‘Now I care’: a qualitative study of how overweight adolescents managed their weight in the transition to adulthood

Abstract

ObjectivesA qualitative study of recalled experiences of early adolescent overweight/obesity revealed low levels of weight-related concern. This further analysis aimed to explore weight-related concern and weight-loss efforts as participants transitioned into adulthood.Design, participants and methodsParticipants were 35 young adults from a population-based cohort study who had body mass index (BMI) >95th centile between ages 11 and 15 and participated in semistructured interviews aged 24. At age 24, they were categorised as: ‘slimmers’ (N=13) who had lower BMI Z-scores at 24 than their adolescent peak and were not obese (BMI<30 kg/m2); ‘relapsers’ (N=8, of whom 2 were morbidly obese (BMI>35 kg/m2) at age 24); ‘stable’ (N=3, of whom 1 morbidly obese); and ‘gainers’ (N=11, of whom 5 morbidly obese). Themes were identified and coded using NVivo qualitative data analysis software, blind to participants’ current weight status.ResultsContrasting with the lack of concern recalled in respect of earlier adolescence, weight-related concerns and/or desire to lose weight generally increased around the time of school leaving and almost all participants described some form of exercise (formal/informal) and dietary weight-control strategies. Among ‘slimmers’, there was some (subtle) evidence of more consistent use of exercise, self-monitoring of diet and exercise and of lifestyle changes becoming habitual and/or part of identity. Few participants had accessed professional support. Diet clubs seemed to have been used most by ‘gainers’, some only recently. Labour-market and housing transitions were strong influences, described as facilitating weight losses by some, but increases by others. For some participants, it appeared that weight loss was simply a by-product of these transitions.ConclusionsIn contrast to earlier adolescence, even the heaviest participants tended to show actual weight loss action or preparation for action. The transition to adulthood could thus be a key life stage for interventions.

Experiences of Reframing during Self‐Directed Weight Loss and Weight Loss Maintenance: Systematic Review of Qualitative Studies

“…You have to allow yourself the odd piece of cake or slice of pizza on special occasions” (Couch et al., ). Finally, in a Scottish study looking at weight control in the transition to adulthood, a female participant explained “… and then I dieted and just started … not so much dieted, it just changed the way I ate, rather than actually following Weight‐Watchers or anything like that” (Sweeting et al., ).…”

“…From "diet" to "way of life": Moving away from the word "diet" and towards language such as "the way I eat" or "way of life" was a common use of reframing across studies, and crossed genders, nationalities, and past weight loss trajectories (Couch, Han, Robinson, & Komesaroff, 2014;Frank, 2012;Hindle & Carpenter, 2011;Jaksa, 2011;Karfopoulou et al, 2013;McKee, Ntoumanis, & Smith, 2013;Ross, Brooks, Touchton-Leonard, & Wallen, 2016;Sweeting et al, 2016;Tyler, Allan, & Alcozer, 1997;Witwer, 2014). "Diet" was often shunned because it evoked either a sense of temporariness, a sense of restriction, or both.…”

Young adults' knowledge and attitudes towards cardiovascular disease: A systematic review and meta‐analysis

“…This contradiction may be attributed to a perception among young adults that diet is more significant given that obesity is often the result of an unhealthy diet (Roberts & Marvin, ). Stress scored higher than obesity as an identified risk factor for CVD (49) possibly attributed to perceiving stress as a health issue and obesity as an image issue (Sand, Emaus, & Lian, ; Sweeting, Smith, Neary, & Wright, ). This perceptual difference is important as the majority of young adults sampled in the included studies under rated the significance of obesity as a risk factor for CVD (Garg, Maurer, Reed, & Selagamsetty, ).…”

“…This contradiction may be attributed to a perception among young adults that diet is more significant given that obesity is often the result of an unhealthy diet (Roberts & Marvin, 2011). Stress scored higher than obesity as an identified risk factor for CVD (49) possibly attributed to perceiving stress as a health issue and obesity as an image issue (Sand, Emaus, & Lian, 2015;Sweeting, Smith, Neary, & Wright, 2016). This perceptual difference is important as the majority of young adults sampled in the included studies under rated the significance of obesity as a risk factor for CVD (Garg, Maurer, Reed, & Selagamsetty, 2014 lowest perceived risk and could quite simply be a reflection of the age of the samples of the included study, as it has been argued that young adults have limited knowledge about advancing age and may consider it as something that they do not have to be concerned about for a long time (Lucacel & Baban, 2014).…”

Successful weight loss initiation and maintenance among adolescents with overweight and obesity: does age matter?

“…Indeed, results corroborate qualitative findings by Sweeting et al . , in which adolescents reported their desire to lose weight increased as they aged, as well as work suggesting that adolescents become more autonomous in decision‐making as they aged . Taken together, adolescents who are younger when they initiate weight loss may benefit from increased parental involvement in their weight loss and maintenance efforts, whereas adolescents who are older when they initiate weight loss may benefit from an emphasis on their ability to be independent and self‐efficacious in their weight loss and maintenance efforts.…”