The transitional period from late adolescence to early adulthood is a vulnerable period for weight gain, with a twofold increase in overweight/obesity during this life transition. Among the 50% of adolescents who attend college, weight gain averages 1.7 kg (females) and 4.2 kg (males) from matriculation to graduation. These increases are compounded by the fact that about one-third of college students are already overweight or obese. The health consequences of overweight and obesity are well established;however, metabolic risks are largely unstudied in this population, with undiagnosed metabolic dysfunction of concern: 26-40% of college students already have one abnormal component of the Metabolic Syndrome. Despite these public health risks and negative health consequences, a gap exists for evidence-based obesity treatment programs targeted to emerging adults (18-26y) and available on college campuses. College campuses make ideal locations from which to launch obesity treatment programs. As of 2009, 70.1% of recent high school completers, including GED recipients, enrolled in college. Additionally, 50% of all adolescents ages 18-19 years old are enrolled in college. The proposed study is based on promising pilot data of a randomized controlled trial (RCT) of 57 college students which demonstrated the initial efficacy of a social media delivered weight loss treatment. To our knowledge, our RCT was the first to examine social media weight loss treatments for college students. The next step in this research is to examine whether this type of program can be translated to other college campus communities. Thus, we propose to randomly assign 450 overweight/obese college students (ages 18- 26) enrolled at two colleges (George Washington University and University of Massachusetts-Boston) to one of two social media weight loss treatments (Tailored or Targeted) or a contact control. The social media treatments consist of Facebook groups to provide social support, connectedness and intervention content, as well as daily text messages. We posit that the use of a social media as an intervention tool will appeal to this age group who are accustomed to technology use. Assessments will be conducted at baseline, 6, 12, and 18 months post baseline, with the primary outcome being weight loss at 18 months. The secondary aim is to evaluate changes in metabolic risk factors among those participants who have maintained at least 5% weight loss at 18 months. Finally, we will conduct additional formative work to evaluate the implementation feasibility of this intervention on college campuses, including an assessment of costs as well as the sustainability infrastructure using the PRISM (Practical, Robust Implementation and Sustainability Model) model as a guide. The results of this study have the potential to significantly impact the delivery of obesity treatment services on college campuses.
Obesity is a public health problem of critical importance, especially among young adults as they transition to adulthood. The college years (ages 18-26) mirror public health risk periods for weight gain and metabolic risk, intersecting with a nearly twofold increase in overweight and obesity. This project has significant public health impact as successful translation could reach as many as 6.2 million overweight/obese college students each year, and change the current standard of practice within college campus communities.