A teenage girl’s perspective of her own social status may have an impact on her health condition later in life, particularly on her weight, according to a new study from Boston-area researchers.

Research has shown that depression and low self-esteem have no positive impact on the obesity burden in adolescents and a new study suggests that a negative self-perception may contribute to weight gain in girls later in their teens.

The study began in 1999 and involved more than 4,000 girls from ages 12 to 18. They were given a questionnaire which included a request for them to place themselves on a ladder of popularity.

All girls were asked to rank their social standing on a 10-point ladder: “At the top of the ladder are the people in your school with the most respect and the highest standing. At the bottom are the people who no one respects and no one wants to hang around with. Where would you place yourself on the ladder?”

The researchers placed the 4,446 adolescent girls in two groups: 4,264 said they were on rung 5 or above, while 182 said they were on rung 4 or below. The girls placing themselves on the bottom of the ladder accounted for 4 percent of the total number of participants. The average self-ranking was 7.7.

The researchers took into consideration several factors that could influence both social status and weight gain, such as body mass index (BMI) at the study's outset, household income, race/ethnicity and self-esteem, as well as their diet, physical activity and whether they had reached puberty.

Two years later, the researchers found that the girls who considered themselves unpopular were 69 percent more likely than the other girls to increase their body mass index by two units, the equivalent of gaining about 11 excess pounds.

In 2001, 11.7 percent of the girls had gained at least two units of body mass index. Almost 20 percent of the girls who had placed themselves lowest on the popularity ladder had at least a 2-unit increase in BMI, compared to 11.4 percent of the girls who ranked their social standing on the higher end of the scale.

“We know that poor diet and exercise contribute to excess weight gain, but how girls feel about themselves, especially in relation to their peers, should be part of all prevention strategies,” lead author Adina Lemeshow told the Boston Globe in an interview.

Lemeshow began the study as a graduate student at the Harvard School of Public Health. She now works at the New York City Department of Health and Mental Hygiene.

Lemeshow and her colleagues said this is the first study to look at girls’ self-perception of social status before weight gain and emphasized the need to consider socioemotional factors such as low self-esteem and self-perception that might contribute to the rising prevalence of overweight in adolescents.

The authors note that the prevalence of overweight girls increased significantly from 1999 to 2004 in the U. S., from 14% to 16%.

The article is available online at the Archives of Pediatrics & Adolescent Medicine, http://archpedi.ama-assn.org/cgi/content/full/162/1/23