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Cortisol and Weight Gain: Understanding the Connection

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Cortisol and Weight Gain: Understanding the Connection

More than one in three men and more than one in four women are overweight, and more than two in five adults are obese (23). Despite eating a healthy diet and exercising regularly, it's all too common for patients to continue to struggle with weight gain. In a time when stress is at an all-time high, the missing piece to this puzzle may be high cortisol levels. 

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What is Cortisol?

Cortisol is a glucocorticoid steroid hormone synthesized in the adrenal glands, which are located on top of the kidneys. Besides its role in stress response, cortisol serves various functions, including increasing blood sugar levels, moderating inflammation, suppressing the immune system, and facilitating energy metabolism. (31

Cortisol secretion patterns align with the body's circadian rhythm. Levels peak in the morning and then gradually decline throughout the day until they are lowest at night. The brain's hypothalamus and pituitary gland regulate its production and release through the hypothalamic-pituitary-adrenal (HPA) axis.

In moments of heightened stress, cortisol is secreted from the adrenal glands, upregulating processes essential for survival and downregulating those processes that are not. This reflex is necessary for survival and benefits the body in acute scenarios. However, chronic HPA axis activation results in cortisol dysregulation and poor health outcomes, including metabolic dysfunction, inflammation, and neurodegenerative diseases. (14, 27

The Stress-Weight Connection

Chronic stress and high cortisol levels in the body can contribute to weight gain via several key pathways.

Cortisol's Role in Stress and Metabolism

Cortisol promotes gluconeogenesis, the process by which the liver produces glucose, leading to elevations in blood sugar (hyperglycemia). Hyperglycemia can trigger chronic inflammation. Chronic inflammation increases visceral fat, prompts overeating, and interferes with physical activity by causing joint pain and fatigue – collectively leading to weight gain. 

Excess glucose that is not utilized for immediate energy needs is eventually stored as fat, particularly in the abdominal region. This contributes to weight gain and metabolic dysfunction, increasing the risk of developing inflammatory conditions such as obesity, type 2 diabetes, and cardiovascular disease.

Cortisol counteracts the effects of insulin, the hormone responsible for signaling cellular glucose uptake from the bloodstream. This can lead to insulin resistance, perpetuating metabolic dysfunction by impairing glucose uptake into cells for energy production, leading to increased fat storage and weight gain.

Chronic stress and elevated cortisol levels can dysregulate appetite-regulating hormones. Leptin, known as the "satiety hormone," signals feelings of fullness to the brain, while ghrelin stimulates hunger. Dysregulation of these hormones can increase appetite, especially for foods high in sugar, fat, and salt. 

Fat Distribution and Visceral Fat

Excessive circulating cortisol and insulin levels trigger the storage of more visceral fat. Visceral fat is particularly harmful as it is metabolically active and releases inflammatory cytokines and adipokines that contribute to systemic inflammation and an increased risk of developing metabolic syndrome, insulin resistance, type 2 diabetes, and cardiovascular disease. (29, 35

Symptoms and Indicators of Cortisol-Induced Weight Gain

There are many potential causes of weight gain. Signs and symptoms that point to cortisol-induced weight gain include:

  • Central obesity, measured by an increased waist-to-hip ratio
  • Cravings for high-calorie, high-sugar foods
  • The development of insulin resistance or metabolic syndrome, which is the co-existence of high blood pressure, high blood sugar, abnormal cholesterol levels, and excess abdominal fat
  • Changes in mood, such as depression and anxiety
  • Sleep disturbances
  • Fatigue, often described as a "tired but wired" sensation.

4 Strategies to Manage Cortisol Levels and Prevent Weight Gain

By implementing these strategies to manage cortisol levels effectively, individuals can minimize the risk of weight gain and promote optimal health.

1. Reduce and Manage Stress

Effective stress reduction practices, such as mindfulness meditation, yoga, deep breathing exercises, and exercise, regulate cortisol levels. According to a 2018 review, these techniques improve eating behaviors and support weight loss efforts.

2. Switch to an Anti-Inflammatory Diet

Dietary adjustments can help manage cortisol levels and prevent weight gain. The Mediterranean diet is a well-studied plan that emphasizes fruits, vegetables, lean proteins, and healthy fats. Research shows that it is positively associated with weight loss and reductions in cortisol, blood sugar, and inflammation.

3. Improve Sleep and, Therefore, Cortisol Regulation

High cortisol levels can disrupt sleep. Poor sleep and inadequate sleep disruption can further disrupt the body's circadian rhythm and perpetuate the dysregulation of cortisol secretion. Sleep deprivation is linked to insulin resistance, overeating, and increased body mass index

Improving sleep hygiene by establishing a consistent sleep schedule, creating a relaxing bedtime routine, and minimizing exposure to screens before bed can help optimize cortisol regulation and support weight management.

4. Engage in Regular Physical Activity 

Regular physical activity is another effective strategy for managing cortisol levels and preventing weight gain. Exercise helps reduce stress, improve mood, promote healthy cortisol secretion, and enhance insulin sensitivity. (13, 43)

Incorporating a variety of activities, including aerobic exercise, strength training, and flexibility exercises, into a balanced fitness routine can help regulate cortisol levels and support overall metabolic health.

The Role of Professional Help

Seeking professional assistance can be instrumental in effectively managing cortisol levels and preventing weight gain. Healthcare professionals can offer personalized guidance, support, and interventions to address cortisol-related issues.

When to See a Doctor

It is advisable to consult a healthcare provider when experiencing persistent symptoms of stress, weight gain, or metabolic dysfunction. Medical consultation is particularly recommended to assess cortisol levels and rule out underlying health conditions such as Cushing's syndrome, a hormonal disorder characterized by excessive cortisol production and symptoms like: 

  • Abdominal weight gain
  • Muscle wasting in the arms and legs
  • A round face
  • Increased fat around the base of the neck and between the shoulders
  • Easy bruising and purple stretch marks

Seeking Nutritional and Psychological Support

Dietitians, nutritionists, and therapists can provide nutritional and psychological support for managing cortisol-related weight gain. 

Dietitians and nutritionists can offer personalized dietary recommendations tailored to individual needs, focusing on nutrient-dense foods, portion control, and stress-reducing eating patterns (30).  

Therapists can provide counseling and behavioral interventions to address underlying stressors contributing to elevated cortisol and develop appropriate and healthy coping strategies. Additionally, psychotherapy can help in addressing the emotional hardships that often accompany weight gain and difficult weight loss; overweight adults have a 55% higher risk of depression. 

Medical Interventions

Patients with Cushing's disease caused by a hormone-secreting tumor require surgical removal of the tumor (41).  

Other hormonal imbalances, in addition to cortisol and insulin, can significantly impact weight management. These may include estrogen and thyroid hormones. In certain cases, hormone replacement therapy under the guidance of a doctor can be beneficial to restore hormonal balance.

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Key Takeaways

  • Cortisol, the "stress hormone," plays a significant role in metabolism and energy regulation. However, chronic elevation of cortisol levels, often due to prolonged stress, can lead to metabolic dysfunction and weight gain.
  • Excessive cortisol promotes fat deposition, particularly visceral fat, which increases the risk of metabolic syndrome, insulin resistance, and cardiovascular disease.
  • Managing stress through stress reduction techniques and adopting healthy lifestyle habits supports healthy cortisol regulation and weight loss. 
  • Seeking professional help from healthcare providers, including doctors, dietitians, and therapists, can provide personalized guidance and support in managing cortisol levels and preventing weight gain.
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
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  1. Anderson, S. (2022, July 18). What Is Adrenal Fatigue? Is It A Real Condition? Rupa Health. https://www.rupahealth.com/post/wired-but-tired-this-isnt-a-normal-part-of-aging
  2. Anderson, S. (2022, July 22). 5 Conditions That Make It Harder To Lose Weight. Rupa Health. https://www.rupahealth.com/post/cant-lose-weight-these-5-medical-problems-may-be-why
  3. Anton, S., Hida, A., Heekin, K., et al. (2017). Effects of Popular Diets without Specific Calorie Targets on Weight Loss Outcomes: Systematic Review of Findings from Clinical Trials. Nutrients, 9(8), 822. https://doi.org/10.3390/nu9080822
  4. Bubnis, D. (2017, September 17). Waist-to-hip ratio: How does it affect your health? Medical News Today. https://www.medicalnewstoday.com/articles/319439
  5. Bush, B. (2014, January 28). The Role of Cortisol in Sleep. Natural Medicine Journal. https://www.naturalmedicinejournal.com/journal/role-cortisol-sleep
  6. Carrière, K., Khoury, B., Günak, M. M., et al. (2017). Mindfulness-based interventions for weight loss: a systematic review and meta-analysis. Obesity Reviews, 19(2), 164–177. https://doi.org/10.1111/obr.12623
  7. Carvalho, K., Ronca, D., Michels, N., et al. (2018). Does the Mediterranean Diet Protect against Stress-Induced Inflammatory Activation in European Adolescents? The HELENA Study. Nutrients, 10(11), 1770. https://doi.org/10.3390/nu10111770
  8. Christie, J. (2023, January 6). A functional medicine approach to obesity and weight management. Rupa Health. https://www.rupahealth.com/post/an-integrative-approach-to-obesity
  9. Cloyd, J. (2023, March 15). The relationship between the sleep stress cycle. Rupa Health. https://www.rupahealth.com/post/the-relationship-between-the-sleep-stress-cycle
  10. Cloyd, J. (2023, July 3). The Role of Physical Activity in Promoting Heart Health. Rupa Health. https://www.rupahealth.com/post/the-role-of-physical-activity-and-exercise-in-promoting-heart-health-including-the-use-of-alternative-exercise-modalities-such-as-tai-chi-and-qigong
  11. Cloyd, J. (2023, October 2). A Functional Medicine Approach to Stress Management. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-stress-management
  12. Cortisol. (2021, October 12). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22187-cortisol
  13. Cox, C. E. (2017). Role of Physical Activity for Weight Loss and Weight Maintenance. Diabetes Spectrum, 30(3), 157–160. https://doi.org/10.2337/ds17-0013
  14. Diorio, B. (2023, March 17). How to test for hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Rupa Health. https://www.rupahealth.com/post/what-is-the-hypothalamic-pituitary-adrenal-hpa-axis
  15. Dziurkowska, E., & Wesolowski, M. (2021). Cortisol as a Biomarker of Mental Disorder Severity. Journal of Clinical Medicine, 10(21), 5204. https://doi.org/10.3390/jcm10215204
  16. Fell, A. (2013, March 27). Mindfulness from meditation associated with lower stress hormone. UC Davis. https://www.ucdavis.edu/news/mindfulness-meditation-associated-lower-stress-hormone
  17. Grossi, G. (2023, November 17). Research Reveals Link Between Sleep Deprivation and Rising Insulin Resistance in Women. AJMC. https://www.ajmc.com/view/research-reveals-link-between-sleep-deprivation-and-rising-insulin-resistance-in-women
  18. Hocking, S., Samocha-Bonet, D., Milner, K.-L., et al. (2013). Adiposity and Insulin Resistance in Humans: The Role of the Different Tissue and Cellular Lipid Depots. Endocrine Reviews, 34(4), 463–500. https://doi.org/10.1210/er.2012-1041
  19. Lasa, A., Miranda, J., Bulló, M., et al. (2014). Comparative effect of two Mediterranean diets versus a low-fat diet on glycaemic control in individuals with type 2 diabetes. European Journal of Clinical Nutrition, 68(7), 767–772. https://doi.org/10.1038/ejcn.2014.1
  20. Min, L. (2016). FUNCTIONAL HYPERCORTISOLISM, VISCERAL OBESITY, AND METABOLIC SYNDROME. Endocrine Practice, 22(4), 506–508. https://doi.org/10.4158/ep161197.co
  21. Mohd Azmi, N. A. S., Juliana, N., Azmani, S., et al. (2021). Cortisol on Circadian Rhythm and Its Effect on Cardiovascular System. International Journal of Environmental Research and Public Health, 18(2), 676. https://doi.org/10.3390/ijerph18020676
  22. Moyer, A. E., Rodin, J., Grilo, C. M., et al. (1994). Stress-Induced Cortisol Response and Fat Distribution in Women. Obesity Research, 2(3), 255–262. https://doi.org/10.1002/j.1550-8528.1994.tb00055.x
  23. Overweight & Obesity Statistics. (2018, December 13). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity
  24. Preston, J. (2023, September 22). How is Chronic Inflammation Linked to Weight Gain? Rupa Health. https://www.rupahealth.com/post/how-is-chronic-inflammation-linked-to-weight-gain
  25. State of the Global Workplace: 2023 Report. (2023). Gallup. https://www.gallup.com/workplace/349484/state-of-the-global-workplace.aspx
  26. Sun, Q., Li, J., & Gao, F. (2014). New insights into insulin: The anti-inflammatory effect and its clinical relevance. World Journal of Diabetes, 5(2), 89–96. https://doi.org/10.4239/wjd.v5.i2.89
  27. Sweetnich, J. (2023, February 28). How to Balance Cortisol Levels Naturally. Rupa Health. https://www.rupahealth.com/post/how-to-balance-cortisol-levels-naturally
  28. Taheri, S., Lin, L., Austin, D., et al. (2004). Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index. PLoS Medicine, 1(3), e62. https://doi.org/10.1371/journal.pmed.0010062
  29. Taking Aim at Belly Fat. (2010, July 20). Harvard Health. https://www.health.harvard.edu/newsletter_article/taking-aim-at-belly-fat
  30. Teeter, L. A. (2023, April 4). Functional Nutrition Strategies For Weight Management and Metabolic Health. Rupa Health. https://www.rupahealth.com/post/functional-nutrition-strategies-for-weight-management-and-metabolic-health
  31. Thau, L., Gandhi, J., & Sharma, S. (2023). Physiology, cortisol. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538239/
  32. The Connection Between Sleep, Diabetes, and Obesity. (2023, March 13). Yale Medicine. https://www.yalemedicine.org/news/sleep-diabetes-and-obesity
  33. Tsigalou, C., Konstantinidis, T., Paraschaki, A., et al. (2020). Mediterranean Diet as a Tool to Combat Inflammation and Chronic Diseases. An Overview. Biomedicines, 8(7), 201. https://doi.org/10.3390/biomedicines8070201
  34. Vafiadis, D. (2021, April 21). How Excess Weight Impacts Our Mental and Emotional Health. National Council on Aging. https://www.ncoa.org/article/how-excess-weight-impacts-our-mental-and-emotional-health
  35. Visceral Fat. (2022, December 9). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24147-visceral-fat
  36. Weinberg, J. L. (2022, March 31). How To Tell If You Have An Estrogen Imbalance. Www.rupahealth.com. https://www.rupahealth.com/post/a-functional-medicine-approach-to-estrogen-imbalance
  37. Weinberg, J. L. (2022, September 7). An Integrative Medicine Approach to Hypothyroidism. Rupa Health. https://www.rupahealth.com/post/understanding-hypothyroidism-and-how-to-treat-it-naturally
  38. Weinberg, J. L. (2022, November 16). What Is the Mediterranean Diet. Rupa Health. https://www.rupahealth.com/post/4-science-backed-health-benefits-of-the-mediterranean-diet
  39. Weinberg, J. L. (2023, January 17). How To Treat Leptin Resistance: A Functional Medicine Approach. Rupa Health. https://www.rupahealth.com/post/how-to-treat-leptin-resistance-a-functional-medicine-approach
  40. Weinberg, J. L. (2023, February 2). 9 Hormone Imbalances That Can Hinder Weight Loss. Rupa Health. https://www.rupahealth.com/post/9-hormone-imbalances-that-can-hinder-weight-loss
  41. Weinberg, J. L. (2023, June 26). Top functional medicine labs that can help individualize integrative treatment options for Cushing's disease patients. Rupa Health. https://www.rupahealth.com/post/top-functional-medicine-labs-that-can-help-individualize-integrative-treatment-options-for-cushings-disease-patients
  42. Weinberg, J. L. (2023, December 19). The Science of Sleep: Functional Medicine for Restorative Sleep. Rupa Health. https://www.rupahealth.com/post/the-science-of-sleep-functional-medicine-for-restorative-sleep
  43. Yoshimura, H. (2023, November 7). The remarkable power of exercise on our health: A comprehensive overview. Rupa Health. https://www.rupahealth.com/post/the-remarkable-power-of-exercise-on-our-health-a-comprehensive-overview
  44. Yoshimura, H. (2023, November 13). Guarding Your Health: Proactive Steps to Ward Off Insulin Resistance. Rupa Health. https://www.rupahealth.com/post/guarding-your-health-proactive-steps-to-ward-off-insulin-resistance
  45. Young, E. R., & Jialal, I. (2020). Biochemistry, Ghrelin. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK547692/
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