You’ve probably heard that chronic stress can make you fat – especially around the middle. Although it can affect anyone, it’s a common concern especially among mid-life women as they start to go into peri-menopause and begin to experience changes in their body that feel out of their control.
In this post I’ll try to define chronic stress, explain the basic stress response and how it impacts fat accumulation and distribution, it’s influence on emotional eating behaviors, disrupted sleep, and finally some stress management coping strategies.
What is Chronic Stress?
Chronic stress refers to a prolonged state of psychological or emotional tension, strain, or pressure that persists over an extended period of time. It can also include physiologic stressors, not just mental or emotional. It is different from acute stress, which is a temporary and short-term response to a specific situation or event, such as the “running away from a saber-toothed tiger” analogy that you’ve heard countless times.
Chronic stress often results from ongoing or recurring stressors, such as:
- work-related pressures
- financial difficulties
- relationship problems
- caregiving responsibilities
- chronic diseases such as diabetes
- health problems such as cancer or a chronic infection
- food sensitivities, especially if you aren’t aware or are eating those foods anyway
- regular exposure to toxins in the environment, skincare products
- regular use of drugs or alcohol
- not enough recovery from exercise
It can also arise from a combination of multiple stressors that continue over an extended duration.
Chronic stress can have a cumulative effect on the body and mind, leading to various physiological and psychological consequences. It can disrupt the body’s natural balance and trigger an overactive stress response, resulting in elevated levels of stress hormones like cortisol. These prolonged periods of elevated cortisol levels can impact multiple systems in the body and contribute to various health problems if left unaddressed.
Cortisol & It’s Impact on Fat Distribution
We can’t really talk about cortisol without giving some basic information about the Hypothalamic Pituitary Adrenal axis (HPA axis) first.
The HPA axis plays a vital role in the body’s stress response and regulates the release of stress hormones, including cortisol.
Here’s a very basic breakdown of how the HPA axis responds to chronic stress:
- Hypothalamus: When the body perceives a stressor, the hypothalamus, a region of the brain, releases a hormone called corticotropin-releasing hormone (CRH). CRH acts as a signal to the pituitary gland.
- Pituitary Gland: In response to CRH, the pituitary gland, located at the base of the brain, secretes adrenocorticotropic hormone (ACTH). ACTH travels through the bloodstream to the adrenal glands.
- Adrenal Glands: The adrenal glands, located on top of the kidneys, produce and release cortisol in response to ACTH stimulation. Cortisol is a primary stress hormone that helps the body deal with stress by increasing energy production and altering various physiological processes.
- Cortisol Release: In the presence of chronic stress, the HPA axis can become dysregulated. The hypothalamus continues to release CRH, leading to the prolonged secretion of ACTH and cortisol from the adrenal glands. This results in elevated and sustained levels of cortisol in the bloodstream.
- Impact on the Body: Prolonged elevation of cortisol due to chronic stress can have several effects on the body:
- Metabolism and Fat Storage: Cortisol can stimulate appetite, leading to cravings for high-calorie foods. It also promotes the redistribution of fat, favoring the accumulation of visceral fat around the abdominal area.
- Blood Sugar Regulation: Cortisol can increase blood sugar levels by promoting glucose production in the liver. This can lead to insulin resistance and potentially contribute to the development of type 2 diabetes. More about this in a minute.
- Immune Function: Elevated cortisol levels can suppress immune function, making individuals more susceptible to infections and diseases.
- Sleep and Mood: Chronic stress and cortisol dysregulation can disrupt sleep patterns, leading to insomnia or poor sleep quality. It can also contribute to mood disorders such as anxiety and depression.
It’s very common for women in mid-life to have difficulty sleeping, especially if they are having hot flashes or other sleep disturbances caused by hormone fluctuations. I’ve already addressed an entire blog post about how poor sleep can lead to fat gain, so I won’t go into that any more here.
Women in peri-menopause or menopause are particularly vulnerable to the stress response and chronically elevated cortisol. Estrogen acts as a buffer for a lot of things – somewhat as an anti-inflammatory hormone as well as an anabolic hormone. It helps us build and keep bone and muscle. Muscle acts like a sponge for blood sugar and insulin, which improves insulin sensitivity. Since we accelerate bone and muscle loss in early menopause, we also become more insulin resistant and more vulnerable to the stress response described earlier.
Cortisol, Insulin, and Belly Fat
Cortisol can have a significant impact on insulin regulation, particularly in the context of chronic stress, insulin resistance, and belly fat accumulation. Here’s an explanation of these interrelated factors:
- Cortisol influences the body’s response to insulin, a hormone produced by the pancreas that helps regulate blood sugar levels. When cortisol levels rise, it can lead to the following effects on insulin:
- Insulin Resistance: Chronic elevation of cortisol, as seen in chronic stress, can contribute to insulin resistance. Insulin resistance occurs when cells become less responsive to the effects of insulin, leading to reduced glucose uptake into the cells and increased blood sugar levels.
- Glucose Production: Cortisol stimulates glucose production through a process called gluconeogenesis. This can lead to increased blood sugar levels and, in turn, trigger the release of more insulin from the pancreas to compensate.
- Impaired Insulin Signaling: Cortisol can interfere with insulin signaling pathways, disrupting the proper functioning of insulin receptors on cells. This interference can further contribute to insulin resistance.
- Chronic Stress, Insulin Resistance, and Belly Fat: Chronic stress, and the resulting dysregulation of cortisol, can contribute to the development of insulin resistance, which in turn can impact fat storage and distribution:
- Belly Fat Accumulation: Insulin resistance can lead to increased abdominal fat deposition. When cells become less responsive to insulin, excess glucose remains in the bloodstream, promoting the conversion of glucose into fat in the abdominal region. This contributes to the accumulation of visceral fat, which is the fat located deep within the abdomen surrounding vital organs.
- Metabolic Syndrome: Insulin resistance, along with other factors such as high blood pressure, elevated triglycerides, and reduced high-density lipoprotein (HDL) cholesterol, can contribute to metabolic syndrome. Metabolic syndrome is a cluster of conditions that significantly increase the risk of cardiovascular disease, type 2 diabetes, and central obesity (excessive belly fat).
- Feedback Loop: The relationship between cortisol, insulin, and belly fat can create a feedback loop that exacerbates the issue. High cortisol levels can lead to insulin resistance, which in turn can promote the deposition of belly fat. The accumulation of belly fat can further contribute to the release of inflammatory substances that perpetuate the stress response, leading to continued cortisol secretion. It’s a vicious cycle that feeds upon itself.
Influence of Chronic Stress on Eating Behaviors
When people experience stress, it can often trigger changes in eating behaviors, leading to stress-induced eating. This response varies among individuals, but generally, stress can influence food choices and appetite regulation. Here’s an explanation of the physiological response to stress-induced eating and its impact on insulin and blood sugar levels:
- Stress-Induced Eating: Stress can lead to changes in appetite, often resulting in the consumption of high-calorie, comfort foods. You probably aren’t binging on broccoli or kale, even though they’re carbs. Right? This is influenced by various factors, including the release of stress hormones and changes in brain chemistry.
- Stress Hormones and Appetite: During times of stress, the body releases stress hormones like cortisol, which can influence appetite and food preferences. Cortisol can stimulate the brain’s reward center, leading to cravings for foods high in sugar, fat, and salt. This can result in an increased intake of calorie-dense foods.
- Impact on Insulin and Blood Sugar Levels: Stress-induced eating, particularly the consumption of high-sugar foods, can affect insulin and blood sugar levels in the following ways:
- Blood Sugar Spikes: Consuming foods high in refined sugars can cause a rapid increase in blood sugar levels. This triggers the release of insulin from the pancreas to help transport glucose into cells for energy production.
- Insulin Response: The surge in blood sugar prompts the pancreas to release more insulin to facilitate glucose uptake by cells. If stress-induced eating occurs frequently or involves excessive calorie consumption, it can lead to higher insulin demands.
- Insulin Resistance: Chronic stress and overconsumption of high-calorie foods can contribute to insulin resistance. Insulin resistance occurs when cells become less responsive to the effects of insulin, resulting in elevated blood sugar levels. This can increase the risk of developing type 2 diabetes.
- Emotional Eating and the HPA Axis: Stress-induced eating is often associated with emotional eating, which involves using food as a coping mechanism for emotional distress. Emotional eating can further impact the HPA axis, leading to a dysregulation of stress hormone release, including cortisol.
- Vicious Cycle: Stress-induced eating can create a vicious cycle. Stress triggers the consumption of unhealthy foods, which can affect insulin and blood sugar levels. In turn, imbalanced blood sugar levels can impact mood, energy levels, and stress resilience, potentially leading to more stress and further unhealthy eating habits.
Stress Reduction Techniques
To mitigate the physiological impact of stress-induced eating on insulin and blood sugar levels, it’s important to develop healthy coping strategies for managing stress. This may include:
- practicing stress reduction techniques such as meditation or breathing exercises
- engaging in regular physical activity that you enjoy
- seeking support from a therapist or counselor
- adopting a balanced diet with nutrient-dense foods
- getting out in nature
- keeping a regular circadian rhythm by getting good sleep at the same time each night
These strategies can help regulate appetite, promote stable blood sugar levels, and support overall well-being.
It’s important to note that chronic stress and prolonged activation of the HPA axis can have a significant impact on overall health and well-being. Implementing effective stress management strategies can help regulate the HPA axis and reduce the negative consequences associated with chronic stress.
Ready to try a new fitness program or work on lifestyle habits to decrease your stress? Contact me to see how I can help.
Herhaus, B., Ullmann, E., Chrousos, G. et al. High/low cortisol reactivity and food intake in people with obesity and healthy weight. Transl Psychiatry 10, 40 (2020). https://doi.org/10.1038/s41398-020-0729-6
Joseph, J. J., & Golden, S. H. (2017). Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Annals of the New York Academy of Sciences, 1391(1), 20–34. https://doi.org/10.1111/nyas.13217
van Rossum, E.F.C. (2017), Obesity and cortisol: New perspectives on an old theme. Obesity, 25: 500-501. https://doi.org/10.1002/oby.21774