Friends Don't Make You Fat

A recent study published in The New England Journal of Medicine suggests that it's not what you know but who you know that makes you obese; if your friend becomes obese, you have a nearly 60 percent higher chance of gaining weight. In other words, the study suggested that obesity is socially contagious. When an article about this study was published in The New York Times, pediatrician Dr. Neil Izenberg, editor-in-chief and founder of, wrote a letter to the editor condemning the study. He spoke with New America Media's health editor Viji Sundaram.

Viji Sunderam: In school, kids are often teased and bullied simply for being fat. Do you think this new study could further cause students to want to disassociate themselves from overweight kids?

Dr. Izenberg: Kids, particularly as they approach the tween and teen years, can be very body conscious as they compare themselves to their friends and to the idealized images in the media. For some girls, an overemphasis on perfection and being thin leads to the unhealthy eating disorders of anorexia and bulimia - though why this happens with some young women and not others is not fully understood.

For those kids who are already hypersensitive to issues concerning their weight, the idea that they might be better off avoiding overweight friends could lead to a lot of hurt feelings. We have to remember, though, that the increasing prevalence of obesity among children is a very worrisome trend with some very serious health implications.

Sunderam: Some U.S. schools have policies that encourage thinness. For instance, one California school weighs children during gym class and tells those who are overweight to shape up. Some others write to parents telling them they should do something to get their kids to lose weight. What do you think?

Dr. Izenberg: Publicly embarrassing kids who are overweight is unforgivable. It's understandable that schools want their students to be healthy - and want to do something about the increasing amount of obesity they're seeing. Many parents, however, have told us at that they have very mixed feelings about receiving notes from schools that their children are overweight or obese. They don't feel the school has any business telling them what they feel is a matter between them, their child, and their doctor.

We know, though, that many parents with overweight children tend to see their child's weight as more "normal" than it actually is. And that's the problem. Parents need to talk with their doctor or nurse about what a healthy weight range for their child should be - and then deal with it rather than ignore the issue.

Sunderam: In your letter in The New York Times, you cite studies that have shown how average-weight kids who associate with overweight kids lose their status in the eyes of their peers. Could you explain?

Dr. Izenberg: Some kids can be thoughtless about the feelings of others. Not only do obese and overweight kids get called names, picked on, and excluded, but studies have shown that even children who are not overweight themselves but have overweight friends lose "status" in the eyes of some of their peers.

Some of that, no doubt, is imitating how they see other kids, adults, and media react to the overweight.

Sunderam: Children in less affluent neighborhoods have less access to fresh produce. Many of these children are obese -- most likely from eating the readily available food that is full of empty calories.

Dr. Izenberg: Less expensive foods tend to be calorie-rich, full of simple carbohydrates and fat. And they are often easier to store at home. For some families, being overweight is more acceptable (and even considered cute or desirable), and parents who have grown up with poor eating habits themselves may feel less motivated to search out fresh fruits and vegetables and get their kids used to eating them. It's a complex, vicious cycle, but one that can have dramatic impact on the health and life expectancy of their children.

Parents, here as in the rest of life, need to set good personal examples: eating fresh fruit and vegetables, limiting fat and carbohydrates, not overeating, and being active. Kids pay close attention and imitate their parents and their friends.

Sunderam: What do you feel will be the negative impact of this research on children?

Dr. Izenberg: The positive impact of this research might be that more people will see eating and activity patterns as being strongly influenced by friends and family. It's a good thing to pay more attention to how you make your choices about what you consume and how active you are. It could be negative though, if you limit your friends based on how they look. If you do that, you'll miss a lot of the richness of life.

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