The purpose of this study was to examine the association between perceived weight change since high school and perceived factors contributing to weight change, or lack thereof, among college students. Students from a large university in the Northeast of the United States self-reported socio-demographic characteristics, and perceived factors contributing weight change (or lack thereof) via an online survey; and, completed an objective health assessment that included the anthropometric measurements. Of all participants (n = 183), most were men (61.2%), juniors/seniors (89.5%), non-Hispanic white (65.9%). Most participants reported gaining weight since high school (n = 113, 62.1%), and these participants had significantly greater abdominal girth, weight, and body fat percentage than those who maintained their weight (p < 0.005). Perceived factors contributing to weight change explained a significant portion of the variance in perceived weight change, and perceived factors contributing to weight change differed significantly between those who perceived that they had lost or gained weight. In summary, perceived weight gain despite awareness of contributing health behaviors among some students reinforces that supporting/facilitating actual health behavior changes, rather than mere awareness of healthy behaviors, should be the focus of health promotion efforts.