Trajectories and determinants of weight gain in two cohorts of young adult women born 16 years apart

Background: The aims were to compare: (1) baseline weights and weight gain trajectories; (2) sociodemographic, behavioural and health characteristics driving weight gain; and (3) estimated average weight in 20 years’ time, in two cohorts of young women. 

Methods: Data were from 16066 participants in two population-based cohorts of young adult women, born in 1973–78 (“GenX”) and 1989–95 (“millennials”). Weight was reported at baseline (age 18–23 in both cohorts) and 4 years later. High weight gain was defined as >2.5% per year. Data were analysed in 2020. 

Results: Women born in 1989–95 were almost 4 kg heavier at age 18–23 and gained weight over 4 years 1.7 times faster than those born in 1973–78. Prevalence of high weight gain was 34.2% in the 1989–95 cohort and 24% in the 1973–78 cohort. In both cohorts, older age, higher education and high physical activity were associated with lower odds of high weight gain, and more hours in paid work, poorer self-rated health and higher baseline BMI were associated with higher odds of high weight gain. Five factors (outer regional areas, one child, ex or current smoker, high stress and depression) were determinants of high weight gain in the 1989–95 cohort, but not in the 1973–78 cohort. Based on average weight at age 21 and annual percentage weight gain, we estimate that women born in 1989–95 will, on average, be 16.7 kg heavier at age 41 (93.2 kg), than women in the 1973–78 cohort (76.5 kg). 

Conclusion: High weight gain was evident in every sociodemographic group in both cohorts but most evident in millennial women with high levels of stress and depression. Without effective weight gain prevention strategies we estimate that more than 50% of the millennial women will be in the obese BMI category in 20 years. This will have serious economic, health and societal consequences.