Pick Your Friends… Carefully

Another in the series, Ten Habits for Healthy Moms

By J. Ron Eaker, M.D.

On my first day of medical school, a stodgy, statuesque professor surveyed the class and prognosticated, ”Look around ladies and gentlemen.  In four years a third of you will not graduate, 1 will commit suicide, and of those who are married now, 30% will be divorced.”  At that moment I about became one of those 1/3, but instead I persisted and learned the lesson that our peer group has an enormous impact on our lives.

A famous motivational speaker is fond of saying that you are the sum total of the qualities of the three people you hang around the most, so pick your friends carefully.  While no one argues that peer groups and associations influence such things as status, behavior and self confidence, few realize that who you hang with can also affect your health.

Those of you with children are often victims of your child’s friendships.  By that I mean your social group is largely determined by who your kids hang out with.  This isn’t always the case; however, there often is somewhat a randomness at this season of life in with whom you can develop a relationship.

A landmark Harvard study published in the New England Journal of Medicine in 2007 shocked sociologists and physicians claiming that a person’s chances of becoming obese increased by 57% if he or she had a friend who became obese in a given interval.  Think about that for a moment.  All other reasons aside, if you were friends with someone who became overweight, you stood a better than not chance of becoming overweight yourself!  This completely changed how we viewed social relations as it applied to health.  Is it really possible that disease could spread through social connections?

These researchers found that the closer you and the perceived friend were the greater the association.  For example, if you claimed someone as a friend not in the survey, and they didn’t reciprocate, there was a less likelihood you would gain weight.  On the other hand, if both of you acknowledged a close relationship and one became obese, the likelihood of the other becoming obese rose by 171%!

The ramifications of this for weight loss programs was immense.  Anecdotally physicians had noted for years that people with a solid accountability group who were either losing weight themselves or being very supportive of the effort dramatically increased the likelihood of success in achieving weight loss.  Now, we partially know why.  Some of it is picking your compadres carefully.

Another study was really frightening.  It showed that if you have a friend who has attempted suicide, you are 4 times as likely to follow suit.  Granted, there are an amazing number of variables that couldn’t possibly be excluded, but the fact remains that who you associate with can impact your health.

Thankfully, benefits can be seen by positive associations.  A study that was mined from the data of the famous Framingham Heart Study showed that if one friend stopped smoking there was a 36% chance that a second friend would also quit.  This was magnified with spouses as the likelihood of mutual stoppage went to 67%.

There is no doubt that behavior affects health and there is ample evidence that social groups influence behavior.  Therefore it makes sense that who you are friendly with can be a factor in your well being.  One study actually concluded that this effect may extend up to three degrees of separation.  In other words, you may influence your friend’s friend and your friend’s friend may be having an impact on your health decisions.

The obvious question in this social network world we inhabit is, can “virtual” relationships influence a person’s health?  The answer there seems also to be yes.  Whether through accountability, motivation, or a variety of other interactions, online friendships can be positive for certain health behaviors.  Interestingly, the degree of influence seems to be a bit less for virtual interactions over in-person associations.

It appears in study after study that it is the intensity and depth of the relationships that hold the strongest influence.  In other words, it’s pretty certain that your 10,348 Facebook friends actually have very little influence on your health, rather the three folks you consider your besties carry most of that water.

One of the key factors for healthy aging described in Dan Buettner’s book, The Blue Zones, is being a member of a community.  This association seemed strongest in communities that espoused generally health behaviors such as in some religious groups. Many studies have shown the negative impact of loneliness on health risks including depression and cancer.  In fact, one author went as far to say, “The mortality risk associated with a lack of a strong social network was comparable to smoking up to 15 cigarettes every day, or more than 6 alcoholic drinks a day.”

So the message is have friends, but pick them wisely to stay healthy, wealthy, and wise!