Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health

Background: No nationally representative longitudinal data have been analyzed to evaluate the incidence of obesity in the transition between adolescence and adulthood. Objective: The objective was to examine dynamic patterns of change in obesity among white, black, Hispanic, and Asian US teens as they transitioned to young adulthood. Design: We used nationally representative, longitudinally measured height and weight data collected from US adolescents enrolled in wave II (1996; ages 13-20 y) and wave III (2001; 19-26 y) of the National Longitudinal Study of Adolescent Health (n = 9795). Obesity incidence was defined on the basis of International Obesity Task Force (IOTF) cutoffs (wave II), which link childhood body mass index (BMI) centiles to adult cutoffs (BMI greater than or equal to 30; wave III), for comparability between adolescence and adulthood. In addition, the more commonly used cutoff of BMI greater than or equal to 95th percentile for age- and sex-specific cutoffs from the 2000 Centers for Disease Control and Prevention growth charts for adolescents (wave II) were compared with adult cutoffs (BMI greater than or equal to 30; wave III). Results: On the basis of the IOTF cutoffs, obesity incidence over the 5-y study period was 12.7%; 9.4% of the population remained obese and 1.6% shifted from obese to nonobese. Obesity incidence was especially high in non-Hispanic black (18.4%) females relative to white females. The prevalence of obesity increased from 10.9% in wave II to 22.1% in wave III, and extreme obesity was 4.3% at wave III on the basis of a BMI greater than or equal to 40. Conclusions: During a 5-y transitional period between adolescence and young adulthood, the proportion of adolescents becoming and remaining obese into adulthood was very high. This upward trend is likely to continue. Effective preventive and treatment efforts are critically needed.