Unreciprocated Friend Ties in Adolescence Predict Future Health Outcomes

Lindsay Stager, Aaron D. Fobian, Alena Borgatti

Contact: lmstager@uab.edu

Introduction: Obesity is a top public health issue in the U.S. Importantly, research has demonstrated that individuals with overweight/obesity (OWOB) are typically less socially accepted by peers. For example, adolescents with OWOB might report having more friends, but are actually less likely to be listed by others as a friend relative to normal weight (NW) peers. The impact of unreciprocated social relationships on future health outcomes remains unknown. Methods: Data were utilized from waves I (Mage=17.3, SDage=.92 ) and IV (Mage=30.2, SDage=.97 ) of the National Longitudinal Study of Adolescent to Adult Health. This study focused on 363 participants (85.4% Male; 16.8% white, 16.3% African American, and 43.8% Asian or Pacific Islander) from one high school who reported height, weight, and nominations of up to 5 female and 5 male friends at wave I. Individuals with no outgoing tie data and those with positive wave IV pregnancy were excluded from analyses. A one-way ANOVA assessed differences in unreciprocated tie ratios (UTR) between individuals with NW (N=271), overweight (N=45), and obesity (N=44). Linear regressions investigated the effects of UTR on wave IV BMI, depression, and inflammation. Depression was measured using the center for epidemiologic studies depression scale (CES-D) and inflammation was measured using C-reactive protein. Results: Significant differences in UTR between individuals with NW, overweight, and obesity were found (F(2, 360)=40.17, p<.001). Follow-up tests revealed significant differences in regards to UTR for individuals with NW as compared to both individuals with overweight (Mdif= -.26, SE=.03; p<.001) and obesity (Mdif= -.16, SE=.04; p<.001). There were no significant differences between individuals with overweight and those with obesity. Race, wave I BMI-for-age percentile, wave IV education, and UTR significantly predicted wave IV BMI, accounting for 25% of wave IV BMI variance (Adj, R2 = 0.25; F(4,248)=34.57, p<.001). Both wave I BMI-for-age percentile (β=.541, p<.001) and UTR (β=.121, p=0.02) were independently significant. UTR, race, wave I CES-D scores, and wave IV education significantly related to wave IV CES-D scores (Adj, R2 = 0.11; F(4,251)=8.59, p<.001). Overall these variables accounted for 11% of the variance in wave IV CES-D scores. In this model, both wave I CES-D score (β=.272, p<.001) and UTR (β=.204, p<.01) independently predicted higher wave IV CES-D scores. UTR, race, and wave IV: anti-inflammation medication use, infectious/inflammatory disease, education, and BMI, significantly predicted wave IV inflammation, accounting for 3% of the variance in inflammation at wave IV (Adj, R2 = 0.03; F(6,225)=2.33, p=.03). UTR was the only significant predictor in the model (β=.20, p<.01). Discussion: These findings confirmed earlier studies suggesting that individuals with OWOB have fewer reciprocated friendship ties than NW same age peers. Importantly, unreciprocated friendship ties during adolescence predicted greater depression, inflammation, and BMI in later adulthood, indicating that adolescent social networks have prolonged health effects. These findings highlight the importance of early behavioral health and psychosocial interventions to promote long term social and physical health.

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