Dec 6 2013
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RWJF Scholar Explores Weight Disparities in Teenage Girls

Janet Tomiyama, PhD, an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2009-2011), is director of the Dieting, Stress, and Health (DiSH) Lab at the University of California-Los Angeles. She was recently named the 2013 recipient of the Early Career Investigator Award from the Society of Behavioral Medicine.

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Human Capital Blog: First, congratulations on receiving the Society of Behavioral Medicine’s 2013 Early Career Investigator Award! What does this award mean for your current research and for your career?

Janet Tomiyama: Thank you! Of course, as I’m fighting my way toward tenure, this kind of recognition is really key to my career. I am trained as a social psychologist, but this award was from the field of behavioral medicine. It shows that my work has interdisciplinary appeal, that people in the medical field find it important. It shows me that I was on the right path in trying to broaden my training through the RWJF Health and Society Scholars program and trying to incorporate aspects of medicine and population health. Getting recognition from a field that’s not my own means a lot to me.

HCB: What specific work did the award recognize?

Tomiyama: I was recognized for a paper about racial disparities in chronic psychological stress and body mass index (BMI) among girls between the ages of 10 and 19. Of all the many, many health disparities out there, the disparity in obesity between Black and White girls in adolescence is one of the biggest. I wanted to tackle a big disparity, and I thought stress had something to do with it. I completed the research during my time as an RWJF Health & Society Scholars fellow.

HCB: What did you find?

Tomiyama: I started out with the premise that stress can make people eat more, but that premise is based on laboratory studies where researchers stress participants out in the lab setting and then give them food to eat. No one had really examined whether these phenomena that we see in the lab are also observable at the population health level. These small studies of 20 to 100 people are great, but we really we need to look at much bigger samples to see whether these processes are observable in the real world.

My faculty mentors at the University of California, San Francisco and at the University of California, Berkeley had a really strong connection with an amazing study, called the NHLBI (National Heart, Lung, and Blood Institute) Growth and Health Study, of nearly 2,400 girls, half of whom were Black and half of whom were White. The study followed these girls once a year, every year, from age 10 to 19. So we have a decade of measurement, and that’s really precious and rare. It was the perfect sample to look at these relationships.

Our basic question was whether stress relates to higher BMI over 10 years of these girls’ lives. Is stress even involved in obesity prevalence at all? We found that it was, by a factor that was much greater than any of us ever anticipated. The strength of this relationship, the connection between stress and BMI, was stronger in Black girls than in White girls. Stress, in other words, seemed to matter more for Black girls than for White girls when it comes to BMI.

HCB: Did you explore what is causing stress for Black girls?

Tomiyama: It’s a lovely data set, but the study didn’t ask about actual stressful events until they were age 17. We are currently looking at that data. I can tell you that the Black girls are experiencing much more intense stressors. Top stressors for Black girls were more likely to relate to violence, such as knowing someone who was shot or knifed. Top stressors for White girls, on the other hand, were more emotional, such as breaking up with a boyfriend or family fights. There are some clues there.

HCB: What are the implications of this study?

Tomiyama: When we talk about obesity disparities, often the conversation is about what are these girls eating. Are they eating high-fat foods? Are they eating high-sugar foods? It really becomes about the food and nutrition, what people are putting into their bodies. These larger psychological factors have been very understudied. I think we need both perspectives. If you ask anyone on the street, they will say, “When I’m stressed, I’ll reach for a doughnut or a brownie.” It’s a phenomenon that has not been studied to the extent that it could be. With a lot of my research, lay people say a finding is obvious but scientists feel it hasn’t been proven.

But there are lots of other ways that stress can contribute to weight gain. Stress can increase the hormone cortisol, which can signal the body to deposit fat in the abdominal region, and abdominal fat is especially toxic. Stress can also make people less likely to exercise. Weight is not always about eating, it’s about a whole complement of human behaviors.

HCB: In your bio on the DiSH Lab website, you say you embody the “research is me-search” cliché. How so?

“Research is me-search” basically means that the research programs that we pursue are to better understand ourselves. I love to eat—it’s a very important part of my life—and that’s why the majority of my research is focused on food and eating.

HCB: Did your RWJF Health & Society Scholars fellowship prepare you for this work?

Tomiyama: Yes, in a very concrete way. The paper I wrote as a fellow is what the early career award is based on. Part of RWJF’s training is to stretch your mind to incorporate other perspectives on science. This study is very much a manifestation of me getting out of the lab and into these larger population health-relevant studies.

HCB: What are your next steps?

Tomiyama: My newest research obsession is understanding stigma around being overweight and obese. As we sound the alarm about obesity and obesity disparities, it’s really important to also consider whether we might be stigmatizing overweight or obese individuals by doing so.

Studies in social psychology show that weight stigma is more common than racism, sexism, or homophobia. And, unlike those types of discrimination, weight is usually not a protected category in legislation or public policy. Even more alarming, some people are advocating the use of weight stigma to motivate people to lose weight. It’s understandable, because it worked to reduce smoking. But some of the research I’m working on shows that using weight stigma can actually backfire. It can make people actually eat more. And it stresses them out, which leads to all these other behaviors that we just discussed. I think it’s too easy to just say “Obesity is bad and terrible.” If we really wanted a healthier, happier society, we also need to pay attention to all the consequences of health promotion efforts, including potential stigmas.

Tags: Health & Society Scholars, Health Disparities, Voices from the Field