Peer Influences on Eating Pathology

Although families represent a central part of the immediate social environment when eating disorders emerge, adolescence marks an important social transition away from immediate family and toward peers. Thus peer values and behaviors come to form an increasingly salient part of the social environment during the period of peak risk for eating disorders. Several studies support significant peer influence on disordered eating behaviors and attitudes during adolescence and young adulthood. The reported frequency of friends’ dieting has been positively associated with unhealthy weight control behaviors in adolescents (Clemens, Thombs, Olds, & Gordon, 2008; Eisenberg, Neumark-Sztainer, Story, & Perry, 2005) and with drive for thinness in adults (Gravener, Haedt, Heatherton, & Keel, 2008).

In longitudinal studies, exposure to peer dieting predicts greater disordered eating several years later. Over a five-year follow-up, friends’ dieting significantly predicted use of unhealthy and extreme weight control behaviors (e.g., fasting and self-induced vomiting) and binge or loss-of-control eating in girls (Eisenberg & Neumark-Sztainer, 2010; Neumark- Sztainer et al., 2007). Among women (but not men), the frequency of dieting by college roommates predicted drive for thinness, bulimic symptoms, and use of self-induced vomiting to control weight at 10-year follow-up (Keel et al., 2013).

The social influence of peers may contribute to gender differences in risk for eating disorders. To the extent that adolescent girls are more likely than boys to express concerns about being fat, engage in “fat talk” (disparaging remarks about one’s own body made to peers, discussed further below), diet to lose weight, and spend more time socializing with other girls than with boys, girls have greater environmental exposure to the thin ideal within their peer group than do boys. Further, longitudinal data suggest that females may be more sensitive than males to social influences on drive for thinness and bulimic symptoms (Keel et al., 2013). This differential sensitivity is seen even when females and males have comparable exposure to such influences: During college, men and women reported that similar proportions of their mothers were frequent dieters; at 10-year follow-up, however, mothers’ dieting status predicted drive for thinness only in women (Keel et al., 2013).

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