Can Stress Cause Weight Gain?

How to keep the world's woes from weighing you down

By Colette Bouchez
WebMD Weight Loss Clinic - Feature

Reviewed By Kathleen Zelman, MPH, RD, LD

Your job is hanging by a thread, and the credit-card bills are mounting. Your teenager wants to quit school and become a professional snowboarder. Or maybe it's the increasing tensions in the world, brought to you 24 hours a day on your TV screen, getting you down.

Regardless of the reason, stress is a way of life in the 21st century. And for some people, the effects go beyond feelings of anxiety and discomfort. For these people, stress can mean facing each day ravenously hungry -- and adding weight gain to their list of worries.

"While the immediate . . . response to acute stress can be a temporary loss of appetite, more and more we are coming to recognize that for some people, chronic stress can be tied to an increase in appetite -- and stress-induced weight gain," says Elissa Epel, PhD, an assistant professor in the department of psychiatry at the University of California at San Francisco.

The problem, she says, lies within our neuroendocrine system -- a brain-to-body connection that harkens back to evolutionary times and which helped our distant ancestors to survive. Though today the source of the stress is more likely to be an unpaid bill than a saber-toothed tiger, this system still activates a series of hormones whenever we feel threatened.

"These hormones give us the biochemical strength we need to fight or flee our stressors," Epel tells WebMD.

The hormones released when we're stressed include adrenalin -- which gives us instant energy -- along with corticotrophin releasing hormone (CRH) and cortisol. While high levels of adrenalin and CRH decrease appetite at first, the effects usually don't last long.

And cortisol works on a different timetable. Its job is to help us replenish our body after the stress has passed, and it hangs around a lot longer. "It can remain elevated, increasing your appetite and ultimately driving you to eat more," says Epel.

While this system works fine when our stress comes in the form of physical danger -- when we really need to "fight or flee", and then replenish -- it doesn't serve the same purpose for today's garden-variety stressors.

"Often, our response to stress today is to sit and stew in our frustration and anger, without expending any of the calories or food stores that we would if we were physically fighting our way out of stress or danger," says Shawn Talbott, PhD, an associate professor in the Department of Nutrition at the University of Utah and author of The Cortisol Connection.


"Often, eating becomes the activity that relieves the stress"

In other words, since your neuro-endocrine system doesn't know you didn't fight or flee, it still responds to stress with the hormonal signal to replenish nutritional stores -- which may make you feel hungry.

Following those stress signals can lead not only to weight gain, but also the tendency to store what is called "visceral fat" around the midsection. These fat cells that lie deep within the abdomen have been linked to an increase in both diabetes and heart disease.

To further complicate matters, the "fuel" our muscles need during "fight or flight " is sugar -- one reason we crave carbohydrates when we are stressed, says endocrinologist Riccardo Perfetti, MD, PhD.

"To move the sugar from our blood to our muscles requires insulin, the hormone that opens the gates to the cells and lets the sugar in," says Perfetti, who directs the outpatient diabetes program at Cedars Sinai Medical Center in Los Angeles. And high levels of sugar and insulin set the stage for the body to store fat.

"So people who are under stress, metabolically speaking, will gain weight for that very reason," Perfetti tells WebMD.

Mind Over Matter

As much as we would like to blame all our weight gain on stress, experts say that eating in response to stress can also be a learned habit -- one that's merely encouraged by brain chemistry.

"Under stress, there's an impulse to do something, to move, and often, eating becomes the activity that relieves the stress. It's easy to do and it's comforting," says David Ginsberg, MD, a psychiatrist and director of the Behavioral Health Program at New York University Medical Center.

In fact, it may be our bodies' initial response to rising levels of cortisol that teaches us there is comfort in sugary or starchy foods.

"During the first couple of days following a stressful event, cortisol is giving you a clue to eat high-carbohydrate foods," Perfetti tells WebMD. "Once you comply, you quickly learn a behavioral response that you can feel almost destined to repeat anytime you feel stressed."

Now for the good news: Whether your urge to eat is driven by hormones or habits or a combination of both, research shows there are ways to interrupt the cycle, break the stress and stop the weight gain.

Here's what the experts recommend:

1. Exercise. This is the best stress-buster -- and also happens to be good for you in lots of other ways. "It not only burns calories, when you move your body, even with a simple activity such as walking, you begin to produce a cascade of biochemicals, at least some of which counter the negative effects of stress hormones -- as well as control insulin and sugar levels," says Talbott.

At the same time, Ginsburg notes that exercising too hard for too long can raise cortisol levels and actually increase stress. The answer, he says is to choose an activity you really enjoy doing -- be it an aerobic sport like running or a calmer activity such as Pilates -- and then keep workouts to a length that doesn't exhaust you (this could be as little as 20 minutes a day, three to five days a week).

2. Eat a balanced diet -- and never skip a meal. "Eat breakfast -- and try to consume six small rather than three huge meals a day, with foods from all the food groups," Ginsberg tells WebMD. This helps keep blood sugar levels steady, which in turn put a damper on insulin production and eventually reduce cortisol levels -- all helping to control appetite and weight.

3. Don't lose sleep, over your weight problems or your stress -- When we don't get enough rest, cortisol levels rise, making us feel hungry and less satisfied with the food we do eat, Ginsberg says.

4. Devote time to relaxation -- Because it works much like exercise to produce brain chemicals that counter the effects of stress, Ginsburg suggests finding the activities that make you feel relaxed and calm. For some, he says, yoga can do the trick. Others may prefer meditation techniques or deep breathing.

And don't overlook the relaxing power of cuddling up on a sofa with a good book or magazine, or even playing your favorite movie on the VCR. "Anything that makes you feel calm and relaxed will help counter the biochemical effects of stress," says Talbott.

5. Snack on whole grain, high fiber foods. If you just can't ignore those stress-related hunger pangs, try filling your tummy with foods high in fiber and low in sugar, like oatmeal, whole wheat bread, or fruits such as pears or plums.

According to Pamela Peeke, MD, MPH, author of Fight Fat After Forty, foods that are high in sugar and simple carbohydrates -- like white flour, cookies, cake, white rice, or pasta -- cause insulin levels to rise, which in turn increases stress hormones and ultimately makes you feel more hungry. But high-fiber, whole-grain foods -- particularly cereals like oatmeal or multi-grain flakes, as well as fruits -- help keep insulin levels on a even keel, which can help control blood sugar levels, and ultimately, hunger, according to Peeke.

6. Avoid caffeine, cigarettes and alcohol -- According to the American Institute of Stress, cigarettes, as well as caffeine-laden soft drinks, coffee, tea, and even chocolate, can cause cortisol levels to rise, stress to increase, blood sugar to drop and hunger to prevail. The institute also cautions against drinking too much alcohol, which can affect blood sugar and insulin levels.

7. Take your vitamins -- A number of medical studies have shown that stress can deplete important nutrients -- particularly the B complex and C vitamins, and sometimes the minerals calcium and magnesium.

Because these nutrients are needed to balance the effects of stress hormones like cortisol, and may even play a role in helping us burn fat, it's important to keep levels high, Talbott says. While a good diet will help, he says, taking a high potency multi-vitamin supplement can insure you give your body what it needs to not only deal with the stress, but also burn fat and lose weight.

And speaking of losing weight, here's one bit of news you may be happy to hear: Experts say you shouldn't try to go on a strict diet when you're under extreme or chronic stress.

In one study, published in the Journal of Clinical Nutrition in 2001, researchers from the University of British Columbia found that severely limiting calorie intake could kick off a series of biochemical events that ultimately not only increased stress levels, but could make people feel more hungry.

The researchers followed 62 women for three days. Of this group, 33 were on a diet of no more than about 1,500 calories a day, while the other 29 consumed up to about 2,200 calories daily.

After analyzing urine samples, researchers found that the women who had consumed the least food had the highest levels of cortisol. Not surprisingly, these same women also reported more stress during what researchers called "daily food-related experiences." In short, the more they restricted food intake, the greater their levels of stress hormones, and, ultimately, the more they wanted to eat.

If you find yourself chronically stressed out, the experts say, you should do what you can to decrease your stress levels, then follow a reduced-calorie, yet balanced, diet to stop the weight gain and lose the extra pounds.

Originally published April 23, 2003
Medically updated May 2, 2005.


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