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Abstract

Background: Children with overweight or obesity are at greatly increased risk of experiencing obesity in adulthoodbut for reasons generally unknown some attain a healthier adult weight. This qualitative study investigatedindividual, social and environmental factors that might explain diverging body mass index (BMI) trajectories. Thisknowledge could underpin interventions to promote healthy weight.Methods: This 2016 study included participants from three adult follow-ups of children who (when 7–15 years)participated in the 1985 Australian Schools Health and Fitness Survey and provided BMI data at each time point.Trajectory-based group modelling identified five BMI trajectories: stable below average, stable average, increasingfrom average, increasing from very high and decreasing from very high. Between six and 12 participants (38–46years) from each BMI trajectory group were interviewed (n = 50; 60% women). Thematic analysis guided by a socialecological framework explored individual, social and environmental influences on diet and physical activity withinthe work setting.Results: A distinct approach to healthy behaviour was principally identified in the stable and decreasing BMIgroups – we term this approach “health identity” (exemplified by “I love having a healthy lifestyle”). This conceptwas predominant in the stable or decreasing BMI groups when participants explained why work colleaguesseemingly did not influence their health behaviour. Participants in the stable and decreasing BMI groups also morecommonly reported, bringing home-prepared lunches to work, working or being educated in a health-related field,having a physically active job or situating physical activity within and around work – the latter three factors werecommon among those who appeared to have a more distinct “health identity”. Alcohol, workplace food culture (e.g. morning teas), and work-related stress appeared to influence weight-related behaviours, but generally thesefactors were similarly discussed across all trajectory groups.Conclusion: Work-related factors may influence weight or weight-related behaviours, irrespective of BMI trajectory,but the concept of an individual’s “health identity” may help to explain divergent BMI trajectories. “Health identity”and its influence on health behaviour warrants further exploratory work.

Item Type:	Article
Authors/Creators:	Sharman, MJ and Jose, KA and Venn, AJ and Banks, S and Ayton, J and Cleland, VJ
Keywords:	diet, food and nutrition, body weights and measures, body promotion weight, over nutrition, exercise, health
Journal or Publication Title:	BMC Obesity
Publisher:	BioMed Central Ltd.
ISSN:	2052-9538
DOI / ID Number:	https://doi.org/10.1186/s40608-019-0239-3
Copyright Information:	Copyright 2019 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/
Related URLs:	Google Scholar: Jose, KA UTAS Profile: Jose, KA Google Scholar: Venn, AJ UTAS Profile: Venn, AJ UTAS Profile: Banks, S UTAS Profile: Ayton, J Google Scholar: Cleland, VJ
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