The lower a teenage girl perceives herself to be on the social ladder the higher her likelihood of gaining weight for the subsequent 24 months of this perception seems to be, says an article in Pediatrics & Adolescent Medicine (JAMA/Archives).

The writers explain that the percentage of American adolescent girls who are classified as overweight has gone up from 14% in 1999 to 16% in 2004. “Children who are overweight experience many health complications but perceive the most immediate consequence of overweight to be social discrimination. To lessen this health and economic burden, it is important to identify factors that contribute to excess weight gain and the development of obesity.”

Adina R. Lemeshow, S.M., Harvard School of Public Health, Boston, and the New York City Department of Health and Mental Hygiene, Bureau of Tobacco Control, and team looked at questionnaires that had been completed by 4,446 girls aged 12-18 years in 1999. In the questionnaires the girls reported their height, weight, TV watching habits, and diet. They also answered the following question “At the top of the ladder are the people in your school with the most respect and the highest standing. At the bottom are the people who no one respects and no one wants to hang around with. Where would you place yourself on the ladder?” Girls had to place themselves in a 10-rung ladder scale.

The researchers compared the girls who placed themselves in the top five rungs to those who perceived themselves to be in the bottom four.

In 1999, the average BMI (body mass index) of all the girls was 20.8; in 2001 it rose to 22.1. During those two years 11.7% (520) of the girls had a BMI increase of 2 units or more.

The researchers wrote “After adjusting for age, race/ethnicity, baseline BMI, diet, television viewing, depression, global and social self-esteem, menarche, height growth, mother’s BMI and pretax household income, adolescent girls who placed themselves on the low end of the school subjective social status scale had a 69 percent increased odds of having a two-unit increase in BMI during the next two years compared with other girls.”

The authors concluded “It is important that researchers consider physical, behavioral, environmental and socioemotional factors that might contribute to the rising prevalence of overweight in adolescents. Previous research suggests that emotional factors such as depression and low self-esteem and self-perception contribute to the burden of overweight in adolescents. Our study contributes to this body of literature in that, to our knowledge, it is the first to prospectively evaluate the relationship between subjective social status in the school community and change in BMI, and our findings suggest that low school subjective social status may be an important contributor to increases in BMI in girls over time.”

Accompanying Editorial

Clea McNeely, M.A., Dr.P.H., and Robert Crosnoe, Ph.D., Johns Hopkins Bloomberg School of Public Health, Baltimore, in an accompanying editorial, wrote “Despite the need for urgent action in the obesity epidemic, the health community’s mixed history of success with peer interventions should serve as a story of caution for designing interventions based on incomplete understandings of how adolescents’ health behaviors are shaped by their peers. Future adolescent health research, therefore, should seek to identify the specific ways that peers transmit health-related information and norms to each other in their everyday lives, either through face-to-face contact or through social networking activities on the Internet (e.g., MySpace). The study by Lemeshow and colleagues contributes to this knowledge base, which in the future can be used to consistently harness the power of peers to promote health.”

“Subjective Social Status in the School and Change in Adiposity in Female Adolescents
Findings from a Prospective Cohort Study”

Adina R. Lemeshow, SM; Laurie Fisher, SM; Elizabeth Goodman, MD; Ichiro Kawachi, MD, PhD; Catherine S. Berkey, ScD; Graham A. Colditz, MD, DrPH
Arch Pediatr Adolesc Med. 2008;162(1):23-28.
Click here to view abstract online

Editorial
“Social Status, Peer Influence, and Weight Gain in Adolescence. Promising Directions for Addressing the Obesity Epidemic”
Arch Pediatr Adolesc Med. 2008;162(1):91-92.
Click here to see first 150 words of the Editorial online

Written by – Christian Nordqvist