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



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.



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.



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.
MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Helen
H
Sweeting
University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Emily
E
Smith
Department of Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Joanne
J
Neary
School of Medicine, University of Glasgow, Glasgow, UK.
Charlotte
C
Wright
D000293:Adolescent; D015992:Body Mass Index; D000068959:Body Weight Maintenance; D002648:Child; D000072001:Diet, Healthy; D015444:Exercise; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D009042:Motivation; D009767:Obesity, Morbid / Q000523:psychology / Q000628:therapy*; D063766:Pediatric Obesity / Q000523:psychology / Q000628:therapy*; D036301:Qualitative Research; D012574:Schools; D006113:United Kingdom; D015431:Weight Loss; D055815:Young Adult
QUALITATIVE RESEARCH; adolescence; overweight; weight loss; weight management