BACKGROUND: We describe body mass index (BMI) trajectories over 20 months in newly settled refugees in the United States.

METHODS: Growth curves were modeled in in hierarchical linear modeling for cohorts from Southeast Asia, Africa, and the Middle East.

RESULTS: For refugees from Southeast Asia and Africa, coefficients suggest an increase of greater than 1.0 kg/m2 per three-month time period, though the best fit function differed between the two groups. A non-linear model was the best fit for refugees from the Middle East, with an average increase of just under 1.0 kg/m2 over the study period.

DISCUSSION: A significant increase in BMI was observed for all refugees but of a different form, predicted by the refugee's region of origin. This may be related to food insecurity, acculturation, environmental factors, and cultural influences prior to and after arrival in the United States, though further study is needed to develop causal relationships.