Experts Reveal How Stress and Obesity Are Linked

Chronic stress influences our behaviors, including eating patterns, which may result in weight gain. Here's what you can do to manage your stress eating.

States with higher stress levels tend to have increased obesity rates, according to a recent Healthnews analysis. For instance, West Virginia, with the highest obesity rate at 40.60%, is among the most stressed-out states, with a stress level score of 57.58.

Meanwhile, Hawaii has the lowest obesity rate of 25% and is one of the most relaxed states, scoring 37.66 on a stress level index.

Both stress and obesity are major health concerns in the United States. Over 40% of American adults have obesity, which increases the risk of type 2 diabetes, coronary health diseases, and stroke, among other conditions.

At the same time, mental health diagnoses are surging — nearly half of adults aged 35 to 44 reported a mental illness in 2023, alongside a significant increase in chronic health conditions, according to a Stress in America survey.

How does stress cause obesity?

Obesity causes stress, and stress causes obesity, according to the authors of a 2022 review, explaining the mechanisms behind the vicious circle of weight gain:

• Stress may interfere with cognitive processes like self-regulation.
• Stress can influence behavior by indulging in overeating foods high in calories, fat, and sugar.
• Stress can increase the production of hormones involved in hunger, such as leptin and ghrelin.
• Stress may increase sedentary activity levels or decrease physical activity.
• Stress can affect sleep cycles. The shorter the sleep duration, the greater the rates of weight gain.

Moreover, animal studies suggest that both acute and chronic stress affects the gut microbiome, impacting eating behavior.

Dr. Susan Carnell, an associate professor of psychiatry and behavioral sciences at Johns Hopkins Medicine, says that stress triggers the release of a hormone called cortisol, which can stimulate insulin release. As a result, insulin can influence the body to store more energy as fat.

Moreover, cortisol can stimulate appetite, leading to eating more, which can also affect body weight over time.

In their studies, Carnell and colleagues found that in some people, a hormone called ghrelin, which is released in the stomach and sends hunger signals to the brain, increased after stress.

Carnell tells Healthnews, “Using brain imaging, we also found increased responses to food cues after stress in a region called the orbitofrontal cortex that processes food reward, as well as decreased responses in a region called the dorsolateral prefrontal cortex that is involved in cognitive control.”

The idea that stress may trigger the brain and body to seek out food and make it harder to control food intake makes sense from an evolutionary perspective, according to Carnell.

It makes sense to take on more energy to help us deal with future threats. And, of course, eating something delicious can make us feel good and is generally quite easy to do.

Carnell

A 2015 study involving 619 adults discovered that chronic stress had a significant impact on food cravings, and food cravings had a major direct impact on body mass index. The authors concluded that chronic stress might enhance motivation for rewarding substances and behaviors.

The relationship between stress and obesity, however, is bidirectional, as having excess weight may have a profound effect on mental health.

For example, people with extreme obesity are almost five times more likely to have experienced an episode of major depression in the past year as compared with those of average weight, according to a 2003 study.

How to manage stress eating?

Thirty-eight percent of American adults have overeaten or eaten unhealthy foods in the past month because of stress, a 2013 survey found. Of those, one-third said overeating works like a distraction.

Although managing stress eating may not be easy, developing healthy eating habits can bring you closer to ending the vicious circle of obesity. Carnell recommends following these tips:

• Address the stress. Keep a diary of your eating patterns and triggers. For example, if you notice you always feel stressed and end up in front of the cupboard in the evening after checking your work email or watching the news, see if you can repattern your behavior to avoid that trigger.
• Ride out the craving. When you feel yourself wanting to reach for a snack that you don’t need, try sitting with the feeling without acting on it. Most likely, it will disappear with time.
• Find an incompatible activity. Instead of reaching for a snack, try doing something else that is fun and occupies your hands, like taking a bath, knitting, or phoning a friend.
• Stress-proof your fridge. The best way to avoid eating foods you don’t want to is to keep them out of the house. This way, you can’t be tempted.
• Get help if needed. If stress eating is starting to negatively affect your mental health, you shouldn’t have to go through it alone. Consider reaching out to a mental health professional with expertise in eating-disordered behaviors.

Although developing good eating habits may have enormous health benefits, the causes of obesity go beyond lifestyle choices. Genetics, certain illnesses, and medications to treat them may lead to weight gain. Additionally, living alone, poverty, unemployment, and low levels of education have been linked to increased obesity rates.

Nevertheless, managing stress can not only prevent gaining excess weight but also lower the risk of a wide variety of conditions like heart disease and cancer.