BACKGROUND Few studies use longitudinal designs to assess patterns of body mass index (BMI) change from adolescence to adulthood or incorporate severe obesity as a unique subgroup. OBJECTIVE To examine patterns of BMI trajectories from adolescence to adulthood and identify demographic characteristics associated with each BMI trajectory pattern. DESIGN Height, weight, and demographic characteristics were drawn from Waves I to V of the nationally representative school-based sample of the National Longitudinal Study of Adolescent to Adult Health (Add Health) conducted from 1994 to 2018 (data collection is ongoing). PARTICIPANTS/SETTING Participants included 3,315 (55.5% female) subjects responding to in-home interviews across all five Waves of Add Health. MAIN OUTCOME MEASURES BMI at each wave modeled over time. STATISTICAL ANALYSES Latent class growth modeling and logistic regression analysis using population sample weights. RESULTS Five classes of weight patterns best fit the sample. Twenty-nine percent of the sample had an always healthy BMI (class 1) and 34.9% changed from healthy weight to overweight (class 2). Moving from healthy weight to obese comprised 21.8% of the sample (class 3). BMI patterns increasing from overweight to obese (class 4) and from obese to severely obese (class 5) comprised 7.6% and 7.1% of the sample, respectively. Weight change was similar for males and females with some racial or ethnic minority participants more likely to be severely obese in adulthood. CONCLUSIONS Results emphasize the importance of tracking weight longitudinally and point to a nationally representative trend of increasing BMI during the transition to adulthood. There was no substantive decreasing trend identified in the sample. Findings highlight the need for effective early and ongoing intervention and prevention strategies and can aid in identification of vulnerable youth who are at the highest risk for moving to problematic weight categories.

中文翻译：

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使用潜在类别增长模型检查从青春期到成年期体重指数变化的纵向模式

背景 很少有研究使用纵向设计来评估从青春期到成年期的体重指数 (BMI) 变化模式，或将严重肥胖作为一个独特的亚组。目的检查从青春期到成年期的 BMI 轨迹模式，并确定与每个 BMI 轨迹模式相关的人口统计学特征。设计 身高、体重和人口统计学特征取自 1994 年至 2018 年进行的全国青少年到成人健康纵向研究（添加健康）的全国代表性学校样本的第一到第五波（数据收集正在进行中）。参与者/环境 参与者包括 3,315 名（55.5% 为女性）在所有五波 Add Health 中对家庭访谈做出回应的受试者。主要结果测量每个波的 BMI 随着时间的推移建模。统计分析 使用人口样本权重的潜在类别增长建模和逻辑回归分析。结果 五类权重模式最适合样本。29% 的样本具有始终健康的 BMI（1 级），34.9% 从健康体重变为超重（2 级）。从健康体重转变为肥胖者占样本的 21.8%（第 3 类）。从超重到肥胖（4 级）和从肥胖到重度肥胖（5 级）的 BMI 模式分别占样本的 7.6% 和 7.1%。男性和女性的体重变化相似，一些种族或少数族裔参与者在成年后更可能严重肥胖。结论 结果强调了纵向跟踪体重的重要性，并指出了在过渡到成年期间 BMI 增加的全国代表性趋势。样本中没有发现实质性的下降趋势。调查结果强调了有效的早期和持续干预和预防策略的必要性，并且可以帮助识别易受伤害的青少年，他们在转向有问题的体重类别方面的风险最高。