How Does Obesity Affect College Students?  

Dr. Christopher McGowan
September 15, 2023

The transition to college is a pivotal moment in the lives of young adults, marked by newfound independence, exciting opportunities, and countless lifestyle changes. This whirlwind of changes can be hard to manage for some young people, though, and the consequences are often surprising. One such phenomenon—sometimes referred to colloquially as the “freshman fifteen”—is the tendency for American college students to gain extra body weight in their first year. This tendency isn’t limited to freshmen of course, and in fact college campuses are just as susceptible to the nationwide obesity epidemic as any other place. 

How Is Obesity Defined? 

The Centers for Disease Control and Prevention (CDC) estimates that the prevalence of obesity is around 42% in America; this represents a significant increase (up from 30%) from a decade earlier. Moreover, the prevalence of severe obesity increased from 4.7% to 9.2%. Apart from the various health conditions linked to obesity, there is also an undeniable stigma associated with even a small amount of excess body weight. This can cause intense emotional stress for some as well as confusion over how obesity is actually defined.  

For doctors, the terms “overweight” and “obese” are meant to indicate a level of excess body fat that is enough to begin affecting a person’s overall health and well-being. This threshold of potential negative health outcomes is measured and defined by a tool called body mass index (BMI). BMI is calculated by dividing a person’s weight in kilograms by the square of their height in meters; while imperfect and limited (in part because it doesn’t take into account things like bone density or muscle mass), BMI is useful in determining the likelihood of an obesity problem in a given individual. Below are the different categories of BMI:   

  • Underweight: BMI less than 18.5
  • Normal weight: BMI between 18.5 and 24.9
  • Overweight: BMI between 25 and 29.9
  • Obesity (Class I): BMI between 30 and 34.9
  • Obesity (Class II): BMI between 35 and 39.9
  • Obesity (Class III): or severe obesity): BMI of 40 or higher

Health Risks of Obesity

In popular culture, being overweight or obese is often presented as an aesthetic problem that is mostly about not looking thin or fit enough compared to one’s peers. This kind of pressure to look a certain way (largely driven by social media these days) is a major issue in terms of mental health, but it isn’t really a consideration when it comes to public health interventions and the effort to reduce obesity rates. Instead, the most important of obesity prevention or treatment is to improve outcomes for a variety of obesity-related conditions

  • Cardiovascular disease: One of the biggest health risks related to obesity is the increased chance of developing heart disease, a collection of conditions that includes coronary artery disease, heart attack, stroke, and high blood pressure (hypertension). Many of these conditions are driven by arterial plaque buildup related to unhealthy eating habits and a lack of physical activity.  
  • Type 2 diabetes: Obesity is also a significant risk factor for the development of type 2 diabetes, a chronic metabolic disorder that is characterized by high blood sugar and problems producing insulin. Carrying extra body fat can lead to insulin resistance, where the body’s cells do not respond properly to insulin; this means that the body starts producing less insulin and the insulin that is produced is less effective. Over time, this can eventually become diabetes.  
  • Sleep apnea: Obesity can also cause problems related to breathing and sleeping, as in the case of sleep apnea. Sleep apnea is a sleep disorder that involves repeated interruptions to restful sleep because of breathing problems. Both the accumulation of fat deposits and chronic low grade inflammation (which are common in obesity) are factors in the development of sleep apnea. 
  • Joint problems: In general, carrying excess body weight places additional stress on the joints of the knees, hips, and spine. This can accelerate the breakdown of cartilage and lead to osteoarthritis, a degenerative joint disease that can cause pain and difficulty moving around.
  • Certain cancers: Obesity is also a risk factor for several types of cancer, including breast, colon, prostate, ovarian, and pancreatic cancer. 
  • Shortened lifespan: The numerous ways overweight and obesity can negatively impact overall health is also why it is generally associated with premature death or lower life expectancy. 

Obesity and University Students      

Most adolescents in high school still live with their parents, and this often means more access to healthy food options. By the time they get to college, though, concerns about healthy eating or weight status tend to become relatively less important. This shift from a student being under the influence of parents and teachers to making their own lifestyle choices is a significant part of why college students may struggle with weight management and maintaining a healthy weight. Indeed, many students are surprised when they step on the scale and discover that their body composition has changed.       

There are a number of factors that make a college campus a prime location for weight gain. First, since universities don’t usually have strict physical education requirements, a lot of young adults who arrive on campus have a fairly sedentary life of studying and lazing around dorm rooms. As almost every health care provider would be quick to point out, regular physical activity or exercise are crucial for a healthy lifestyle; but having a full class load and new friends and countless extracurricular activities can make it difficult to live a balanced life. 

Also, even though college campus cafeterias usually have healthy food choices available, they may not seem appealing compared to fast food and other high calorie foods. An otherwise healthy young adult might almost inadvertently begin to develop poor dietary habits simply because of the unique situation. Some students may gain some extra weight during their first year and then eventually return to a healthy weight. But for others, a pattern can start that leads to a much longer-term change in eating habits. 

Sustainable Long-Term Weight Loss     

The unfortunate truth is that college students are just as susceptible to gaining weight as other demographic groups. The environment of a college campus and the unique season of life can create a situation where unhealthy eating habits become the norm. Over time, this can lead to weight gain; and while gaining a little weight during your college years isn’t a definite path to obesity, the associated eating habits can be hard to change once they become engrained. 

Whether you’re a college student or long out of college, obesity can lead to a variety of health problems. Yet making lifestyle changes and losing weight is much easier said than done. That’s why at True You Weight Loss, we are dedicated to helping people start on a new path to a healthy weight. If you’d like to learn more about how True You can help you find the freedom you’ve been looking for, please contact us today to request a consultation.  

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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