Healthy weight in college: Why lifestyle matters more than a number on the scale

College represents a period of profound transition. Students are navigating academic pressure, social change, and new independence, often while managing their health without family support for the first time. Amid these shifts, weight frequently becomes a focus. Yet the most important message for college students and campus leaders alike is this: healthy weight is not about achieving a target number on a scale, but about sustaining a lifestyle that supports physical health, mental well-being, and academic success.

Research consistently shows that habits formed during emerging adulthood influence long-term health trajectories.¹ As a result, colleges are uniquely positioned to shape environments that promote healthy behaviors rather than narrow weight goals.

What “healthy weight” really means

Healthy weight is often discussed using body mass index (BMI), but BMI is a limited screening tool. It does not account for muscle mass, genetics, body composition, or overall metabolic health.² More importantly, it says little about how a student feels or functions.

Recent college-specific research demonstrates that lifestyle behaviors such as eating patterns, sleep, and stress management are stronger predictors of weight stability than intentional weight control efforts. For example, students who practiced greater “food conscientiousness” showed less weight fluctuation across an academic term, independent of baseline weight.³

The often-overlooked risks of being underweight

While discussions of college health often emphasize weight gain, being underweight carries its own risks, particularly in young adults whose bodies and brains are still developing.

Underweight students may experience fatigue, impaired concentration, nutrient deficiencies, hormonal disruption, and reduced bone density, which can directly affect academic performance and long-term health.⁴ Importantly, underweight status may reflect food insecurity, chronic stress, excessive exercise, or disordered eating, factors that are prevalent on college campuses.⁵

A lifestyle-focused approach that emphasizes adequate nourishment, regular meals, and recovery, rather than reinforcing thinness as a health ideal, is most effective for campus initiatives.

Health implications of excess weight

Excess weight among college students has been associated with higher rates of elevated blood pressure, abnormal cholesterol, insulin resistance, and sleep disturbances.⁶ These outcomes are closely tied to behavioral and environmental factors common in college life, including irregular schedules, limited access to nutritious food, inadequate sleep, and high stress. Studies show that improvements in dietary quality, such as reducing high-calorie and high-salt foods and increasing fiber intake, are associated with measurable improvements in students’ physical health, yet messaging should shift focus away from weight loss and toward supporting healthier routines and surroundings.⁷ To learn more about the prevalence of obesity among students, and how campus environments can be supportive in fighting its impacts, click here [LINK to obesity article].

Prevalence of eating disorders

National Eating Disorder Awareness Week – February 23 to March 1 – is an annual campaign to raise awareness of the prevalence and realities of eating disorders.⁸  Eating disorders are serious, life-threatening illnesses that often coincide with other mental health conditions, such as anxiety, depression, and substance abuse, and can increase the risk of chronic or contagious diseases.⁹

Eating disorders affect students across genders, races, and body types, and are surrounded by social stigma. Initiatives focused on healthy weight management should center holistic well-being, acknowledge the prevalence of disordered eating, avoid weight-centric or appearance-changing health messaging, normalize screenings and early intervention, and underscore the importance of non-stigmatizing, lifestyle-centered health care, particularly in campus settings.

Weight, mental health, and academic performance

Healthy weight, mental health, and academic success are deeply interconnected. Cross-sectional studies among college students show that irregular eating patterns, poor sleep, and sedentary behavior are significantly associated with anxiety, depression, and poorer self-rated health.¹⁰ 

Weight stigma further complicates this relationship. Multiple studies demonstrate that perceived and internalized weight stigma, rather than weight itself, is associated with disordered eating, psychological distress, and avoidance of healthcare among college students.^11,12 These effects are seen across weight categories.

Sustainable habits for lifelong health

Promoting healthy weight in college is not about defining ideal bodies or enforcing standards. It is about supporting students in meeting their physical and mental needs during a formative life stage.

The most effective approach to healthy weight in college prioritizes sustainable behaviors over numeric goals. These include:

• Eating regular, balanced meals
• Access to affordable, nutritious food
• Enjoyable and inclusive physical activity
• Adequate sleep and stress management
• Early identification and support for mental health and disordered eating concerns

By shifting the conversation away from target numbers and toward healthy living, colleges can reduce stigma, improve student engagement, and foster habits that extend well beyond graduation. Ultimately, a healthy lifestyle, not a number on the scale, is the strongest foundation for lifelong well-being.

Your next read…

In another Campus Health 360 article, we dive deeper into obesity, how it impacts student health, and what college and university-based interventions may help fight obesity on your campus – Obesity: Impact on students and interventions for campus [LINK].

References

1. Bourke, M., Brown, D., & Kwan, M. Y. W. (2025). Lifestyle Behavior Patterns During the Transition From Adolescence to Emerging Adulthood: Associations With Mental Health and Wellbeing. Emerging Adulthood, 13(6), 1381-1394. https://doi.org/10.1177/21676968251376750 (Original work published 2025)
2. Centers for Disease Control and Prevention. (2024). Healthy weight, nutrition, and physical activity. https://www.cdc.gov/healthyweight
3. Shimizu, M., Janke, K., & Rose, P. (2025). Food conscientiousness as a buffer against college students’ weight gain. Frontiers in Public Health, 13, Article 1434091. https://doi.org/10.3389/fpubh.2025.1434091
4. Zerga, A. A., Tadesse, S. E., Ayele, F. Y., & Ayele, S. Z. (2022). Impact of malnutrition on the academic performance of school children in Ethiopia: A systematic review and meta-analysis. SAGE open medicine, 10, 20503121221122398. https://doi.org/10.1177/20503121221122398
5. Bruening, M., Argo, K., Payne-Sturges, D., & Laska, M. N. (2017). The struggle is real: A systematic review of food insecurity on postsecondary education campuses. Journal of the Academy of Nutrition and Dietetics, 117(11), 1767–1791. https://doi.org/10.1016/j.jand.2017.06.022
6. American College Health Association. (2023). National College Health Assessment III: Reference group executive summary. American College Health Association. https://www.acha.org/wp-content/uploads/2024/07/NCHA-III_SPRING_2023_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf
7. Zhang, L., Chen, Y., Wang, S., & Liu, Q. (2025). Impact of dietary habit changes on college students’ physical health. Nutrients, 17(4), Article 512. https://doi.org/10.3390/nu17040512
8. National Eating Disorder Association. (n.d.). National eating disorder awareness week. https://www.nationaleatingdisorders.org/nedaw/
9. National Institute of Mental Health. (2024). Eating Disorders. https://www.nimh.nih.gov/health/topics/eating-disorders
10. Li, X., Zhang, Y., Liu, H., & Wang, J. (2025). Association between healthy lifestyle behaviors and mental health among college students: A cross-sectional study. BMC Public Health, 25, Article 21482. https://doi.org/10.1186/s12889-025-21482-4
11. Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health, 100(6), 1019–1028. https://doi.org/10.2105/AJPH.2009.159491[LM5] 
12. Chang, E. C., Li, M., & Chen, C. (2023). Weight stigma and mental health concerns among college students. American Journal of Preventive Medicine, 65(6), 842–850. https://doi.org/10.1016/j.amepre.2023.07.012