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

Sweeting, H. , Smith, E., Neary, J. and Wright, C. (2016) 'Now I care': a qualitative study of how overweight adolescents managed their weight in the transition to adulthood. BMJ Open, 6(11), e010774. (doi:10.1136/bmjopen-2015-010774) (PMID:27807079) (PMCID:PMC5128912)

Sweeting, H. , Smith, E., Neary, J. and Wright, C. (2016) 'Now I care': a qualitative study of how overweight adolescents managed their weight in the transition to adulthood. BMJ Open, 6(11), e010774. (doi:10.1136/bmjopen-2015-010774) (PMID:27807079) (PMCID:PMC5128912)

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Abstract

Objectives: A 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 methods: Participants 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. Results: Contrasting 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. Conclusions: In 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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wright, Professor Charlotte and Neary, Miss Joanne and Sweeting, Dr Helen
Authors: Sweeting, H., Smith, E., Neary, J., and Wright, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:02 November 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in BMJ Open 6(11):e010774
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727641SPHSU Core Renewal: Setting and Health Improvement Research ProgrammeKathryn HuntMedical Research Council (MRC)MC_UU_12017/12IHW - MRC/CSO SPHU