AJHE Table of Contents

Does an Effective Theoretically Based Weight Loss Treatment for Middle-Aged Women Work for Young Women?

The prevalence of obesity among U.S. adults has increased from 13.3% in 1960–1962 to 37.7% in 2013–2014. There is considerable evidence that obesity has increased the risk for many chronic diseases, including coronary heart disease, dyslipidemia, hypertension, type 2 diabetes, sleep apnea and respiratory problems, osteoarthritis, gallbladder disease, and certain cancers, and is associated with the deaths from cardiovascular diseases and from all causes. In efforts to stop or slow down the increasing weight among U.S. adults, there have been numerous weight loss programs, among which behavioral weight loss programs that focus on diet and/or exercise behaviors are considered most effective treatments for individuals with obesity.

Though numerous behavioral weight loss programs have been developed for adults with obesity, young adults, especially those aged 25 years and younger, have not been well represented in such trials. Gokee-LaRose et al analyzed data pooled from 3 National Institutes of Health–funded trials and found that less than 1% of the participants were aged 25 years and younger and 7% were aged 35 years and younger. In addition, participants 35 years and younger attended significantly fewer treatment sessions and were significantly more likely to dropout, with a reported 75% lost to follow-up by 6 months. Similar phenomena were also observed by other researchers. For example, in one behavioral obesity treatment that intentionally recruited young adults, 25- to 35-year-olds represented only 25% of the participants and had a significantly higher dropout rates than older participants (73.6% vs 65.2%, P < .05) at month 12. In another study, adults aged 25 years and younger represented 4% of the sample, and 67% of them dropped out of the 12-week low-intensity weight loss program.

The problem of very low participation in weight loss research programs by young adults with obesity is further complicated by the fact that young adults are gaining weight at a much faster pace than their parents. For example, obesity rates among youth aged 12–19 have increased nearly 5 times from 4.6% in 1960s to 20.5% in 2013–2014,2 whereas adult obesity prevalence increased at about half of that pace during the same time period. The average weight gain from the age of 18 to the age of 35 is between 1 and 2 pounds per year and is often more for individuals with high baseline body mass index (BMI). In addition, an increasing number of young people with obesity have been diagnosed with many chronic diseases, such as coronary atherosclerosis, hypertension, and type 2
diabetes, that were only seen in adults in the past and are in more aggressive forms.

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