College students walk together at their college campus.
Be careful to not allow the freedom (and stresses) of college to become excuses for overindulgence. (For Spectrum Health Beat)

I’m taking a detour away from menopause for a bit to talk about another equally important topic: the Freshman 15.

Whether you’re 20 years old or 40 years old, you have probably experienced this yourself or you know someone who has.

I see women of all ages, and I am frequently asked by my patients how to lose weight or simply not gain any more weight. I’ve spent a great deal of time helping women address weight gain later in life.

But what should you do if you’re in your late teens or early 20s and you’re having weight issues?

For many teens, weight is not an issue during high school because they are so active, participating on a different sports team each season. Other young people deal with weight issues from time to time, so they’re accustomed to the challenges of their teen years.

Their late teens and early 20s, however, may bring some new challenges. When they start that next phase of life—college, or the years immediately after—they’re surprised when their jeans are suddenly tight.

Still others may view the time after high school or college as a way to get out from under their parents’ rules about eating and start making their own choices—sometimes unhealthy—about what to put in their mouths.

No matter which category you fall into, a post-high school life is a perfect time to evaluate your eating habits and decide which ones can help you maintain a healthy weight that is right for you.

Off to college

Let’s discuss a patient I’ll call Lindsey and how college life affected her weight.

Lindsey graduated from high school and went off to Grand Valley State University the following fall. Immediately, she felt like she fit right in—she liked her classes and her dorm, being out of her parents’ home, and all the new friends she was making.

She instantly found herself busy with classes, a club, working part-time, and just “hanging out with friends.”

The cafeteria was easy and convenient, and the food tasted pretty good, complete with a salad bar and just about anything else she could imagine eating. In high school, Lindsey played soccer year-round and never had to worry about her weight.

But in college, things were different. She didn’t play on a sports team and there wasn’t a coach to push her to stay in shape. In addition, her mom wasn’t there to cook for her or pack healthy lunches.

For Lindsey, this was definitely new territory.

The first several months went well for her. She wasn’t too stressed, she slept well most nights, and she stayed fairly active.

But then exams hit. Lindsey worked hard in school and stayed up late most nights, making sure she was well prepared for her exams. She also put in extra time working on a big team project with a group of kids from her class.

As a result of this schedule, Lindsey grabbed whatever convenient food sounded good. This meant eating late and ordering pizza if she missed the cafeteria hours, which happened many times.

Suddenly, she noticed her jeans getting a little snug, but she thought it was because she dried them in the dryer instead of hanging them to dry like her mom always did. When Lindsey went home after finals, all of her pants—even the ones she had left at home—were too tight to wear comfortably.

Lindsey was not happy. When she returned to school, she tried to be more conscientious about what she ate and when, and she even hit the gym occasionally.

Unfortunately, it wasn’t enough. By Christmas she had gained another 5 pounds. By the time she came to see me for her annual checkup at Christmas, she was frustrated and almost didn’t get on the scale.

The perfect storm

Lindsey had hit what we call the perfect storm: increased stress, lack of sleep, late-night snacking, too many carbs, and little or no exercise. It was time to help her change her habits or reset her expectations about her weight. I talked to Lindsey about the five things affecting her weight gain:

  • Stress: When your body is stressed, it goes into survival mode and can mess up your metabolism. In this mode, your body is thinking there won’t be enough food tomorrow, so it wants to store whatever calories come in today. Insulin goes up and calories are stored in the form of fat. If your muscle mass is dropping at the same time, the fat can get stored in the muscles, slowing down your metabolism even more.
  • Sleep: Lack of sleep, to be specific. Decreased sleep, especially at the same time your stress increases, pushes your metabolism even more into storage mode. Women who do not get enough sleep—this even applies to young women—will not lose weight, period.
  • Late-night snacking: Eating late at night promotes weight gain. While it’s true that weight gain is very much related to the theory of “total calories in versus energy out,” timing also makes a difference. This is especially true if you are already overweight or have a higher risk of diabetes. By the end of the day, and especially late at night, the cortisol is down, the insulin is up and your body will tend to store the calories coming in.
  • Diet: A diet high in simple carbohydrates such as cereal, pizza crust, yogurt (the high-sugar kind), sugary drinks, mashed white potatoes, bread and similar items will lead to weight gain. At first you may notice an increase of about 5 to 10 pounds, but if the poor dieting continues, the weight gain will rapidly accelerate.
  • Exercise: Many of us complain that we don’t have time to exercise, but the reality is we must make the time. Exercise is extremely important to help us get into shape and stay in shape. Lindsey thought that by walking to class across campus each day she would be just fine. Plus there just didn’t seem to be enough time for workouts at the gym. This is a similar scenario for many young women.

Lindsey listened to what I had to say and decided to make a plan to get fit. She joined a soccer team that played twice a week, committed to a gym workout twice a week and joined a Saturday morning yoga class.

She made rules for herself about setting a consistent bedtime and no more all-night studying. She also swore off late-night pizza and after-dinner eating, except on weekends. Just as important, Lindsey planned to cut out the simple carbs and add more protein.

Her plan worked.

Lindsey sent me an email letting me know that by spring break, her extra weight had melted away and she felt good about going to the beach.

She had also learned a valuable lesson.