How do your friends make you fat?

Multiple studies have reported social clustering of obesity.  One widely cited report, based on longitudinal data from the Framingham Heart Study, showed that obesity spreads through social groups.  Various mechanisms for this social clustering have been proposed, including: shared social norms, shared lifestyle and behavior, similar dietary preferences and habits, shared physical and cultural environment, and common economic status.

A recent study, published in the supplement to the American Journal of Public Health, looked at the possible role of social norms in the clustering of obesity.  The authors recruited 101 women, ages 18 to 45 years, from the Phoenix, AZ, area and 812 of their friends and family members, her network, age 18 and older.

They first confirmed clustering of Body Mass Index (BMI) within their sample and then evaluated three measures of body size related norms.  The measures assigned numerical values to their (1) concept of ideal body size, (2) antiobesity preference: a rating of obesity compared to other undesired conditions, and (3) antifat stigma: the degree to which the respondent agreed with prejudicial statements about obesity.  The statistical analysis then evaluated the influence of each of these norm measures on the association between the individual’s BMI and her network’s BMI.

There was a strong correlation between an individual’s BMI and her own concept of weight, and between her network’s average BMI and the network’s average concept of weight.  The individual’s ideal body size and her antiobesity preference explained a fraction of the influence of the network’s BMI on her BMI.  The individual’s antifat stigma did not account for any of the clustering of BMI.  None of the three measures of social norms for the network explained the effect of the network’s BMI on the primary individual’s BMI.

The authors conclude that: “we found minimal support for the proposition that similarity in BMI can be accounted for by shared social norms.”  Limitations of the study include possible inadequate or inappropriate social norm measures or insufficient statistical power. Social norms are probably only one of numerous factors leading to the clustering of obesity.

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