This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.
More than one third of college students who are overweight or obese are in need of weight loss programs tailored to college students. However, the availability and accessibility of these programs is unknown.
The aim of this study is to examine the availability and ease of access to weight loss programs for students at 10 universities with the largest undergraduate enrollment.
The 10 public universities with the largest student bodies with a mean (SD) undergraduate enrollment of 41,122 (7657) students were examined. The websites of the universities were assessed to determine the availability of weight loss programs. Services for high-risk health needs common to university campuses (ie, alcohol and other drugs, victim services, sexual health, and eating disorders) were searched.
Of the universities searched, 3 (30%, 3/10) offered weight loss programming, however, none met the predetermined criteria. Comparatively, all schools (100%, 10/10) offered no-cost and continual enrollment programming for the other high-risk health needs.
There are limited weight loss services available to undergraduate students compared with other university services. Collaboration between existing college health service providers is suggested for the delivery of appropriate programming for overweight and obese undergraduates wanting to lose weight.
College campuses provide a foundation for the development of lifelong behaviors for over 70% of young adults between the ages of 18 and 24 who enroll in college [
Services for high health risk needs, like alcohol and other substance use, eating disorders, sexual health services, and victim services are generally recognized as critical to ensure the health of undergraduate students and other university members. However, the prevalence of the high health risk needs requiring services on college campuses varies dramatically. For example, the prevalence of undergraduate students with alcohol use disorders ranges between 20.4% [
As with the services for high-risk needs described above, colleges have the unique opportunity to address weight and weight-related topics to further ensure the health of their student body. Average weight gain from college matriculation to graduation ranges from 3.5 pounds [
Despite this public health concern, there remains a need on campuses for weight management services tailored to undergraduates [
Research suggests that weight gain [
This study examines the availability and ease of access of weight loss programs for undergraduate students compared to existing services for other high-risks health needs (ie, alcohol and other drugs, eating disorders, victim services, and sexual health).
The 10 public universities with the largest undergraduate student bodies, with a mean (SD) undergraduate enrollment of 41,122 (7657.4) students, were identified using the 2013 US News and World Report College Guide [
Structured searches of university pages using standardized search terms were conducted over a period of 4 months (July 2013 to October 2013). Search terms were typed into the university’s main page by 3 independent coders (2 undergraduate and 1 graduate research assistants). Phone calls were placed to university health, counseling, and wellness centers to confirm the Web search findings.
Search terms were initially selected through a brief survey of undergraduate students that asked students to identify what term they would use to search for weight loss services on their campus. The suggested search terms were reviewed by 2 clinical psychologists and a registered dietitian with experience in the development and delivery of undergraduate weight loss programming, as well as by 2 undergraduate and 2 graduate research assistants. A total of 15 key terms were used to search for student-specific weight loss programs using the search box found on the home page of the respective universities: diet program, weight loss program, losing weight, fitness program, nutrition counseling, nutritionist, dietician, dietitian, exercise facility, weight watchers, student weight loss, student diet program, student weight loss program, weight management, and student weight management
Search terms for traditional high-risk health services offered on university campuses (ie, alcohol and other drugs, victim services, sexual health, eating disorders) were included to compare the availability of these services to student weight loss services. These terms were also typed in the search box found on the home page of the respective universities.
Search terms were additionally typed into the search box on the student health services page and university counseling pages to ensure no programs were not found due to website-derived search algorithms unknown to the research team.
The aforementioned clinical psychologists established criteria prior to the webpage reviews. In order to be coded as a weight loss program, the program must have been undergraduate student-specific, offered on campus, no additional cost, and delivered by university-funded treatment providers. Results were also coded as “related weight loss services” (missing one or more of the weight loss program criterion, fee-based weight loss program, nutrition counseling, personal training, research on college student weight loss or community-based weight loss program), or no weight loss program (group fitness programs, academic research with a focus outside the scope of college student weight loss, nutrition and physical activity handouts).
Two undergraduate and one graduate research assistant piloted the search terms on 4 large (undergraduate student enrollment greater than 30,000 students) test universities, which were randomly selected from a list of universities from the US News and World Report [
Although the predetermined criteria were not met, the following 3 universities offered some weight loss programming: (1) University of Minnesota offered a weight loss program for their undergraduate students; however, the 12-week program for undergraduates cost US $250, (2) Florida International University offered an 8-week program for undergraduate students inspired by the Biggest Looser for US $80, and (3) University of Texas-Austin offered a 12-week program exclusively to graduate students for US $60. Phone calls placed to university health, counseling, and wellness centers verified the results. The aforementioned programs had discrete enrollment periods. Two other universities offered short-term programs, but there was no confirmed plan to continue those regularly beyond the planned dates of the one program. For the purpose of this paper those programs were not included.
The results of our findings are shown in
Three schools offered weight loss programming, however, none met the predetermined criteria. Comparatively, all schools offered no-cost and continual enrollment programming for the other high-risk health needs. Given the current prevalence of overweight and obesity among college students and the demonstrated weight gain during college, there is a need for obesity-related services on campuses. Universities have competing wellness priorities for their students, and they may designate resources for those behavior and health risks that have more immediate negative consequences such as suicide or alcohol-related death or injury [
The focus of weight management on college campuses may reflect changes in health services mandated by the Affordable Care Act (ACA). Students are now able to remain on their parents’ insurance until the age of 26 years old [
The largest public universities and the health services offered (N=10).
University | Number of studentsa | Weight loss program | Victim services | Sexual health | Alcohol and other drugs | Eating disorder treatment |
University of Central Florida | 51,269 | 0b | Xc | X | X | Rd (only screening offered) |
Texas A&M | 44,315 | 0 | X | X | X | X |
Ohio State | 44,201 | 0 | X | X | X | X |
Penn State | 40,085 | 0 | X | X | R (fee) | X |
University of Texas at Austin | 39,979 | R (fee; only for graduate students) | X | X | X | X |
Florida International University | 39,045 | R (fee) | X | X | X | X |
Arizona State University | 38,735 | 0 | X | X | X | X |
Michigan State | 37,988 | 0 | X | X | X | X |
University of Minnesota | 34,449 | R (fee) | X | X | X | X |
University of Florida | 33,168 | 0 | X | X | X | X |
aAcademic year 2013-2014.
b0 is no program.
cX is a program that meets established criteria.
dR is a related program that does not meet established criteria for program.
Despite these opportunities, colleges and universities are faced with a number of demands in terms of academic and health-related priorities and limited funds. Examining the barriers and facilitators on college campuses to delivering weight loss programming is an important step in understanding the broad scale implementation and acceptability of these programs. One on-going project, funded by the National Institutes of Health (DK 100916), is examining the efficacy of using social media and text messaging for delivering weight loss programming to college students on 2 different campuses [
A 2011 analysis of the American College Health Association-National College Health Assessment (ACHA-NCHA) database found that the top two most trusted sources of health information were health center medical staff and health educators [
For these and other reasons, a multidisciplinary approach to disseminating and marketing a weight loss program specific to college students is critical. Collaboration with the counseling center may be particularly important. The is concern that weight loss services on college campuses may promote disordered eating and/or eating disorders in a vulnerable college population [
There is literature suggesting that there may be a common underpinning for both excessive weight gain and eating disorders. These shared experiences and characteristics are dieting, media use, body image dissatisfaction, and weight-related teasing [
While many university health officials and administrators recognize the need for an environment that promotes healthy weight loss practices and relevant programming, there are a number of challenges faced by these key leaders on campus. There are competing priorities for resources, time, as well as other behavioral and health needs with more immediate consequences [
This study provides only a snapshot of the availability and ease of access to weight loss services on college campuses. Only the websites of the ten largest public universities were reviewed, limiting the search and possibly ignoring student weight loss programs available at smaller and/or private universities. Universities often update their webpages so that recent content is pushed to the top of searches, so it is possible that the results presented here were influenced by search mechanisms unknown to the study authors. Lastly and importantly, this study was not able to determine the extent of the utilization of available weight loss services by university students.
This study examined the avaliability and ease of access to weight loss programs for college students. The results highlight that there are limited weight loss services available and accessible to college students when compared to other university services, such as alcohol and other drugs, eating disorders, sexual health, and victim services.
Advocacy from student groups and collegiate administrators is called for to provide treatment and reduce stigma regarding accessing resources specific to weight loss for overweight and obese students wanting to lose weight.
Affordable Care Act
body mass index
We would like to acknowledge Stephanie Goldstien and Jana Howard, who helped with the coneptualization of this project. Additionally, we would like to thank Hillary DeCarl for her assistance in coding the webpages.
This project was partially funded by an internal grant from The George Washington University Food for Thought Initiative.
None declared.