Teen girls' popularity predicts weight change, study shows

Adolescent girls who placed themselves low on the ladder of popularity were more likely to gain weight later in their teen years than girls who saw themselves as having higher social standing, Boston-area researchers say.

Depression and low self-esteem have been identified as contributing to the burden of obesity in adolescents, but Adina R. Lemeshow of the Harvard School of Public Health and her colleagues wanted to know whether girls' perception of their social standing predicted changes in their weight.

The study, which appears in the current Archives of Pediatrics & Adolescent Medicine, is the first to ask questions about social status before weight change, the authors say, making a stronger case for linking the two than previous work by others that looked at only one point in time.

“We know that poor diet and exercise contribute to excess weight gain, but how girls feel about themselves, especially in relation to their peers, should be part of all prevention strategies,” Lemeshow said in an interview. Now a project analyst at the New York City Department of Health and Mental Hygiene, she led the research while she was a graduate student at Harvard.

For the study, more than 4,000 girls from ages 12 to 19 whose mothers are participating in the Nurses Health Study II were given questionnaires to fill out in 1999. They were asked to place themselves on their school social ladder, with people at the top getting the most respect and those at the bottom being the ones “who no one respects and no one wants to hang around with.”

Two years later, 11.7 percent of the girls had gained at least two units of body mass index, or about 11 pounds, after accounting for normal growth and other factors during that time. Almost 20 percent of the girls who ranked themselves at the bottom of the social scale gained two BMI units or more, compared with 11 percent of girls who said they had higher social rank. Those who saw themselves lower on the scale had 69 percent higher odds of gaining two units of body mass index. The number of girls who ranked themselves low on the ladder was small, however.

“The contribution of the article by Lemeshow and colleagues is to show that subjective social status as well as the traditional objective measures of status -- education and income -- predict greater morbidity,” Clea McNeely and Robert Crosnoe of Johns Hopkins Bloomberg School of Public Health write in an accompanying editorial. “A greater understanding of how peers influence health behaviors will help guide interventions in the future.”