Chronic Psychological Stress and Racial Disparities in Body Mass Index Change Between Black and White Girls Aged 10–19
Open accessAbstract
BACKGROUND: One of the largest health disparities in the USA is in obesity rates between Black and White females. PURPOSE: The objective of this study was to test the hypothesis that the stress-obesity link is stronger in Black females than in White females aged 10-19. METHODS: Multilevel modeling captured the dynamic of acute (1 month) and chronic (10 years) stress and body mass index (BMI; weight in kilograms divided by height in meters squared) change in the National Heart, Lung, and Blood Institute Growth and Health Study, which consists of 2,379 Black and White girls across a span of socioeconomic status. The girls were assessed longitudinally from ages 10 to 19. RESULTS: Higher levels of stress during the 10 years predicted significantly greater increases in BMI over time compared to lower levels of stress. This relationship was significantly stronger for Black compared to White girls. CONCLUSION: Psychological stress is a modifiable risk factor that may moderate early racial disparities in BMI.
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Among developing youth, higher perceived stress forecasts larger increases in BMI across time.
“In observational studies of developing youth, subjective, perceived stress predicts more excessive gains in adolescents’ BMI over time (Tomiyama, Puterman, Epel, Rehkopf, & Laraia, 2013).”
From Relationship of Mindfulness to Distress and Cortisol Response in Adolescent Girls At-Risk for Type 2 Diabetes. (2018) · cites this paper as Tomiyama, Puterman, Epel, Rehkopf, & Laraia, 2013
The Step 4: Conditional Growth Model section reports that higher chronic perceived stress predicted steeper BMI growth over ten years. The study followed Black and White girls aged 10–19, so the citing sentence’s broader reference to adolescents is not established for boys. (LLM, conf=0.82)
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BackgroundRacial-ethnic Disparities in Inflammation: Evidence of Weathering in Childhood?
Schmeer, K. K., & Tarrence, J. (2018) · Journal of Health and Social Behavior · doi:10.1177/0022146518784592 · Cited by 84 · see citing works
“Children’s current BMI was also hypothesized to be part of the explanation for racial-ethnic disparities in inflammation, as psychosocial stress is associated with children’s obesity (Wilson and Sato 2014) and BMI gain (Tomiyama et al. 2013), and higher BMI is associated with elevated inflammation (Visser et al.”
BackgroundParental stress increases body mass index trajectory in pre‐adolescents
Shankardass, K., McConnell, R., Jerrett, M., Lam, C. N., Wolch, J. R., Milam, J. E., Gilliland, F. D., & Berhane, K. T. (2013) · Pediatric Obesity · doi:10.1111/j.2047-6310.2013.00208.x · Cited by 53 · see citing works
“house) in our cohort (26), it may act as a marker for psychosocial stress in children (12,27–30), which has been associated with weight gain (31,32) and metabolic syndrome (33,34) in adolescents.”
BackgroundValuing the Diversity of Research Methods to Advance Nutrition Science
Mattes, R. D., Rowe, S. B., Ohlhorst, S. D., Brown, A. W., Hoffman, D. J., Liska, D. J., Feskens, E. J. M., Dhillon, J., Tucker, K. L., Epstein, L. H., et al. (2022) · Advances in Nutrition · doi:10.1093/advances/nmac043 · Cited by 46 · see citing works
Nelson, D. S., Gerras, J. M., McGlumphy, K. C., Shaver, E. R., Gill, A. K., Kanneganti, K., Ajibewa, T. A., & Hasson, R. E. (2017) · Childhood Obesity · doi:10.1089/chi.2017.0218 · Cited by 28 · see citing works
“30 Given the moderating effects of pubertal development, physical activity, dietary intake, and psychological stress on the relationships between environmental factors and BMI, 3,10,23,31 these variables were also included in the regression models.”
Educational Attainment and Dementia: Mediation by Mid‐Life Vascular Risk Factors
Liu, C., Ma, Y., Albert Hofman, D., Waziry, R., Koton, S., Pike, J. R., Windham, B. G., Power, M. C., Sharrett, A. R., & Gottesman, R. F. (2023) · Annals of Neurology · doi:10.1002/ana.26647 · Cited by 25 · see citing works
Hasson, R. E., Adam, T. C., Pearson, J. A., Davis, J. N., Spruijt‐Metz, D., & Goran, M. I. (2013) · Journal of Obesity · doi:10.1155/2013/512914 · Cited by 24 · see citing works
Addressing Disparities in Physical Activity Participation Among African American and Latino Youth
Hasson, R. E. (2018) · Kinesiology Review · doi:10.1123/kr.2018-0015 · Cited by 23 · see citing works
Nutrition Board (2014) · Cited by 20 · see citing works
Longitudinal exposure to neighborhood poverty and obesity risk in emerging adulthood
Huang, Y., & Sparks, P. J. (2022) · Social Science Research · doi:10.1016/j.ssresearch.2022.102796 · Cited by 17 · see citing works
The Moderating Effects of Social Support and Stress on Physical Activity in African American Women
Brown, A., Wilson, D. K., Sweeney, A. M., & Horn, M. L. V. (2020) · Annals of Behavioral Medicine · doi:10.1093/abm/kaaa051 · Cited by 16 · see citing works
“91 in national samples [25], has demonstrated convergent and divergent validity with other stress measures [7, 26], and has been used in African American samples [27].”
BackgroundCurtis, D. S., Fuller‐Rowell, T. E., Doan, S. N., Zgierska, A. E., & Ryff, C. D. (2016) · Journal of Behavioral Medicine · doi:10.1007/s10865-016-9756-4 · Cited by 15 · see citing works
“Differential vulnerability to the effects of psychological stress on BMI trajectories among AA and EA female adolescents has also been documented (Tomiyama et al., 2013).”
BackgroundResultFactors related to obesity and overweight among Black adolescent girls in the United States
Winkler, M. R., Bennett, G. G., & Brandon, D. (2016) · Women & Health · doi:10.1080/03630242.2016.1159267 · Cited by 15 · see citing works
“In addition, chronic stress had a positive relationship with increasing BMI across adolescence, which was stronger than the relationship among White girls (Tomiyama et al. 2013).”
BackgroundBrown, K. L., Hines, A. L., Hagiwara, N., Utsey, S. O., Perera, R. A., & LaRose, J. G. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01030-7 · Cited by 16 · see citing works
Exercise mitigates cumulative associations between stress and BMI in girls age 10 to 19.
Puterman, E. M., Prather, A. A., Epel, E. S., Loharuka, S., Adler, N. E., Laraia, B. A., & Tomiyama, A. J. (2015) · Health Psychology · doi:10.1037/hea0000258 · Cited by 13 · see citing works
“To fill this gap in the literature, and in light of the independently reported findings that cumulative stress promotes (Tomiyama et al., 2013) and maintenance of physical activity mitigates (Kimm et al.”
BackgroundMethodSelf-citationSkoranski, A., Kelly, N. R., Radin, R. M., Thompson, K. A., Galescu, O., Demidowich, A. P., Brady, S. M., Chen, K. Y., Tanofsky-Kraff, M., Yanovski, J. A., et al. (2018) · Journal of Child and Family Studies · doi:10.1007/s10826-018-1065-9 · Cited by 10 · see citing works
Influence of Parent Stressors on Adolescent Obesity in African American Youth
Allport, L., Song, M., Leung, C. W., McGlumphy, K. C., & Hasson, R. E. (2019) · Journal of Obesity · doi:10.1155/2019/1316765 · Cited by 10 · see citing works
Laraia, B. A., Brownell, K., Friebur, R., Perera, R., Brown, E. M., Mayer, S. E., Feng, I., Clermont, S., Ritchie, L. D., & Epel, E. S. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-072957 · Cited by 5 · see citing works
Self-citationIntroduction to the Second Special Section on Health Disparities
Whitfield, K. E., Bogart, L. M., Revenson, T. A., et al. (2012) · Annals of Behavioral Medicine · doi:10.1007/s12160-012-9453-7 · Cited by 5 · see citing works
“[1] shows how body mass index, one of the largest health disparities between Blacks and Whites, is moderated by stress.”
BackgroundAdverse Childhood Experiences and BMI: Lifecourse Associations in a Black–White U.S. Women Cohort
Chiu, D. T., Brown, E. M., Tomiyama, A. J., Brownell, K., Abrams, B. F., Mujahid, M. S., Epel, E. S., & Laraia, B. A. (2023) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2023.09.004 · Cited by 4 · see citing works
Self-citationEffects of Parenting and Perceived Stress on BMI in African American Adolescents
Kipp, C., Wilson, D. K., Sweeney, A. M., Zarrett, N. R., & Horn, M. (2021) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsab025 · Cited by 3 · see citing works
“Although these studies provide evidence that perceived stress may be related to BMI in AA youth, further longitudinal analyses are needed to understand the impact of chronic stress on health inequities among AA families (Tomiyama et al., 2013).”
BackgroundMethodResultInfluentialWilson, D. K., Quattlebaum, M. J., Sweeney, A. M., Simmons, T., Kipp, C., White, T., Wood, V., Horn, M. L. V., & Martin, P. P. (2025) · Annals of Behavioral Medicine · doi:10.1093/abm/kaaf034 · Cited by 2 · see citing works
Surachman, A., Hamlat, E. J., Zannas, A. S., Horvath, S., Laraia, B. A., & Epel, E. S. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117142 · Cited by 2 · see citing works
Self-citationKebiasaan Makan, Aktivitas Fisik, dan Indeks Massa Tubuh Mahasiswa S-1 UNS
Nurkhopipah, A., Probandari, A. N., & Anantanyu, S. (2018) · Indonesian Journal of Human Nutrition · doi:10.21776/ub.ijhn.2017.004.02.6 · Cited by 2 · see citing works
“Hasil ini sesuai dengan penelitian yang dilakukan Nugroho yang dalam penelitiannya yang berjudul: Hubungan Aktivitas Fisik Dan Pola Makan Dengan Perubahan Indeks Massa Tubuh Pada Mahasiswa Semester 2 Program studi Ilmu Keperawatan Fakultas Kedokteran.”
InfluentialO’Leary, D., Gross, J. J., & Rehkopf, D. H. (2020) · Affective Science · doi:10.1007/s42761-020-00010-0 · Cited by 2 · see citing works
Self-citationEthnic Differences in Insulin Resistance as a Mediator of Cancer Disparities
Hasson, R. E., & Goran, M. I. (2014) · Springer eBooks · doi:10.1007/978-3-319-06103-0_8 · Cited by 2 · see citing works
“Another study reported that higher levels of psychological stress over a 10-year period predicted significantly greater increases in BMI over time compared to lower levels of stress, and this relationship was significantly stronger for African American compared to Caucasian girls [103].”
ResultVisceral obesity and psychosocial stress: a generalised control theory model
Wallace, R. (2016) · Connection Science · doi:10.1080/09540091.2016.1141873
The Influence of Stress on Obesity Development in Children
Goran, M. I. (2016) · CRC Press eBooks · doi:10.1201/9781315370958-19
Perceived Stress, Insulin Resistance and the Effects of Physical Activity
Hedgeman, E. (2017) · Deep Blue (University of Michigan)
العلاقة بين الضغوط النفسية والسمنة لدى الراشدين.
المحسن, ش. م. م. ع. (2017) · Maǧallaẗ Kulliyyaẗ Al-Adāb - Ǧamiʿāẗ Sūhāğ /Maǧallaẗ Kulliyyaẗ Al-Adāb - Ǧamiʿāẗ Sūhāğ · doi:10.21608/bfa.2017.190689
Narcisse, M., Wang, M. L., Stanford, F. C., Schwarz, A. G., & McElfish, P. A. (2024) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-024-02102-0
“Past studies have identified psychosocial stress and adverse life events as significant risk factors for increased BMI in adolescence [63, 64], with evidence of a more potent effect in Black compared to White youths [63].”
Culturally responsive recruitment of Black daughter-mother dyads through community engagement
Banks, T., Julion, W. A., Halloway, S., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1634312
Why Do Black Women Have a Higher Obesity Prevalence Than White Women in the United States?
Frisco, M. L., Graham, C., & Hook, J. V. (2025) · Demography · doi:10.1215/00703370-12352812
Reed, M., Schoeny, M. E., Banks, T., Swanson, B. A., Tangney, C., & Julion, W. A. (2026) · Western Journal of Nursing Research · doi:10.1177/01939459261431023
“16,25,26 Surveillance data show that black youth consume more calories from sugar-sweetened beverages (SSBs), 27 consume fewer vegetables, and eat breakfast less often than recommended compared with other racial/ethnic groups.”
Bouka, M., Pagkalidou, E., Chiappe, S. G., Osei, T. B., Grittner, U., Nimptsch, K., & Pischon, T. (2026) · Systematic Reviews · doi:10.1186/s13643-026-03361-0
“Among these, 15 studies [86, 102, 125, 137, 142, 143, 146, 153, 156, 161, 162, 165, 173, 174, 179] provided a justification for the use of mixed-effects models, most commonly citing their ability to account for correlation between repeated measurements within individuals, accommodate unbalanced…”
- Authors
- Tomiyama, A. J., Puterman, E., Epel, E. S., Rehkopf, D. H., & Laraia, B. A.
- Affiliations
- University of California, Los Angeles (US)
- University of California, San Francisco (US)
- Stanford University (US)
- University of California, Berkeley (US)
- Corresponding author
- Tomiyama, A. Janet
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-09-20
- Volume
- 45
- Issue
- 1
- Pages
- 3-12
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- PMC
- PMC11412232
- OpenAlex
- W2055642256
- Semantic Scholar
- b57e96195ff665552bda639d6fe89bd7e268af91
- Cited by
- 37
- References
- 77
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 1 · 2014: 3 · 2013: 2 · 2012: 1
- FWCI
- 2.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Office of the President, University of California (142691)
- National Heart, Lung, and Blood Institute (R01HL158555)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- chronic psychological stress, racial disparities, body mass index change, childhood obesity, adolescent girls, Black girls, weight gain, socioeconomic status
- MeSH terms
- Adolescent, Age Factors, Black or African American, Child, Female, Humans, Longitudinal Studies, Obesity, Puberty, Social Class, Stress, Psychological, United States, Models, Statistical, Comorbidity, Body Mass Index, White People, Health Status Disparities, Young Adult
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