OBJECTIVE To investigated the association between weight change patterns across adulthood and incident gout. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES), we categorized individuals into four weight-change groups based on their recalled weight during young adulthood and midlife. Hazard ratios (HR) and 95% CI relating weight change patterns to incident gout over 10-year follow-up were calculated. The hypothetical population attributable fraction (PAF) for

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... the weight change patterns was calculated. RESULTS Among our sample of adults who were 40–74 years old at their midlife weight measure (n = 11079), 320 developed to gout. Compared with participants who remained stable non-obese during adulthood, the highest risks were found for gaining weight (HR 1.65; 1.19–2.29) participants. And stable obese pattern had a marginal significance of the elevated risk of incident gout conditions (HR 1.84; 0.98–2.78). No significant associations were found between losing weight change patterns and the risk of gout during the study period. If participants who gained weight had become non-obese during the 10-year follow-up, an estimated 3.2%(95% CI: 0-6.3) of observed gout cases could have been averted. Also, if the population had maintained a normal BMI, 32.9%(95% CI: 18.2–44.9) of cases could have been prevented during the ten years. CONCLUSIONS Gaining weight over adulthood was associated with increased risks of gout. These findings highlight that maintaining non-obese weight and weight loss across adulthood is essential for the prevention and treatment of gout in adult life.