The book's plot addresses different moral and religious issues that teenagers often face. Kay Vadergrift, a professor at Rutgers University, also cites the book as one of the 100 most important young adult novels, citing an article by Carol Jones Collins that states that the book demonstrates the power of young adult relationships.
A movie adaptation is in development through the Riverrock Entertainment Group.
The book also made an appearance in the comic book Teen Titans where writer Geoff Johns references a character named Mia, who is HIV positive. Mia is the protégé of the hero Green Arrow and states that one of her favorite books is Staying Fat For Sarah Byrnes.