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BackgroundThere is an increasing prevalence of obesity among college/university students in developing countries similar to the trend being observed in industrialized countries. Of great concern is the persistence of weight gain among this young population with the risk of being overweight and obese increasing with years of study and till adulthood. The aim of this study is to describe the trend and burden of overweight/obesity and emerging associated chronic disease risks among adolescents and young adults at the University of Ibadan, Nigeria.MethodThis is a 10-year retrospective review of medical records of students (undergraduate and post-graduate) admitted between 2009 and 2018 at the University of Ibadan, Nigeria. A total of 60,168 participants were analysed. The Body mass index (BMI) categories were determined according to WHO standard definitions and blood pressure was classified according to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) ResultThe mean age of the study participants was 24.8, SD 8.4 years. A large majority was ≤ 40 years (95.1%). There was a slight male preponderance (51.5%) with a male to female ratio of 1.1:1; undergraduate students constituted 51.9%. The prevalence of BMI categories was underweight (10.5%), overweight and obesity 18.7% and 7.2% respectively. We found significant association between overweight/obesity and older age, being female and undergoing postgraduate study (p = 0.01). Furthermore, females had a higher burden of coexisting abnormal BMI characterized by co-occurrence of underweight, overweight and obesity. Hypertension was the most prevalent obesity-associated non-communicable disease in this study with a prevalence of 8.1%. Also, a third of the study population (35.1%) had prehypertension. Hypertension is significantly associated with age, male sex, overweight/obesity and family history of hypertension. Other rare obesity-associated diseases include asthma, diabetes, dyslipidemia, osteoarthritis and gallstones.ConclusionThis study identified rising trends in the prevalence of obesity, a double burden of malnutrition among the study population and the emergence of non-communicable disease risks with a lifelong implication on their health and concomitant burden on the healthcare system. Cost-effective interventions are urgently needed at the secondary and tertiary-level educational institutions to address these issues.