Not Fat and Happy Think Stress
Forget those notions about overweight people being blissed out
science says excess weight might be due to an excess of stress and
the hormone cortisol.
You may not feel your best first thing in the morning but your
cortisol production is humming along at peak performance levels.
Notoriously dubbed the "stress hormone," cortisol, a steroid hormone
produced by the adrenal glands, is secreted at higher levels early in
the morning than later at night, when it may be virtually
The pituitary gland and hypothalamus of the brain control cortisol
secretion, which dramatically increases during
moments of physical or psychological stress. A parking ticket, a
violent encounter, or a debilitating ailment can trigger the flight
or fight response and the release of cortisol, which immediately puts
glucose, protein and fat into circulation, accelerating energy levels
in response to threat.
As the danger recedes so do cortisol levels, which quickly normalize.
Problems occur when cortisol levels remain high over a protracted
period of time a not unlikely scenario, given the emotional
stresses and strains of modern life.
Implicated in weight gain, heart disease, diabetes, depression, and
lowered immunity, cortisol, all that negative publicity aside, is
critical to efficient body function, helping to regulate blood
pressure, cardiovascular activity, the immune system and metabolism.
"Illness can occur in conditions of cortisol deficiency or cortisol
excess. The condition of cortisol deficiency is called `adrenal
deficiency' or Addison's disease. John F. Kennedy was believed to
have had Addison's. The condition of cortisol excess is called
Cushing's syndrome. The resulting clinical problems result from lack
or excess of action of this important hormone at many sites in the
body," says Dr. William J. Kovacs, professor of medicine at the
Vanderbilt University School of Medicine in Nashville.
Symptoms of Addison's include weakness, weight loss and digestive
problems. Cushing's causes weight gain, particularly in the abdomen,
while the muscles of the legs and arms lose mass. Skin and bones are
thinned and easily damaged.
"The immune system tends to be suppressed and Cushing's patients are
subject to infections, sometimes odd ones. They tend to have high
blood pressure and diabetes and are at increased risk for
cardiovascular disease. Adrenal tumors can make cortisol and some
cancers of other sites, usually lung, can drive the adrenal to make
too much cortisol," says Dr. Kovacs, a member of The Endocrine
Society, a research body.
All that surging cortisol in response to stress and depression
appears to act as a stimulant to the appetite, which promotes weight
gain among certain people although, mysteriously, not everyone reacts
to episodes of stress by secreting excess levels of cortisol. On the
other hand, in some susceptible individuals, worry, alone, is enough
to send levels skyrocketing.
"Recent research by members of The Endocrine Society has revealed the
amazing fact that cortisol might also be made locally in some
tissues, not just the adrenal. One surprising finding was that
abdominal fat can `reactivate' cortisol that's been degraded to an
inactive form in the body. This locally produced cortisol appears to
play a role in the metabolic disorders accompanying weight gain with
fat deposits in the `beer-belly' location," says Dr. Kovacs
Can Cortisol Make You Fat?
Elevated cortisol may not only predict weight gain but influence the
location of fat. "It generally results in abdominal fat deposition,
but since research indicates that fat can make cortisol, this locally
produced hormone may have influences on the fat itself or on the
liver to increase glucose output and make one tend toward diabetes,"
says Dr. Kovacs.
Abdominal fat is associated with increased risk for cardiovascular
disease, including heart attack and stroke.
Yale researchers appear to have established a correlation between
abdominal fat in otherwise slim women and elevated cortisol levels as
women with pesky paunches report more stress, secreting more cortisol
Exercise is an effective way to manage stress and weight gain.
Relaxation techniques, meditation and yoga are also helpful.
"Obviously, lots of other regulatory systems and behavioral inputs
affect when, where and how we put on weight," says Dr.
Kovacs. "Cortisol is not the whole story. In Cushing's patients,
reversal of the hormone abnormality results in dramatic weight loss.
Remember, these are rare diseases and most obesity is not due to