Peer Contagion: Eating Disorder Friends

Updated: Oct 9, 2020

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Off the top of my head, I can name three people from high school who also had eating disorders. All girls and they all ran in my circle. Those were just the obvious ones, who knows how many more of my peers struggled with it.

My eating disorder started in my junior year during the winter. It wasn’t until senior year that I saw the same signs in my classmates - skipping meals, making excuses, etc. I hope I didn’t start a trend, but I might have.

The Research

Studies have shown that same-gender, mutual friends had a significant influence on body image, eating habits, and obesity and that 13.2% of adolescents will develop an eating disorder by the age of 20. So it stands to reason that eating disorders would arise among multiple girls in one school, while other schools wouldn’t see any cases.

The phenomenon is known as peer contagion. Peer contagion is defined as the influence a friend has on your behavior and emotions; it’s the transfer of bad behavior from one person to another under the guise of friendship. For example, if one person in the friend group shoplifts, the other people are more likely to steal merchandise. Likewise, if a junior in high school has anorexia, their closest friends will likely have it.

Why is that?

The research concludes the most prominent factors of peer contagion is self-regulation, structure, social rejection, and status.

Self-regulation, or self-control, is the control of oneself without external influence. It is acting in one’s interest, or it is to achieve specific goals. Individuals with more self-control are less likely to be influenced by their peers.

Teens in a structured environment with positive parental involvement have shown to have a significant effect on peer contagion. These adolescents are less likely to be influenced by their friends if they have more excellent parental monitoring.

Social rejection is when an individual is deliberately excluded from social events, friendships, or gatherings. Because of this dismissal, the individual is more likely to be influenced by their counterparts and perform deviant behavior.

Research has shown that social conformity is influenced by status; people are more likely to be affected by someone with a higher rank. If someone you respect and admire has an eating disorder, you will more likely have an eating disorder.

In summary, if a person has less self-control, a cynical, chaotic environment, is rejected by their peers, or influenced by someone of higher status, they are more likely to conform via peer contagion.

Birds of a feather...

Let’s go back to my high school friend group. I went to a small high school, graduating with seventy-four people. Including myself, I think four individuals had eating disorders. I can’t speak for everyone, but I can speculate why they also had behavioral addictions.

I have mentioned the popular girls in my high school in the blog post, How My Eating Disorder Started, but I want to summarize them again. I believe they played into my friend’s eating disorders too.

The friend group I refer to as the popular girls had a bad reputation for messing with other girls - spreading nasty rumors, being two-faced, typical Mean Girls stuff. The ratio of boys to girls in the class was 2:1 because the popular girls drove away all rivals. The ladies that remained didn’t challenge the status quo.

When I started high school, I wanted to be popular so bad. But I was so nervous; I just came off as weird and awkward. Lots of popular girls played sports, so I spent a lot of time with them organically. And because I was so odd and inept, they avoided me. They looked at me funny when I said anything. They ignored me.

In being rejected by the friend group, I thought I should belong to, my self-confidence was wrecked, which played into all the other factors that lead to my eating disorder. I speculate that this rejection was part of Nadia’s, Jasmin’s, and Heather’s eating disorder.

The first girl, let’s call her Nadia, was a theater nerd and avid dancer, meaning she had to focus on appearance more. One of the popular girls was also involved in the theater and dance programs. I didn’t learn this information until later, but this popular girl often strung Nadia along. Pretended to be her friend one day, almost spitting on her the next.

The second girl, let’s call her Jasmin, used to be the pretty girl at our middle school, but that changed when they mixed everyone for high school. She developed an eating disorder after gaining weight over the summer from working at an ice cream shop. As our high school experience played out, Jasmin became more reserved. I didn’t learn until later, but Jasmin felt like she couldn’t find any friends.

The last girl, let’s call her Heather, had always been the chubby kid. The stereotype is terrible, but she was often overlooked for her weight and could very quickly blend into the background. I believe Heather wanted to change that, and because she was closest to Jasmin, their habits rubbed off on each other.

They became close because these girls ate together by the lockers. For the entirety of our senior year, they never ate the cafeteria food but brought their food. I don’t know what they ate for lunch, but I can tell you they messed with what they ate. A little less here, a little more there - which caused problems.

I want to add a few more explanations for peer contagion that was true in my high school friend group, especially when it comes to females. The first is that women are compassionate and empathetic. Women are willing to do anything for a friend, even bend reality. Shared distress allows women to become close. Lastly, we tend to seek any clarification for our pain.

First, women are empathetic. We tend to meet people where they are, whether in their sadness, their playfulness, or their views. We want to understand each other’s pain, so instead of heaving them up, we allow them to pull us down.

Second, women are willing to bend reality for a friend. Have you ever hated someone because a friend hated them? Maybe our friend told you a story about them that was a little embellished and now everything they do is wrong? Women are often willing to look past anything for a friend.

Third, women forge friendships through emotions. Traumatic experiences often build deep connections. Two people might not connect until they figure out they both lost a parent to cancer. When someone else has the same experience that you do, you just click.

Fourth, women want an explanation for their struggles. We always want to know why? Why is this happening? Why is that how it is? That was part of my eating disorder - “I don’t have friends, because I’m fat,” when going to such a small school limited my possibilities. I just wanted clarification for my pain.

What now?

If you had an eating disorder in high school or college, some of your friends also had an eating disorder. Everyone probably had a hand in developing behavioral addiction. It’s no one’s fault; that’s just how it happened. What is important is what you can learn from it.

  1. Your eating disorder can influence others. When you binge at a party, someone might use that as an excuse to binge as well. When you talk about body image negatively, someone else might too. You are only responsible for you, but be aware of how your eating disorder influences those around you. Take steps to mitigate the damage.

  2. Don’t ignore the signs of your ED in someone else. If you feel comfortable, you can ask this person if they have an eating disorder. Try not to jump to conclusions or seek to be their therapist, but pointing out their odd behavior can be just the encouragement they need to find help.

  3. For Parents: If your child has the disorder, consider discussing it with their friend’s parents because their kids might have it. This situation is a little tricky because you want to respect your child’s privacy, but you want to keep their friends safe. Encourage your child to talk to their friends about it.

  4. Burn the bridge. Some friendships might be too toxic and need to end. If you have a specific friend who is influencing your eating disorder, you might need to create boundaries. As a last resort, you might have to terminate that friendship.

  5. Seek positive influences. Research has shown that positive impacts can undermine peer contagion. If a parent or other respected adult intervenes by encouraging healthy behaviors, the individual is more likely to stop their deviant behavior. Likewise, if society promotes positive values like compromise and open discussion, a teen will likely value that.

Peer contagion creates an echo chamber in the friend group, then in the person’s life. Echo chambers worsen single-mindedness and obsession. To make the echo stop, you need to leave the chamber. One way to do that is to change the people or events that influence you. If you and your friend group struggle with eating disorders, you might consider breaking up the group or bringing in a positive influence.

Further Information

Anorexia and Friendship: The Science of Their Reciprocity

Anorexia and Friendship: What Eating Disorders Do to Friends

Anorexia and Friendship: How Friendship Can Affect Anorexia

Anorexia and Friendship: Can Friends Galvanize Recovery

Peer Contagion in Child and Adolescent Social and Emotional Development

Social Conformity | Brain Games

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