The present study extends our previous work by examining the reciprocated friendships of obese youth in their classroom environment. While the majority of obese children had at least one reciprocated friendship in their classroom, ~32% lacked a friendship. In contrast to developmental literature suggesting that friends tend to be similar, our data suggest that the reciprocated friends of obese youth function more adaptively in the peer environment. These RFs were more well-liked, had more positive social behaviors, and were seen as more attractive and athletically skilled than the obese children. Furthermore, the majority of these RFs were not visually rated as overweight.
Our findings are in contrast to those of Strauss and Pollack (2003
) who reported low rates of friendship nominations and reciprocity for overweight adolescents relative to normal-weight peers. Further, they found that adolescent who nominated an overweight peer as a friend, received less friendship nominations than friends of normal weight youth. Comparison of our data to Strauss and Pollack’s proves difficult given the use of differing sociometric procedures and the potential differences in that study’s use of a large epidemiological sample (Add Health) relative to our clinical sample. In addition, Add Health participants were older (13–18 years) than those in the current study (8–16 years), and recent work has suggested that stigmatization/weight bias from peers may worsen as children become adolescents (Puhl & Latner, 2007
). Our finding that most of the RFs of obese children were not visually rated as overweight is also in contrast to two recent studies that suggest that overweight adolescents are more likely to have overweight friends (Halliday & Kwak, 2009
; Valente, Fujimoto, Chou, & Spruijt-Metz, 2009
). The current finding however should be interpreted cautiously, given that the weight status (overweight or nonoverweight) of RFs was based on a visual rating by research staff rather than the obtainment of anthropometric measurements either objectively or through self-report.
Although not a primary aim of the present study, it is noteworthy that our findings suggest obese children do not differ from nonoverweight peers in self-reported depressive symptoms. These data add to the literature documenting that depressive symptomatology is not a consistent correlate of obesity in youth (Zeller & Modi, 2008
). Similarly, group differences were not found for self-reported loneliness. However, consistent with extant pediatric obesity literature (Phillips & Hill, 1998
; Thompson et al., 2007
), obese children reported significantly lower global self-worth as well as lower self-perceptions of appearance and athleticism relative to comparisons. Contrary to our hypotheses, only one dimension of emotional well-being varied significantly by friendship status. Specifically, obese children with a reciprocated friendship had higher self-perceptions of appearance than those obese children without a friendship. This suggests a potential buffering effect for a friendship tie. Perhaps, having a reciprocated friendship with a peer who is socially well-adjusted and nonoverweight protects obese youth from appearance and weight-based teasing or the internalization of any such stigmatizing experiences, resulting in them feeling better about their appearance. This is important as some research has suggested that weight-related teasing by peers is associated with low body satisfaction and low self-esteem (Eisenberg, Neumark-Sztainer, & Story, 2003
). However, in contrast to this research, no interaction between obesity status and reciprocated friendship status was identified for global self-worth in the current study.
Clearly, in the broader developmental literature, friendship has been demonstrated to be important for all children regardless of weight status (Bagwell et al., 1998
; Nangle et al., 2003
; Parker & Asher, 1993
). However, in the current study, correlational analyses indicated that having more reciprocated friendships was significantly associated with less loneliness and higher global self-worth for obese children, but not nonoverweight comparisons. In addition, for obese children, a friendship tie in the classroom was found to buffer the expected link between sensitive–isolated behaviors and feelings of loneliness. Perhaps, having a reciprocated friendship is particularly salient for obese children given their other social difficulties, including low peer acceptance. Further, the present findings suggest that the RFs were better socially adapted than the obese children. This is noteworthy given that friendships are typically formed between peers who are more similar to each other than are non-friends (Haselager et al., 1998
; Kupersmidt et al., 1995
; Rubin et al., 2006
), and that this similarity has implications for emotional well-being. For instance, Rubin and colleagues (2006
) found that the best friends of shy/withdrawn children were perceived by peers as more shy and withdrawn relative to the best friends of controls, and that shy/withdrawn children and their best friends experienced more victimization than control children and their friends. Furthermore, there is some evidence for peer contagion of internalizing difficulties such that the depressive symptoms of friends are longitudinally predictive of adolescents’ own depressive symptoms (Prinstein, 2007
). Thus, friendships with better socially adapted youth may be especially beneficial in buffering obese children against future difficulties such as depressive symptoms.
Strengths of this study include use of psychometrically sound measures, a demographically similar nonoverweight comparison group, and multiple reporters (e.g., peer and self- report). Although researchers have found links between overweight or obese youth’s self-perceptions of their peer experiences (e.g., victimization, weight-related teasing) with depressive symptoms, loneliness, or poor self-concept (Eisenberg et al., 2003
; Storch et al., 2007
), this is the first study to utilize peer perceptions, considered the most valid source of social functioning (Cavell, 1990
), with self-reported emotional well-being for obese children. However, this study has several limitations. First, these data characterize a clinically referred sample of obese youth. The addition of a nontreatment seeking and demographically similar obese comparison group would further elucidate whether these peer relationship patterns are also typical of obese youth in the broader community who do not or cannot access care. Second, these data were cross-sectional in nature. Future studies should examine the impact of reciprocated friendships on the social functioning of obese youth over time as well as to address the reciprocal effects between social functioning and emotional well-being as these youth enter later adolescence and early adulthood. It may be that over time, obese children with RFs function more adaptively in the peer environment, similar to their RFs, or conversely, their social difficulties may continue over time, resulting in later internalizing difficulties. Third, although this study provided evidence that obese children’s RFs were better socially adjusted in general than they were, friendship quality (e.g., closeness, security, conflict) was not evaluated. Moreover, only friendship ties within one classroom were examined. For younger children, friendships are typically made within the classroom where children with similar abilities are grouped together (Ollendick et al., 1990
). However, some children, and adolescents in particular, may have additional friendships outside of the classroom.
These data may have important implications for the physical health of obese youth. Although we did not examine physical health or lifestyle behaviors, previous work has indicated the benefits of friendship for greater activity (Strauss & Pollack, 2003
) and of peer social support for weight loss and maintenance for adolescents (Jelalian & Mehlenbeck, 2002
) and children (Wilfley et al., 2007
). Because the majority of the RFs of obese youth in the current study were doing well socially and were not overweight, they may be a source of support for better psychosocial and physical health outcomes for obese children. In contrast, obese children without friendships may be at particular risk for poor outcomes, suggesting that interventions such as social skills training are necessary.