July 22, 2022
Obesity Care in College Students in the US
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While obesity is a global problem, college students in the United States are among the most affected populations (1,2). A significant number of college students gain weight during their college years. Almost 1 in 3 college American students have obesity presently (1). According to a survey in 2021, 44% of college students in the US described their weight as more than normal, i.e., either in the overweight or obese category. Despite this, there is limited progress in addressing the problem of obesity among college students.
Obesity has a substantial negative impact on students, including their overall well-being and academic performance (6). Obesity is a risk factor for a variety of health conditions, including diabetes, cardiovascular disease, and hypertension (7). Obesity can negatively impact the grades of students. Specifically, it causes a working memory deficit among many students with obesity. Obesity poses a detrimental effect on mental health and lowers self-esteem (6).
What contributes to obesity in college?
Two of the most significant causes of obesity among college students are poor food choices and large meal portions. Once a student leaves his or her home, he or she becomes responsible for buying groceries, meal choices, cooking methods, etc. Many students are doing this for the first time in their lives. This, coupled with the limited financial budget, makes their choices even more difficult. Hence, the tendency to do the easiest thing is to grab the first item available to eat at the lowest cost.
College students live a stressful life with hectic schedules and multiple assignment deadlines to meet. Unhealthy eating or snacking related to stress and late-night studying further add to their poor habits (4).
Consumption of alcohol is rampant among college students and is typically not seen as being a risk factor for obesity. A recent study showed that more than 80% of college students drink alcohol, and more than half of them report binge drinking (3,4).
As college students get involved in their busy work schedules and social lives, they find less time to indulge in physical activity. They spend a lot of time sitting in classes, completing assignments on computers, or using social media, which results in “limited movement” throughout the day (4).
What can college students do to develop healthy habits and prevent weight gain?
Prevention and treatment of obesity boil down to changing a person’s behavior as well as building and sustaining healthy habits (1,4 14). It is time that we re-consider dorm meals, a lot of which offer limited food options and are “unhealthy.” Moreover, there is no rationing of the food, and students are allowed “unlimited refills.” This can lead to increased consumption of food and, thus, weight gain. Students should be taught the responsibility of arranging their meals so that they become comfortable in independently making healthier choices. They may consider skipping the college meal plan if they are comfortable with this responsibility. Eventually, this may be a healthier and more cost-effective method for a student. Creating one’s budget, shopping for groceries, buying healthier food items, and cooking meals have been shown to help develop positive habits that assist in losing weight. A general rule of thumb for a healthy eating plate would be to include (4,9,10,11,12,13,14):
- Vegetables and fruits ½ of the plate
- Whole grains ¼ of plate
- Proteins the remaining 1/4th of the plate
- Consumption of fats and oil in moderation
- Drinking at least 64 oz. of water. Cutting back on alcohol intake and eliminating sugars.
Create realistic goals and plans. Pre-planning how much one will eat out at the restaurant that night or that week, what groceries to buy from the store that week depending on the leftovers etc., allows one to be mindful in their eating. Stocking up on low-cost nonperishable snacks like nuts, cheese, hard-boiled eggs, oatmeal, and fruit cups. Consider eating non-organic fruits and vegetables, which are usually cheaper. Explore the options for grocery stores that are more affordable such as ALDI, Walmart, Trader Joe’s, etc.
Learning to navigate through stress by practicing mindfulness and meditation has proven to be helpful. Having a structure for the day is key (4). Avoiding all-nighters and developing healthy sleeping habits are important. Avoid procrastinating work to prevent stressing out when the deadlines are approaching. Several meditation/mindfulness tutorials are free of cost on YouTube, podcasts, and apps such as Headspace (basic plans). Student discounts are also available on many such services.
Staying physically active is very important. One simple way in which students could increase their daily physical activity would be walking to class and taking stairs instead of elevators. Most universities offer free or affordable access to recreational facilities and gyms. Finding a fitness buddy and engaging together in activities such as yoga, dance, and swimming could be an enjoyable time to burn calories. Getting involved in a sports club or a league could offer participation in some vigorous physical activity routinely. Investing in buying a cheap pedometer could help track daily step counts (4,15,16).
What can colleges do regarding obesity care for their students?
One of the strategies that have been employed by colleges is the provision of obesity prevention education. Some colleges have also developed “Weight-gain prevention programs” for the students. These programs offer access to education about nutrition, group physical activity classes, and psychological coaching for developing healthy, sustainable habits. Universities could consider including financial wellness and health wellness in the orientation agenda during admissions. Thereafter, it could be discussed annually in their well-being visit with a campus nurse or physician (5).
Having a variety of healthy foods in the cafeteria and changing menus regularly is another way to provide nutritious food to the students. Another way colleges can improve dorm meals is by analyzing demographic distribution in each admission cycle and catering menus to changing demographics. For example, a college with having high Hispanic students must include an array of healthy meals catering to their palate. College cafeterias can also label foods with green/yellow and red stickers to indicate which food is healthy and ingestion of what foods should be limited. The colleges could consider affiliating with local grocery stores offering coupons and lower rates for groceries to their college students. Colleges could also partner with local farmers’ markets and potentially hold a weekly farmers market on the campus offering affordable healthy groceries to their students (9,10,11,12,13,14).
Last but not least, it is essential that college students understand that, most of the time, obesity is an acquired condition and that genetics play a role in a few cases (8). Obesity can be controlled/treated with appropriate strategies. Education about building healthy habits should ideally start when they are still at home and school. Our children are the future of our society. Raising healthy adults is just as important as, if not more, raising professionally qualified students. It is, therefore, upon every institution, school, public health stakeholders, parents, and eventually, the students to focus on developing healthy eating and exercising to curb obesity in this very important population.
1) Alejandra Ellison-Barnes, MD, MPH, assistant professor, medicine, Johns Hopkins University School of Medicine, Baltimore; Caroline Apovian, MD, co-director, Center for Weight Management and Wellness, division of endocrinology, diabetes, and hypertension, Brigham and Women's Hospital, Boston; Journal of the American Medical Association, Nov. 23, 2021 (https://www.usnews.com/news/health-news/articles/2021-11-23/almost-1-in-every-3-college-age-americans-are-now-obese) 2) Sparling PB. Obesity on campus. Prev Chronic Dis. 2007;4(3): A72. 3) Valerie Strauss, How much do college students really drink?, The washington post, 2013 4) Timon Kaple, Obesity awareness and resources for college students, Edumed, 2021 https://www.edumed.org/resources/college-obesity-awareness/ 5) Obesity prevention education has positive impact on college students, study finds, UNC global school of Public health, 2016 https://sph.unc.edu/sph-news/obesity-prevention-education-has-positive-impact-on-college-students-study-finds/ 6) Anderson AS, Good DJ. Increased body weight affects academic performance in university students. Prev Med Rep. 2016;5:220-223. Published 2016 Dec 28. doi:10.1016/j.pmedr.2016.12.020 7) Field AE, Coakley EH, Must A, et al. Impact of Overweight on the Risk of Developing Common Chronic Diseases During a 10-Year Period. Arch Intern Med. 2001;161(13):1581–1586. doi:10.1001/archinte.161.13.1581 8) McPherson R. Genetic contributors to obesity. Can J Cardiol. 2007;23 Suppl A(Suppl A):23A-27A. doi:10.1016/s0828-282x(07)71002-4 9) National Prevention Council. (2011). National prevention strategy: America’s plan for better health and wellness. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General. 10)Cason, K. L., & Wenrich, T. R. (2002). Health and nutrition beliefs, attitudes, and practices of undergraduate college students: A needs assessment. Topics in Clinical Nutrition, 17(3), 52 11) New York State Department of Health. (2009, October). Guidelines for healthy meetings. New York State Department of Health. 12) Center for Disease Control and Prevention. (2010, March). The CDC guide to strategies for reducing the consumption of energy dense foods. Atlanta, GA: U.S. Department of Health and Human Services 13) White House Task Force on Childhood Obesity. (2010). Solving the problem of childhood obesity within a generation: White House Task Force on Childhood Obesity report to the President. Washington, DC: Executive Office of the President of the United States. 14) Nutrition, NYU, https://www.nyu.edu/life/safety-health-wellness/live-well-nyu/priority-areas/nutrition.html 15) Martinez YTS, Harmon BE, Nigg CR, Bantum EO, Strayhorn S. Diet and Physical Activity Intervention Strategies for College Students. Health Behav Policy Rev. 2016;3(4):336-347. doi:10.14485/HBPR.3.4.5 16)Schaben JA, Furness S. Investing in college students: the role of the fitness tracker. Digit Health. 2018;4:2055207618766800. Published 2018 Apr 4. doi:10.1177/2055207618766800