The prevalence of obesity among 18- to 24-year-olds has steadily increased. Given that the majority of young American adults are enrolled in colleges and universities, the higher education setting could be an appropriate environment for health promotion programs. Historically, health and fitness in higher education have been provided via activities-based education (APE) courses with a shift toward conceptually based (CPE) courses. The purpose of this retrospective pre-post study was to assess health and behavioral outcomes associated with a combination APE--CPE course, an APE course, and a CPE course. The ecological model and social network theories were considered within the context of this assessment. Paired t tests were used to examine pre--post changes for body mass index, body composition, and self-reported physical activity behaviors using the International Physical Activity Questionnaire (IPAQ) among 61 students in the three self-selected learning conditions. No significant change in total duration of exercise was observed in any of the groups; however, significant changes were observed in specific IPAQ subscales within each of the three groups. Days spent exercising vigorously (+34%, p = 0.02) and duration spent engaged in moderate exercise (+87.2%, p = 0.02) increased in APE and CPE participants. Days spent walking (+11.3%, p = 0.04) and walking time (+65%, p = 0.03) increased in CPE participants. Body fat percent (-11.8%, p = 0.04) decreased in APE participants; however, days spent engaged in vigorous exercise also significantly decreased (-31.6%, p = 0.00). Differences in outcomes between APE, CPE, and APE-CPE courses were observed. This study provides information to young adults selecting between health and fitness courses, as well as to higher education providers. Effective health promotion courses for college students can potentially reduce premature morbidity and mortality associated with obesity and a sedentary lifestyle.