Stress, Anxiety, and Weight Gain among University and College Students: A Systematic Review

Background Stress and anxiety levels are elevated among university and college students. Although high stress levels can lead to an increase in adiposity, it is not clear whether stress and anxiety experienced when in university or college have an influence on students' weight. Objective The aim of this systemic review was to investigate whether stress and anxiety levels encountered during university and college enrollment were associated with higher adiposity or weight changes among students. Method A search strategy was used to identify peer-reviewed studies published between 1985 and March 2017 using the following databases: Medline using Ovid; PubMed, CINAHL using EBSCO, Embase using Ovid, PSYCHINFO, and Open Access Theses and Dissertation. Two reviewers independently assessed the title, abstract, and then the full article of the studies that met the inclusion criteria. Data were extracted and quality assessment was conducted for the included studies. Results Twenty-five observational studies were identified in this review (23 cross-sectional and two longitudinal); 11 found that there was no association between stress and body mass index or weight change. In addition, five studies did not find a significant association between anxiety and body mass index. A few studies revealed stress and anxiety might be associated with higher or lower weight status, thus there is a possibility that stress can increase or decrease weight, demonstrating that a bidirectional influence on body mass index may exist. Conclusions The current data in this review are inadequate to draw firm conclusions about the role of stress on weight change in university and college students. The inconsistency of results in the literature reviewed for this article suggest that a focus on longitudinal studies with adequate sample size would better evaluate the relationship between stress or anxiety and its influence on weight status or weight change among college and university students.