Stress-related weight gain is a real thing and plagues many people. We know from research that there are associations between chronic stress and the body holding on to that stubborn weight, particularly in the place we want it the least…. Our belly!
Researchers in specialized areas of health and science, such as neurobiology, have observed overlaps between psychological stress and factors associated with body weight, including appetite and energy regulation. They have also observed the effect of psychological stress on various cognitive processes such as executive function and self-regulation.
Psychological and/or psychosocial stress, as it could be categorized, that may result from work, relationships, life balance, and finances have all been assessed in association with eating behaviors.
Furthermore, studies have established various connections between stress-induced eating patterns, such as the tendency to turn to “comfort food” or impulsive over eating. Each of which could lead to an increase in visceral fat.
Excess visceral fat is something we are looking to avoid!
Stress can also impact hormonal activity, such as cortisol the primary hormone involved with stress response, which may set off a cascade that influences body weight as well. Cortisol also influences blood sugar regulation, mood, motivations, and even fear. It is relevant when chronic stress is considered and can trigger the process that leads to weight gain.
A stressful event also prompts the release of glucose in which the body can convert to quick, readily available energy (for example, if the need to quickly run away from something frightening presented itself). However, if elevated stress levels are either initiated when they are, perhaps, less necessary or end up being prolonged (i.e. chronic), it can lead to a release of glucose when it’s not needed for that type of use. Then, the storage of energy can be created in the form of body fat. This is something that has been observed when elevated stress levels have resulted from psychological sources.
The connection between stress and inflammation levels has been thoroughly reviewed. Furthermore, this can contribute to the onset of many adverse health conditions. The Institute for Functional Medicine (IFM) summarizes this HERE.
Needless to say, there are a lot of things that excess stress levels can impact, including how our bodies manage weight.
Although researchers are still trying to nail down exactly who is most affected by these dynamics and why so, certain people may be at greater risk.
This study in Obesity suggests that women who are caregivers in tougher situations, such as caring for an autistic child, may have a higher likelihood of facing challenges with their weight as influenced by chronically elevated stress levels. This was observed to be especially applicable when the participant demonstrated a higher likelihood for more impulsive risk-taking behavior in the past.
The researchers in the study mentioned above pointed out that although MBSR (Mindfulness-based Stress Reduction) could be a good start to proactively manage harmful stress levels, that the framework would likely be enhanced for better outcomes in weight loss with an added focus on eating mindfully. This was recommended to retrain the behavioral dynamic between reward-related eating as a coping mechanism for circumstances such as experiencing chronic stress.
Mindful eating is further supported by a systematic review in Current Obesity Reports, while another review in Nutrition Research Reviews highlighted mindfulness as a potentially viable strategy to address emotional eating which could influence weight management. Essentially what a review article implies is that across a body of evidence, the solution has demonstrated favorable results and is, therefore, considered more valid.
The researchers behind this article in The Journal of Behavioral Medicine explored stress and weight gain in women shortly after the birth of their first child. The rationale to take a deeper dive in this area was related to the shift in the available time, energy, and motivation for self-care that can occur with a new mother as well as the relationship between the health of the mother to that of the child. They suggested that stress management should be integrated into lifestyle health approaches for a longer-term post-childbirth, but that this type of resource is not widely available. Also, they included mind-body approaches as a potential avenue to consider due to the whole systems perspective as well as joining supportive networks.
Another population of interest is people that are coping with PTSD (post-traumatic stress disorder) which is sort of a unique category of stress because it arises from events that are considered acute vs chronic or recurring but may result in longer-term effects that then make the stress response chronic.
Prevalence of overweight and obesity has been monitored in individuals with PTSD. Studies have been a little bit fragmented, but, as a systematic review published in Harvard Review of Psychiatry reported, PTSD may lead to higher BMI, a standardized measure of weight status, particularly in women. Review articles published before this one also had similar conclusions.
This study in the JAMA Psychiatry (Journal of American Medicine) looked specifically at women with PTSD. The researchers mentioned previous studies where decreased physical activity, increased consumption of unhealthy foods and beverages, and generally dysregulated food intake was noted in people with PTSD. Furthermore, internal dysregulation, such as neuroendocrine function, cortisol levels, and impact on other biochemical activity, has been observed. Unfortunately, no specific method of treatment was suggested in their discussion.
It is important to point out that BMI can a bit subjective as a measure of weight status, but has been a standard for several years and is a measurement used across many studies. Studies that have included other measures, such as waist circumference (WC) and/or waist-to-hip ratio (WHR), could be more telling.
Other emerging research is looking at various interrelationships between certain biochemical factors associated with post-traumatic stress, such as inflammatory markers or neuroendocrine activation. It is possible that internal responses to this sort of stress could be the primary reason that individuals with PTSD have a greater risk for the onset of obesity.
Many of the articles detailing these studies indicated support for greater emphasis on healthcare provider knowledge and the ability to address stress management in consideration for patient’s health. Therefore, it may be a good idea to include this on the list of topics of discussion when you meet with healthcare providers.
It is unclear why the emphasis in many of the research studies has been on such refined or specific populations, such as women in a specific time frame of life or circumstance, and that other groups have not been as thoroughly reviewed.
However, what is clear that a key recurring theme in the research is “chronic stress” which can influence mental well-being, hormone regulation, immune health, and inflammation levels. Furthermore, this can present challenges to the endocrine system as a whole. Also, when paired with other factors that may also lead to weight gain or the various metabolic diseases related to obesity, the association between chronic stress and weight status, is usually strengthened.
There is also a dynamic between what is referred to as “obesity stigma” and the definition of one’s identity. This topic could be a follow-up article all in itself, but there is supportive evidence to suggest that finding ways to reduce stigmas associated with overweight or obese weight statuses could be meaningful for both reducing psychological stress and better approaches to weight loss.
So, how can we reduce chronic stress for better weight loss or management?
Essentially, when we are looking at impacts of stress, there is a range of interactions across cognitive functions, physiology, biochemistry, and our behaviors. Therefore, approaches that consider these interacting facets have the most support.
Self-care is widely mentioned across both literature and major health advising sources, such as The Mayo Clinic. Self-care is a combination of daily activities and behaviors in support of overall health and well-being as well as favorable mental and emotional engagements.
Two areas within self-care that may be worth dedicated consideration are 1) sleep and 2) physical activity. Adverse stress is thought to be disruptive to the patterns associated with each of these areas and they are also relevant to effective weight management.
Keeping tabs on factors that may be influencing physiology and biochemistry is another integrated strategy worth placing focus. Our bodies are biochemical and although we may not feel the effects of imbalances, we may have inadvertently set ourselves up to ignore them or don’t realize what might be an indicator of a problem. These imbalances can essentially hack our ability to keep excess weight off and could be influencing our mental well-being as well. Therefore, creating a vicious cycle that may be challenging to escape from.
Oxidative stress, for example, is a different kind of stress but is ever so important to consider in a weight management approach. Again, the research is consistently emerging in this area and there is evidence to suggest that certain levels of oxidative stress may be good for us. For this discussion, I’m referring to adverse oxidative stress levels.
The association between adverse oxidative stress and obesity has been observed across both human studies of epidemiological (meaning patterns of disease) and clinical nature as well as animal studies, as highlighted in this journal article. In a nutshell, it is thought that adverse oxidative stress could trigger extra adipose tissue, i.e. part of what we are looking at when we discuss “belly fat”, and influence other underlying factors associated to obesity, such as chronic inflammation or impaired mitochondrial function which would influence our body’s ability to produce and regulate energy.
The health of the microbiome is another aspect. The composition of the gut microbiota is influenced by both bodyweight itself and dietary factors. It is also responsive to psychological stress. It is relevant because we have come to understand just how many physiological functions are influenced by the health of the microbiome including stress response, body weight, and eating behaviors. An important subset point here is to also monitor the intake of sugar which could go back to that “comfort food” discussion above.
Monitoring cortisol levels may be another thing worth the while. Essentially the approach here is to determine whether or not what is happening with cortisol in the body also places someone in a higher risk category. As discussed in a more scientific language in a Current Obesity Reports journal article, certain patterns of cortisol may lead to more abdominal obesity which is more tightly linked to metabolic and cardiovascular diseases.
It is important to recognize that much of this research is ongoing, however, what is clear, is that dietary factors do play a role. A dietary approach rich in nutrients and relevant compounds paired with low intake of inflammatory foods could help both your weight and stress levels.
Working with a health professional can also be helpful versus going at stress management on your own. Qualified health professionals can help with internal factors, such as those mentioned above, and to help identify the source(s) and, if possible, type of stress.
A few questions you might ask yourself include:
- “Is your psychological stress mostly chronic mild stress related to daily life?”
- “Are there specific social circumstances leading to your stress and what kind of social position are they putting you into?”
- “Have you experienced a traumatic event and, if so, when in your life did this occur?”
There is also such as thing as “perceived stress” which, in a nutshell, is an indicator of how the person psychologically responds to stress or how they interpret how much stress they are under versus simply quantifying the stress as a dose alone and applying it generically across individuals. To bring further context to this, some people will find circumstances more or less stressful while others may not even find those same circumstances stressful at all.
Practicing approaches involving mindfulness AND eating mindfully could be one of the best research-backed solutions for both stress and behavior associated with eating patterns. Although more studies are needed which include the approaches within weight management programs, studies have shown that these practices increase internal awareness.
The current direction of the research is compelling since stress-induced eating patterns can be harder to remedy. This is, in part, because often they are reducing psychological stress for the person engaging in the patterns. Therefore, it may take a more integrated, comprehensive approach including a focus on both the mindset and behavior to make changes happen. This is where mindfulness related practices, including the framework of mindful eating, serve to make the most impact. Also, as this article details, the approach is less focused on rules to eating which may be cumbersome for people. Instead, it is much centered on sensational factors, such as enjoyment.
A transcript from Duke Integrative Medicine provides a popular mindful eating exercise with a raisin while this article from Mindful provides 6 other tactics for those who may not be as into the raisin exercise.
Furthermore, mind-body practices emphasize a whole-systems perspective honing in on the various interconnections between mental, physical, emotional, social, and physiological. The emphasis on each of these aspects to health has the potential to decrease stress and improve outcomes associated with weight simultaneously. Yoga, meditation, and therapies such as acupuncture are common to mind-body medicine.
Actively practicing relaxation may be a viable way to intervene on the tendency for stress-induced eating that is not healthful. It is thought that relaxation techniques, such as progressive muscle relaxation and meditation, could mediate reward pathways, emotional facets, and habits related to coping mechanisms.
Other tips from the research include 1) practicing realistic avoidance, 2) joining a supportive network (even if online), and 3) integrating the approaches as a long-term strategy (versus assuming something will be a quick fix).
To recap, research-backed approaches to stress which can help with weight loss are:
- Consistent self-care
- A check-up with a health professional
- Addressing factors associated with health physiology and biochemistry
- Appropriate nutrition
- Behavioral- & mindset-based interventions, such as those that focus on mindfulness
- Realistic avoidance
- Relaxation
- Social activity and/or supportive networks
- Considering it for the long-haul
Photo by Jennifer Burk on Unsplash
Ashley L Arnold, MBA, MPH is a lifestyle health educator and coach who supports clients to channel authority over their health, well-being, and overall vitality. Offering health education approaches and 1-on-1 coaching modules, she gets them out of excess weeds of information and inconsistent practices that don’t get desired results. Through helping people focus on the right applications paired with appropriate consideration for bio-individual facets, they become stronger, more confident self-advocates for their health. Bottom line, they will surpass challenges, embrace healthful living with ease, and, best of all, feel a greater sense of empowerment and more energy!
In need of formalized support to make healthful lifestyle changes? Contact me through my business site.
Sources:
Duke Integrative Medicine. (n.d.). Mindful Eating Exercise. Retrieved from https://www.dukeintegrativemedicine.org/dukeimprogramsblog/wp-content/uploads/sites/4/2017/08/Mindful-Eating-Transcript.pdf.
Dunn, C., et al. (2018, Mar). Mindfulness Approaches and Weight Loss, Weight Maintenance, and Weight Regain. Current Obesity Reports, 7(1), 37-49.
How Do Stress and Inflammation Contribute to Chronic Disease? (n.d.) The Institute for Functional Medicine. Retrieved from http://bit.ly/Stress-ChronicDisease (shortened link).
Huberty, J., et al. (2017, Feb). Exploring the Need for Interventions to Manage Weight and Stress During Interconception. Journal of Behavioral Medicine, 40(1), 145-158.
Kubzansky, L.D., Bordelois, P., & Jun, H.J. (2014, Jan). The Weight of Traumatic Stress: A Prospective Study of Posttraumatic Stress Disorder Symptoms and Weight Status in Women. JAMA Psychiatry, 71(1), 44-51.
Manna, P. & Jain, S.K. (2015, Dec 1). Obesity, Oxidative Stress, Adipose Tissue Dysfunction, and the Associated Health Risks: Causes and Therapeutic Strategies. Metabolic Syndrome and Related Disorders 13(10), 423-444.
Masih, T., Dimmock, J.A., Epel, E.S., & Guelfi, K.J. (2017, Nov 1). Stress-induced Eating and the Relaxation Response as a Potential Antidote: A Review and Hypothesis. Appetite, 118, 136-143.
Masodkar, K., Johnson, J., & Peterson, M.J. (2016, Jan 7). A Review of Posttraumatic Stress Disorder and Obesity: Exploring the Link. The Primary Care Companion for CNS Disorders, 18(1).
Mason, A.E., et al. (2018, Mar 22). Chronic Stress and Impulsive Risk-Taking Predict Increases in Visceral Fat over 18 Months. Obesity, 26, 869-876.
Michigan Medicine, University of Michigan. (n.d.). Stress Management: Doing Progressive Muscle Relaxation. Retrieved from https://www.uofmhealth.org/health-library/uz2225.
Nelson, J.B. (2017, Aug). Mindful Eating: The Art of Presence While You Eat. Diabetes Spectrum: a publication of the American Diabetes Association, 30(3), 171-174.
Phillips, A.C. (2013). Perceived Stress. In: Gellman M.D., Turner J.R. (eds) Encyclopedia of Behavioral Medicine. Springer, New York, NY.
Razzoili, M. & Bartolomucci, A. (2016, Jul). The Dichotomous Effect of Chronic Stress on Obesity. Trends in Endocrinology & Metabolism, 27(7), 504-515.
Savini, I., Catani, M. V., Evangelista, D., Gasperi, V., & Avigliano, L. (2013, May). Obesity-Associated Oxidative Stress: Strategies Finalized to Improve Redox State. International Journal of Molecular Sciences, 14(5), 10497–10538.
Suliman, S., et al. (2016, Jul-Aug). Posttraumatic Stress Disorder, Overweight, and Obesity: A Systematic Review and Meta-analysis. Harvard Review of Psychiatry, 24(4), 271-293.
Tenk, J., et al. (2018, Sep). Perceived Stress Correlates with Visceral Obesity and Lipid Parameters of the Metabolic Syndrome: A Systematic Review and Meta-Analysis. Psychoneuroendocrinology, 95, 63-73.
Tomiyama, J.A. (2019). Stress and Obesity. Annual Review of Psychology, 70, 5.1-5.16.
van der Valk, E.S., Savas, M., & van Rossum, E.F.C. (2018, Apr 16). Stress and Obesity: Are There More Susceptible Individuals? Current Obesity Reports, 7(2), 193-202.
Warren, J.M., Smith, N., & Ashwell, M. (2017, Dec). A Structured Literature Review on the Role of Mindfulness, Mindful Eating and Intuitive Eating in Changing Eating Behaviors: Effectiveness and Associated Potential Mechanisms. Nutrition Research Reviews, 30(2), 272-283.
Willard, C. (2019, Jan 17). 6 Ways to Practice Mindful Eating. Mindful. Retrieved from https://www.mindful.org/6-ways-practice-mindful-eating/.
