Objective: To assess weight changes, exercise and diet behaviors among college students from the beginning of freshman year until the end of senior year. Design: Longitudinal observational study. Setting: Private university in St. Louis, Missouri. Participants: College students (138 females, 66 males). Main Outcome Measures: Weight and height were measured, body mass index (BMI) was calculated, and exercise and dietary behaviors were assessed by questionnaire. Analysis: Changes in weight, BMI, exercise, and dietary patterns from the beginning of freshman year to the end of senior year. Results: Females gained 1.7 [plus or minus] 4.5 kg (3.75 [plus or minus] 9.92 lb) [mean [plus or minus] SD] from freshman to senior year, and males gained 4.2 [plus or minus] 6.4 kg (9.26 [plus or minus] 14.11 lb) (both P [less than] 0.001). Weight changes were highly variable between students, however, ranging from -13.2 kg to +20.9 kg (-29.10 to +46.08 lb). Conclusions and Implications: Weight gain was common but variable among college students. Importantly, exercise and dietary patterns did not meet the recommended guidelines for many college students, which may have long-term health implications.