2-year community and technical colleges) to identify the ways in which
successful intervention strategies will need to be modified and tailored to address the individual needs of specific
populations
Identify other settings in which large-scale intervention strategies may be implemented to target emerging adult
populations that are not accessible within postsecondary populations
Examine food environments in postsecondary institutions to identify intervention opportunities related to food
availability, food service styles (e.g., buffet vs. a la carte dining), pricing, and point of purchase nutrition labeling which
may influence dietary intake
Interpersonal environments Examine interpersonal and social influences on meal patterning, dietary intake, and physical activity among emerging
adults to identify intervention opportunities using social networks. For example, social networks and peer leaders
could be used to diffuse skills or ideas for effective weight management
Individual factors Develop intervention strategies targeting other lifestyle characteristics which are likely influential in weight
management among emerging adults (e.g., stress, time management, and sleep insufficiency) and may be offered
through campus health-care delivery systems
Identify ideological motivations for emerging adult health behavior among current and future generations, as well as
how such motivations may be tied to weight-related health behaviors and identity formation, which may
affect long-term behavioral patterns

obesity | VOLUME 16 NUMBER 10 | OCTOBER 2008 2209

perspectives
commentaries
In some cases, lessons learned from
research in other settings (e.g.,  primary
and secondary schools) may be highly
applicable in postsecondary ­institutions.
For example, once observational research
is available to characterize postsecond-
ary campus food environments, exist-
ing school-based strategies to improve
healthy food availability, pricing and
labeling might be successfully adapted
to fit intervention strategies in these
­settings. However, although ­school-based
environmental interventions have gained
much scientific attention in recent years,
important individual-level factors spe-
cific to this age group should not be
overlooked. Emerging adults and col-
lege youth experience many new bar-
riers to healthy lifestyle characteristics
(e.g., high stress, poor sleep, challenges
in time management) and interventions
targeting individual-level skill building
and coping strategies in these areas may
be highly effective in obesity prevention
efforts, particularly when used in combi-
nation with environmental approaches.
Important setting-specific research
also remains to be done, examining
2-year student lifestyles and facilities and
identifying means by which we may be
able to efficiently target emerging adults
who are not attending postsecondary
institutions. Although research in other
areas of health promotion suggests that
emerging adults who are not attending
postsecondary institutions may represent
particularly high-risk youth (70), virtu-
ally no research to date has examined
weight-related health behaviors among
this population, work in this area is lim-
ited by the few mechanisms through we
can reach these youths. Although 2- and
4-year postsecondary institutions may
offer a prime opportunity to develop
health-promotion strategies targeting
large groups of at-risk youth, there is a
continued need to develop mechanisms
through which nonstudents can also be
targeted, ensuring that we do not forget
about the “forgotten half ” (70).
Finally, research is also needed to
explore the ideological motivations for
health behavior, which may also change
for many individuals during the emerg-
ing adult years, particularly as youths
begin to increasingly balance ideologies of
2210
autonomy (where values are focused pri-
marily on individuals’ needs) with those
of community (focusing on responsibili-
ties and obligations to others) (71). This
growing sense of community and com-
mon good may manifest itself in numer-
ous ways that exert an important influence
diet and physical activity–related behav-
iors. For example, environmental concerns
such as sustainable agriculture may result
in choosing to eat locally grown produce or
concern about global warming might lead
to increasing walking/biking for transpor-
tation. Emerging adults may begin to con-
sider their future roles as parents and be
more attentive to staying healthy and prac-
ticing habits related to a healthy lifestyle so
that they will be good role models. Under-
standing the motivations and ideologies of
emerging adults, particularly in the specific
context of diet and physical activity, will be
essential in developing effective health-
promotion messaging and intervention
strategies. Such interventions may be suc-
cessful in drawing upon these ideological
motivations to promote weight-related
health behavior.
In conclusion, much additional
research is needed to understand how
to tailor health-promotion strategies to
best suit the needs of college students
and other emerging adults who are not
enrolled in postsecondary institutions.
Although substantial evidence indicates
that this is an important and vulner-
able period for adverse weight-related
behavior change, little work to date has
sought to understand the modifiable
determinants of weight-related factors
among emerging adults, and few weight-
related intervention strategies have been
developed and tested in this population.
Given that a large proportion of youths
aged 18–24 years enroll in postsecond-
ary institutions, the campus setting
represents a prime setting for health-
promotion intervention efforts targeting
this understudied age group.
DISCLOSURE
The authors declared no conflict of interest.
© 2008 The Obesity Society
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