Does Stress Increase Belly Fat?

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Most of my clientele are women in their thirties, forties, and fifties. This can be a very tumultuous time for women. Their careers are usually booming (long hours, high stress jobs) and they are in the “sandwich generation” taking care of children as well as helping aging parents. During this stage of life most women are also dealing with the hormonal fluctuations and symptoms associated with perimenopause. They are dealing with increased belly fat, fatigue, brain fog, and anxiety/depression. They are often very unhappy with their bodies and are unable to lose “the belly” despite following a low-calorie low-fat diet and doing HIIT workouts and running. Nothing is working for them and they are extremely frustrated. They don’t like the way their clothes fit, how they look, or how they feel. 

Many have heard that stress increases belly fat. They go on social media and see influencers sharing before and after pics of their “cortisol faces” and bellies and are told that they too can heal themselves using their special supplement plan. Just comment “CORTISOL” to learn more! 

Then on the other side of the gamut are influencers saying stress and cortisol have nothing to do with your belly fat or face shape. You are just eating too much and need to focus on calories in versus calories out. All you have to do is eat a low-calorie, low-fat diet and weigh every piece of food that goes in your mouth on a food scale and obsessively count and track. There’s never any discussion of what to do when weight loss plateaus, or more importantly how to safely increase your calories again without gaining weight.

How and why we gain body fat, how to safely reduce body fat (while maintaining and/or building muscle), and most importantly how to maintain a healthy body composition and weight is a nuanced conversation. Belly fat and weight gain cannot be totally blamed on stress and cortisol, nor can it be totally blamed on calories in versus calories out. Both play a role, and today I’m going to explain how chronically high stress and elevated cortisol levels can increase belly fat and lead to weight gain.

Stress Hormones

When we are under stress – either physical or emotional, real or perceived – the body releases hormones that help us react to and deal with that stressor. Our main stress hormones (cortisol, norepinephrine, and epinephrine) are produced and released by the adrenal glands, two triangular-shaped organs that sit atop our kidneys. The hormones produced by the adrenal glands help keep all other hormones in balance (blood sugar/insulin, thyroid hormones, sex hormones, and neurotransmitters). *The adrenal glands also produce aldosterone, DHEA, testosterone, estrogen and progesterone but for this discussion we’ll be focusing on the “stress” hormones, cortisol in particular.

Cortisol is our primary stress hormone produced by the adrenal glands and the one we need to worry about when thinking about chronic stress and increased abdominal fat. Cortisol is a glucocorticoid hormone and it raises blood sugar (aka blood glucose) levels so we can fight or flee a danger or stressor. It raises blood sugar levels in a few different ways: 

  • By down regulating or decreasing the release of insulin from the pancreas. Insulin is a hormone that helps usher glucose out of the blood stream and into our cells to be used for energy or to be stored as glycogen and fat. 
  • By decreasing the sensitivity of insulin receptors on our cells. 
  • By stimulating a process called gluconeogenesis which is the formation of glucose from non-carbohydrate sources like protein and fat. This can lead to muscle breakdown and decrease our bodies ability to build muscle. 

Why would our body want to increase blood sugar levels while decreasing insulin secretion and receptor sensitivity when we’re stressed?!? It seems counterintuitive, but it is a protective mechanism and a way to conserve that precious glucose for our brain! You see, glucose is the preferred or main source of energy for our brain. If we need to fight or flee we want to have our wits about us to make quick decisions!

When we are faced with a crisis our bodies in their innate wisdom slow down unnecessary bodily functions (i.e. digestion, reproduction, repair and healing) so we can focus and deal with the situation at hand. Once the threat has passed, everything goes back to normal or to homeostasis. That is a good thing, that is how things *should* work. However, when we are under prolonged stress cortisol can remain elevated which means our blood sugar also stays elevated. This is a problem…

Chronic Stress -> Elevated Blood Glucose Levels -> Insulin Resistance -> Abdominal Fat

That was a lot, so let’s do a little recap! When we are under stress our adrenal glands release cortisol. Cortisol helps raise our blood glucose levels. As our blood glucose levels rise (or stay elevated) the pancreas normally responds by releasing more and more insulin. Cortisol inhibits the release of insulin from the pancreas, makes our insulin receptors less responsive in order to conserve glucose for the brain, and tells our liver to make even more blood glucose from proteins and fats. Over time, our cells can become insulin resistant and stop responding to insulin. This causes blood sugar levels to rise and stay elevated, a situation called hyperglycemia. Insulin resistance and hyperglycemia can lead to Metabolic Syndrome also know as pre-diabetes. This is a cluster of conditions that occur together increasing your risk of heart disease, stroke, type 2 diabetes mellitus, and non-alcoholic fatty liver disease (NAFLD).

Chronic Stress and Chronically Elevated Cortisol Has Body Wide Effects

  • Infertility and menstrual cycle issues
  • Anxiety
  • Depression
  • Impaired memory and concentration
  • Alzheimers 
  • Sleep disturbances
  • Headaches
  • Muscle tension and pain
  • Decreased bone density
  • Muscle weakness
  • Severe fatigue 
  • Digestive issues
  • Weight gain (especially the face and abdomen)
  • Fatty deposits between the shoulder blades (lipodystrophy, aka Buffalo Hump).
  • High blood pressure
  • Heart disease
  • Heart attack
  • Stroke
  • Suppressed immune function

Testing Cortisol Levels

If you have severe symptoms and think you may have high cortisol it is worth discussing the benefits of testing with your doctor or healthcare provider. Cortisol levels naturally fluctuate throughout the day and follow your circadian rhythm. Cortisol production is normally highest 30 minutes after waking and declines steadily throughout the day, reaching its lowest point at bedtime. Salivary diurnal cortisol tests measure your cortisol levels throughout the course of a day (upon waking, before lunch, before dinner, before bed). Diurnal cortisol patterns can help your healthcare provider determine if you may have adrenal gland dysfunction and if additional testing may be required. 

Other Causes of High Cortisol

There are other reasons besides stress that can cause high cortisol (Santos-Longhurst, 2024): 

  • Pituitary Gland Issues: an overactive pituitary gland, benign pituitary tumors, or cancerous pituitary tumors.
  • Adrenal Gland Tumors (benign or malignant).
  • Medication Side Effects: oral contraceptives and corticosteroids (prednisone, cortisone, methylprednisolone, dexamethasone) can increase cortisol levels.
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Stress Management Tools

Many of the women I talk to are dealing with stubborn belly fat and describe themselves as “extremely stressed.” Even without testing it is likely that stress and cortisol is exacerbating their belly fat, and often times when we address the stress they start to make progress. 

We can’t always get rid of our stress, but we can find healthy ways to manage it. Here are some of my top recommendations to manage stress:

  • Eat a well balanced diet. Your meals should consist of protein, fat, and complex carbohydrates which will help stabilize blood sugar levels. When we are under stress we burn through nutrients like vitamin C, the B-complex of vitamins, protein, and minerals so it is important to eat nutrient rich whole foods to replenish our body’s stores!
  • Participate in regular physical activity. Exercise increases glucose uptake into cells even without insulin’s help! It also increases fat burning and builds muscle which increases metabolism. It can also be a great stress reliever. It is important to note that HIIT training and anaerobic exercise can temporarily increase cortisol levels. If you are doing predominantly anaerobic workouts and are struggling with weight gain and belly fat despite exercising regularly you may need to switch to a gentler form of exercise (strength training and Zone 2 cardio – all things I can help guide you on as a certified personal trainer).
  • Practice relaxation techniques. Yoga, meditation and deep breathing exercises activate the parasympathetic nervous system which helps us rest and digest and decreases stress hormones. Try a local yoga class or find a YouTube video to try. Download a mediation app like Calm, Headspace  or Waking Up. Or try Box Breathing or 4-7-8 Breathing. 
  • Take breaks from the news and social media. 
  • Maintain a healthy social support network.
  • Take time out for socializing and hobbies
  • Speak with your doctor, therapist or counselor. If you feel you need more help managing your stress levels please never hesitate to reach out to your doctor or seek the assistance of a licensed therapist or counselor. 

I’ve had to navigate my own issues with stress and cortisol and it’s why I’m so passionate about helping other women uncover and heal what is at the root cause of their fatigue, weight gain, and menstrual cycle issues. Back when I was in the thick of my symptoms my cortisol was low in the morning and midday and was high in the afternoon and evening. No wonder I was so tired during the day but I couldn’t sleep at night! Through dietary and lifestyle changes I was able to reduce my symptoms and bring my cortisol levels back to healthier levels.

There’s no magic pill (or combination of pills) that can “fix” your physiology because YOU ARE NOT BROKEN! Your body is smart and is doing the best it can with the situation and inputs it’s given. You just need to figure out how to better support your body to get back to homeostasis. This is where I come in. I can help you assess how your current diet and lifestyle are supporting or detracting from your health and put you on a pathway to better balance and healing. And if it appears that you may need some testing or labs done I can guide you on how to advocate for yourself at your doctor’s appointment. 

Call or e-mail me today to schedule your no-obligation Nourish to Flourish Strategy Session to explore how I can help support you! 

In Health,

Amanda Watson, BCHN®

References:
American Psychological Association. (2023, March 8). Stress effects on the body. https://www.apa.org/topics/stress/body

Santos-Longhurst, A. (2024, January 25). What are the symptoms and causes of high cortisol levels. Retrieved on May 14, 2024 from https://www.healthline.com/health/high-cortisol-symptoms#what-it-is

Schernthaner-Reiter, M. H., Wolf, P., Vila, G., & Luger, A. (2021). The Interaction of Insulin and Pituitary Hormone Syndromes. Frontiers in endocrinology, 12, 626427. https://doi.org/10.3389/fendo.2021.626427

https://www.zrtlab.com/landing-pages/diurnal-cortisol-curves/

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