The aims of this prospective cohort study were to examine 16-year trajectories of weight and BMI in young adult women who had a healthy BMI in 1996 and determinants of remaining in the healthy BMI category.
A total of 4,881 women with healthy BMI at baseline and either healthy, overweight, or obese BMI at 16-year follow-up reported their weight, height, health, and health behaviors in six surveys of the Australian Longitudinal Study on Women's Health between 1996 (aged 18–23 years) and 2012 (aged 34–39 years). Determinants of BMI maintenance were estimated using binary logistic regression and generalized estimating equations in 2015.
Almost 60% remained in the healthy BMI category from 1996 to 2012, (mean weight gain, 0.19 kg/year), 29% transitioned to overweight BMI (0.83 kg/year), and 11.6% transitioned to obese (1.73 kg/year). The mean rates of annual weight gain in each group were consistent over time. Only three factors (low alcohol, moderate/high physical activity, having a university degree) were positively associated with maintaining a healthy BMI. Additional behavioral factors (smoking, high sitting time, energy intake, dieting, takeaway food, and use of oral contraceptives), as well as blue collar occupation, separation/divorce/widowhood, and major illness were negatively associated with BMI maintenance.
To prevent the transition from healthy to overweight/obese BMI, weight gain must be limited to <0.5 kg/year. Women with healthy BMI, but with higher rates of weight gain in their early 20s, could be identified by health professionals for assistance with prevention of becoming overweight/obese.