Chapter 10 Cortisol: Stress Can Make You Fat

ere’s one for you, stress may cause you to gain weight. When we’re under significant stress, extra cortisol is released. As we have learned, insulin and glucagon make sure calories are either stored or burned.  Now, cortisol directs where the fat is to be stored.  And when there is too much cortisol, from too much stress, calories are stored in the intra-abdominal area, or belly.  This is the type of fat we want to get rid of because belly fat is associated with all kinds of health problems.

 With our new environment, yet another good hormone has become dysfunctional.

            When we have plenty of food and are not under a lot of stress, the calories we eat are sent to our muscles for daily work. But add a lot of stress to our lives, and our “fight or flight” mechanisms kick in. Suddenly we want starchy food to give us quick energy. And sugary foods give us the kind of energy we need to run fast.

 Unfortunately, Mother Nature made no differentiation between physical danger and emotional danger. In our modern life, we don’t run away from saber-toothed tigers; instead, traffic jams are what give us stress. Instead of running away from danger, we stew in stress at work or in front of the television. Cortisol courses through our body. But we’re not moving, not burning calories.

 When we are under stress and not moving, cortisol moves fat cells to our belly for future use. Over time, this belly fat creates the insulin resistance that you learned about in the insulin chapter and leads to hypertension, diabetes, hyperlipidemia, infertility, and certain cancers.

 When cortisol is elevated due to stress, one of the comfort hormones called dopamine becomes depressed. Dopamine is responsible for the wonder we feel when we hold a little baby’s hand, view a glorious sunset, or enjoy the company of someone we love. Usually when we eat tasty food, dopamine gives us similar feelings.

 But when we’re under stress, especially when we are overweight, cortisol blunts the dopamine effect. It’s not hard to imagine that this could lead to eating more than is necessary, hoping to create satisfaction and pleasure that would normally be there.

 What makes things worse is the foods our bodies want when we are under stress are high in sugar and fat for quick energy that can be used to help us run fast and far away from our apparent attackers. 

 For instance, one of my patients is a single grandmother who adopted her two-year-old hyperactive grandson (and what two-year-old isn’t hyperactive?).

 On one visit, she told me about her grandson, “I love him, he’s my blood, but he drives me nuts. When he finally goes to sleep, I’m exhausted, stressed, and an emotional wreck. All I want at that point is a whole pint of ice cream. And I don’t want to eat it out of a bowl. No, I want it straight out of the carton. When I’ve eaten it all, I feel calm and refreshed, and I can sleep like a baby.”

 Perhaps you also have a food that comforts you when you’re stressed. You may think you simply have a bad habit, but the truth is your brain picked the right food for you. It chose one that would best solve the chemistry of stress by raising the levels of dopamine and other comforting brain hormones.

Cortisol: Stress Can Make You Fat

Most people prefer high glycemic foods to fill the void.  They tend to choose either savory foods such as breads, chips, and French fries, or reach for sweet foods, such as cookies, candies, and cakes. However your body seeks to solve its chemistry problem, its ultimate goal is to increase dopamine levels so you’ll feel better. Unfortunately, these are usually the foods that pump up your insulin, makes you become insulin resistant, and cause you to put on belly weight, which will eventually make you sick.

 It’s important to state that cortisol is critical to our survival. Remember how “balance” is always the formula to health.  For instance, cortisol keeps us from going into shock when we are dehydrated. It also reduces inflammation when we’re injured. It even improves our memory.  But long-term exposure to large doses of cortisol will also kill us—eventually. Cortisol raises our blood pressure, our heart rate, and blood glucose because it’s preparing us for a fight. We also need more calories for this anticipated battle, so cortisol compels us to eat starchy and sugary foods. But when nothing happens, and we’re still sitting at our desk, our blood vessels begin to suffer, we are at risk for diabetes and our calories keep getting stored as belly fat.

 And it gets worse. How well do you sleep when you are stressed out?  Most of us find we stare at the ceiling, toss and turn, and basically wake unrefreshed. When we are sleep deprived, our bodies react the same way they do when we face starvation. We hold on to calories.  Our metabolism slows down. It turns out that sleep is very important to keep our weight under control.

Make sure stress doesn’t get in the way of your sleep. It simply isn’t worth it. Worse, as people gain weight, they may suffer from sleep apnea, which not only makes our sleep less satisfying, but can actually contribute to more obesity.  This occurs through the retention of carbon dioxide, which has been found to correlate with additional weight gain.

These findings have led many scientists to further examine the metabolic effects of sleep deprivation.  There was a fascinating study that was done on healthy college students.  We knew that people who get less sleep tend to be heavier but we did not understand the actual biology.  These students were given a baseline test in a sleep lab with a normal eight hours of sleep.  The fat cells between their skin and muscle walls were biopsied.  These cells were tested for their ability to handle carbohydrates in a healthy way.  Then, two months later they were brought back to the laboratory and were sleep deprived for just five nights.  Fat biopsies were repeated.  The molecular ability of the fat cells to deal with carbohydrates was significantly decreased.

 So find a way to deal with your stress and make sure you get a good night’s sleep. That way, you will literally be able to lose weight while you sleep.  Better biology leads to a better weight. 

There are numerous ways to deal with stress. Consider Teresa’s story. She was a single, middle-aged woman who did all the right

Cortisol: Stress Can Make You Fat

things. As she got older, she adjusted her diet to accommodate changes in her metabolism. But while her body stayed firm and slim, her belly seemed to get larger.  Teresa’s real problem was her career. Not only did it keep her from having an involved relationship, the stress it caused was through the roof. This stress was having a negative effect on multiple aspects of her health, and that was why she was seeing me.

 I jokingly prescribed a long vacation for her. When things that were overwhelming became “super overwhelming”, she finally filled that prescription with a three-week vacation that included a seven day cruise.

 Of course, you can’t diet on a cruise. And as she traveled through different countries, Teresa enjoyed local cuisines and delicacies that would not be part of her usual weight loss program. But Teresa wasn’t on this vacation to lose weight; she was there to relax and get her life and health back on track.

 Toward the end of the second week of her vacation, Teresa was lounging on a beach. She looked down at herself and suddenly realized that her tummy seemed smaller. She jumped up to look at herself standing. Sure enough, there was less flesh around her middle. When she got back to her hotel room and stood in front of a full-length mirror she confirmed that, yes, her belly fat had definitely gotten smaller.

 I can still remember the excitement in her voice when she told me about that day. We had a good laugh about the success of my prescription.

 Will a vacation on an “all you can eat” cruise work for you? Well, maybe or maybe not. I share Teresa’s story only to illustrate how stress often contributes to belly fat, especially in women, and how reducing stress may help. Perhaps you need a vacation to get perspective on life, reduce your stress, and begin sleeping well at night. And you’ll need to keep that stress down once you return back to the real world.

 Perhaps a better strategy would be to weave  mini-vacations into your weekly schedule where you set aside all the worries of life and simply relax. Our bodies weren’t designed to run away from saber-toothed tigers for days on end; we need moments of peace.  As we reduce stress in our lives, we will naturally get healthier. Maybe you won’t see an immediate reduction in weight, but you will make better choices that will ultimately help you achieve a healthy weight.