Stress Related Abdominal Fat: When Diet and Exercise Fails

By: Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM


Stress related abdominal fat can occur on anyoneMany women and men may have noticed that no matter how skinny they are, and no matter how much they diet, at some time or the other, their tummy just seems to get bigger. Nothing seems to help, not even exercise. The truth of the matter is, you may have stress related abdominal fat. Belly fat does not solely happen to the obese person. Anyone can get it, no matter how thin they are.

Many people may say it is just another sign of aging, but belly fat, in actuality, may be visceral fat that surrounds your organs, puffing out your belly into what many people commonly call a beer gut. This type of fat is often the prelude to insulin resistance, diabetes, heart disease, and even certain types of cancer.

So if you find yourself with this unwanted tummy, and dieting and exercise do not work, you may need to look at other factors for its development. Amongst these are your hormones and stress.

What is Stress Related Abdominal Fat?

Stress, especially chronic stress, is one of the major causes of abdominal fat in today?s society. Stressors constantly bombard you, whether it is the pressure of your job, your relationships, your lifestyle, or environmental factors over which you have almost no control. We are all subject to these stressors.

However, in order to understand how stress related abdominal fat increases, it is important to understand how stress affects the body.

The Effects of Stress

When you are subjected to stress, the hypothalamus in the brain springs into action and starts a cascade of events so that your body can protect itself. Chemical messengers are sent to the pituitary gland, which in turn instructs the adrenal glands to produce cortisol, the fight or flight hormone. Your body goes into a mode that readies it to deal with the threat, either by fighting or fleeing.

This protective process is controlled by the hypothalamic-pituitary-adrenal (HPA) axis as part of the body?s natural NeuroEndoMetabolic (NEM) Stress Response ? a reaction that is automatic.

During this time, your adrenals produce more cortisol (and adrenalin), your liver allows the release of more glucose (so that you have extra energy), and those systems and pathways in your body not deemed essential for immediate survival are either shut down or slowed down (such as your digestion). Under normal circumstances, this reaction is short-lived. The brain indicates that the threat has passed and everything returns to normal.

Stress related abdominal fat and chronic stressThe problem arises when the stress is chronic, when you are subjected to stress over a long period of time. As a result, your adrenal glands keep up their heightened cortisol production, while possibly even trying to increase the production. This causes a cascade of events throughout the body, such as insulin resistance, high glucose levels, hormonal imbalance, inflammation, and a host of others.

At some point, the adrenals cannot keep supplying the demand for cortisol. They become fatigued, and your body ultimately ends up with too little cortisol. At this point, you are reaching the advanced stages of adrenal fatigue and adrenal exhaustion.

How Stress Leads to Abdominal Fat

One of the side effects of long-term stress is the increase of belly fat, which has side effects of its own.

Belly fat acts like a part of the endocrine system, as it is able to produce hormones such as estrogen. Through this mechanism, it can also produce a hormonal imbalance in your body. It may also produce cytokines, which are immune system chemicals, thereby heightening your risk of inflammation and related conditions. Stress related abdominal fat may also be linked to insulin resistance and the occurrence of diabetes.

But how does this relate to the development of abdominal fat?

Stress may increase your appetite.

While many people under stress may not feel like eating, your body responds by producing hormones that stimulate hunger. Your brain, however, when under stress, does not readily register a point of satiety, and you may consume more food than is needed. The extra calories that you consume are then stored by the body as fat. When your cortisol levels are high, as is the case when you are stressed, the first port of call for fat storage is your abdominal area.

Stress can encourage poor food choices.

During times of stress, your body needs more energy. Thus more glucose is released while, at the same time, particularly with chronic stress, food cravings develop. These cravings are usually for high-energy foods such as carbohydrates and sugar.

These foods that are high in carbohydrates initiate the release of insulin which acts at controlling blood sugar levels. The release of insulin also decreases your cortisol levels, making you feel less anxious and stressed.

However, constantly eating in order to feel better and the accompanying higher production of insulin could potentially lead to insulin resistance and diabetes. Also, it may inadvertently cause even more cortisol production to deal with chronic stress. Ultimately, a hormonal imbalance develops, your brain is unresponsive to messages indicating satiety, and you eat more of the unhealthy foods your brain tells you it craves.

Stress may cause inflammation.

Stress related abdominal fat and inflammationWhen your immune and endocrine systems are healthy, cortisol works as an inflammation moderator. In other words, it is beneficial to your health. As you move through the different stages of adrenal fatigue, however, and reach the last stages, your adrenals become fatigued and are not able to keep up the constant, increased demand for cortisol. The result is that your cortisol levels drop. However, very low cortisol levels are just as bad for your health as very high cortisol levels. One of the effects of low cortisol levels is an increased production of pro-inflammatory cytokines that in turn results in the over-activation of your immune system and inflammation.

Chronic stress thus increases abdominal fat, in the last stages of adrenal fatigue, amidst low cortisol levels, by inducing inflammation that runs rampant throughout the body, as there is not enough cortisol to suppress it. Inflammation also reduces the effectiveness of leptin, the hormone that helps with weight control, resulting in fat storage, particularly in the abdominal area.

This starts a vicious cycle. Stress results in an increase in abdominal fat via inflammation, while fat causes inflammation resulting in more weight gain.

Stress may interfere with your sleep.

Stress interferes with your sleep in a number of ways. It can cause insomnia or interrupted sleep, for example.

Increased cortisol levels lead to a lower production of melatonin, commonly referred to as the sleep hormone. Without sufficient melatonin, you will have problems going to sleep or sleeping soundly throughout the night. But how does this affect your weight?

Not getting enough sleep affects two important hunger hormones: ghrelin and leptin.

Ghrelin tells your brain you need to eat, and the less you sleep, the more ghrelin is produced. This means you are constantly feeling hungry.

Leptin, on the other hands, tells your brain you are satiated, in other words, have had enough to eat. Lack of sleep decreases leptin production. Thus, your brain gets no prompt to stop eating.

An imbalance in these two hormones due to a lack of sleep thus results in weight gain, with high cortisol from stress the initiator.

Stress may cause a lack of energy.

Stress causes high cortisol levels, as has been mentioned. Cortisol, however, as well as most other steroid hormones, are made out of a precursor hormone, pregnenolone. Chronic stress, however, and it’s constant and often increased demand for cortisol, results in most of your pregnenolone being converted into cortisol. This causes a hormonal imbalance, as the other hormones necessary for your proper physiological functionality are not produced in adequate amounts, including testosterone, estrogen, and thyroid hormone, all of which have a function when it comes to your metabolic rate. The result is that you use up fewer calories as fuel and gain weight.

Added to this, your slower metabolic rate may leave you feeling listless, and not wanting to tackle any physical activities. Thus the lack of exercise compounds the problem of weight gain.

How Do You Get Rid of Stress Related Abdominal Fat?

Getting rid of stress related abdominal fat requires a two-pronged approach: you need to try to eliminate as many stressors as possible, while improving both your diet and lifestyle. While removing certain stressors may not be easily achievable, you can control others.

Tips for Managing Stress and Belly Fat

Stress related abdominal fat and diet management

  • Eat regularly. Planning meals beforehand and eating three times per day, or breaking your meals up into smaller but more frequent meals throughout the day, helps you avoid cortisol spikes.
  • Meals should consist of protein, vegetables, and healthy fats. This may help keep blood sugar levels stable while improving the release of the ?appetite? hormones.
  • Try to avoid sweet and high carbohydrate foods.
  • Eating anti-inflammatory, high antioxidant foods helps your body to heal from the ravages of high cortisol. Examples include leafy green vegetables, berries, avocado, olive oil, multicolored vegetables (carrots, yellow and red peppers, and aubergines, for example), and legumes.
  • Practice relaxation exercises such as deep breathing and meditation.
  • Try to get eight hours of sleep a night. Although easier said than done when suffering from adrenal fatigue, there are a few steps you can take. Sleep in a dark room without electronics. Also, try to avoid exposure to bright lights, including computer or television screens, and stimulants before bedtime like alcohol or coffee.
  • Get moving! Exercise is a great stress buster and helps you lose weight. Low impact exercise such as walking or yoga is a great option. Following a regular exercise routine improves your HPA-axis function while helping to build up some lean muscle. However, don?t overdo things at first. Go for slow and steady and increase your exercise intensity as your fitness level goes up. The weaker you are, especially if you have advanced adrenal fatigue, the more careful you should be with exercise intensity and frequency. Many people feel good during and immediately after exercise, but experience fatigue later.

With enough small steps towards improving your diet, lifestyle, and stress levels, you can get rid of that belly fat. Stress related abdominal fat can be more sneaky than other forms of weight gain, and you make need to look at a bigger picture to get back to the healthy shape you want, but it can be done. Staying healthy as you progress towards your goals should be your focus.

? Copyright 2017 Michael Lam, M.D. All Rights Reserved.


Dr. Lam’s Key Question

Menopause may be a possible reason for stress related abdominal fat as menopausal women tend to undergo fluctuations in their hormones. Hormonal imbalance is one of the key contributors to belly fat.


Stress related abdominal fat