Alisa Turner - Integrative Health Coaching

All the kale in the world, perfectly balanced macros, and an optimized fitness routine will probably not get your excess weight off if your stress is through the roof.  

Those habits are still having a very positive impact on your health, and you’d be worse off without incorporating them, so don’t lose them!  AND…if you want to get the weight off, you’ll need a strategy to manage both the acute and chronic stress and address/repair the damage done.   And until then, you MUST give yourself extra grace and lower expectations for weight loss.  Because stressing about being stuck is part of what’s keeping you stuck! 

Managing Stress is key to improving health, weight loss and overall fitness

Let’s start with just one way stress is negatively impacting our health and then dive into what to do about it:

  1. Stress causes changes in hormones like adrenaline, cortisol, and insulin which also impact weight (1,2,7).  In fact, researchers found a reduction of 104 calories per day burned from stress and elevated cortisol levels (~11lb weight gain in 1 year!) (7)
  1. Every time you’re stressed, there’s a complex hormonal cascade, your adrenal glands release adrenaline and cortisol, and then cortisol taps into protein stores via glycogenesis in the liver so that glucose can be released into your bloodstream and supply the muscles with an immediate (primary) energy source.  
  • Normally, as blood sugar goes up, so does insulin to help get the blood sugar into the cells.  But one of the functions of cortisol is to inhibit insulin production in attempt to favor glucose for fast use and prevent it from being stored (3).  
  • From an evolutionary perspective —  this was all by design so we would have the energy needed to fight or flee imminent danger (4).  When the immediate stressor is resolved, blood sugar and hormones should return to normal.  
  • However, chronically elevated cortisol from our high-paced, high stress life leads to chronically increased blood sugar levels.  And since cortisol is inhibiting insulin, the body remains in a general insulin-resistant state. 
  1. Over time, the pancreas struggles to keep up with the high demand for insulin, glucose levels in the blood remain high, the cells cannot get the sugar they need, and the cycle continues leading to cells that are starved of glucose.  
  • In turn…hunger signals are sent to the brain, even if food is not required for energy. This can lead to overeating (particularly calorie dense foods) (5,8), as cortisol is both directly (through its work on the hypothalamus receptors in the brain) and indirectly (through its impact on other hormones that influence appetite) stimulating appetite.  And because sugar supplies your body with the quick energy it thinks it needs, it’s often the first thing you reach for when you’re stressed. (6)
  • At the end of the day… any unused glucose is eventually stored as body fat.   And so, the vicious cycle starts: get stressed, release cortisol, gain weight, crave more sugar, eat more sugar, gain more weight (13).
  1. Cortisol can also mobilize triglycerides from storage and relocate them to visceral fat cells, and visceral fat cells have more cortisol receptors than subcutaneous fat so over time this process can lead to an accumulation of visceral fat (2). 
  1. All the above is just a glimpse of the effects of cortisol on weight.  Cortisol also effects the immune system, the GI system, the cardiovascular system, mental health, and sleep disorders.  (14,15).  And all of these can also have an impact on weight.  
  1. Cortisol levels are not cut and dry.  Low and high cortisol levels can BOTH be indicative of a problem, and symptoms may appear similar on the surface.  Treatment depends on the duration of stress, the presence of other symptoms, and a full evaluation of the nutritional landscape, so be sure to consult a professional. 

Another important note on stress:  It’s probably impacting you much more than you realize because it comes in so many forms besides the emotional stress that we think of first (that feeling of overwhelm, long workdays, or trauma induced stress from a divorce, a death, or a layoff). In reality, the body doesn’t know the difference between chemical, emotional, and physical stress, so we are bombarded by stress not just emotionally, but also by things like injury, illness, medication, environmental chemicals, EMF, and insufficient sleep.   

If you’re curious about your cortisol levels, I highly recommend a saliva test over a blood test.  They’re not cheap, but they give a much more comprehensive picture than blood.  If that’s not in the cards for you, but you feel like stress is a factor in your weight, you can start with a few simple things. 

  1. INCREASE SLEEP — Increase your hours of sleep and practice sleep hygiene to improved sleep quality.  Insufficient sleep is absolutely a source of stress on the body and linked to elevated cortisol levels (16,17).
  1. REDUCE CHEMICALS — Environmental toxins disrupt the stress circuitry and response (18,19), so cut back on your chemical exposure.  Buy organic when possible.  Read labels and make sure you recognize the ingredients on your food, skincare, and household items. 
  1. IMPLEMENT MEDITATION — Meditation has repeatedly been shown to have a positive effect on cortisol levels (20,21).  It doesn’t need to be long, but it does need to be consistent.  Start with 5 minutes a day (pick the same time each day because routine helps build habit) and increase from there.
  1. GET OUTSIDE.  Frequent long walks out in nature can be some of the best medicine for the stress response (22)!  Make it a walking meditation, put on an inspirational podcast, or invite a friend for the social advantage!  Social outlets (unless you tend to over schedule) can help reduce the impact of stress on a body.  

And spend some time barefoot if you can.  This grounding technique can serve many purposes, including reducing inflammation and pain and regulating your body clock and  immune system which are all related to cortisol levels.

  1. DON’T OVER-EXERCISE — Limit or HONESTLY evaluate the “perceived stress” from intense cardio, HIIT training, and hot yoga practices during stressful seasons.  Exercise is essential but over-exertion is just another form of stress on the body and over-training has been linked to changes in cortisol levels and other changes detrimental to overall health (23-30) — so when stress is already a significant factor, less intensity is often actually more effective.  Everyone’s body is different, and what works for me may not serve you.  So really tune in to how you feel during and after your exercise.  If you feel depleted, it’s too much.  If you feel energized and like you want to keep going, it’s probably ok.   This is counter-intuitive for many of us with a history of disordered eating and distorted body image issues, so you REALLY need to be extra intentional about tuning in to subtleties in your body, and you may need to work through a mental shift here with a professional.  
  1. EAT AN ANTI-INFLAMMATORY DIET – Systemic inflammation causes elevated cortisol levels (11,12). If we can naturally decrease inflammation in the body and minimize stress, decreased cortisol levels should follow.  What is anti-inflammatory for one person may not be for another so be mindful of your bio-profile.  But in general, we want to eat an abundance and a variety of color, fiber, antioxidants, and phytonutrients: vegetables, fruits, whole intact grains, nuts, seeds, and beans; and limit alcohol, caffeine, dairy, gluten, saturated fat, trans fatty acids, and processed foods in general.
  1. PRACTICE MINDFUL EATING — Eat mindfully with an attitude of curiosity rather than criticism.  Becoming aware of how you use food to manage stress is an important part of the process.  Guilt and shame are not.  Eating mindfully is associated with significant improvements in the cortisol awakening processing and reduction in abdominal fat (9,31,32).  The best way I have found to be mindful is to slow down, practice gratitude and grace, and track what you eat and how it makes you feel. And studies consistently show that tracking your food yields better results than not tracking.  (10) 
  1. SUPPLEMENT — Support your adrenals with quality whole food supplements, probiotics, and omegas.  The best choices for you will depend on many factors so be sure to consult a professional.
  1. DRINK PLENTY OF WATER — Dehydration and lack of minerals is a significant source of stress on the body and can alter cortisol levels (33,34,35).  Additionally, thirst can often be misunderstood for hunger.  Both are easy problems to eliminate.  Buy yourself a large water bottle and track how many you drink each day.  
  1. FOCUS ON GRATITUDE — Write 5 things you’re grateful for each morning.  As the saying goes…Where your focus goes, energy flows.  Sometimes we can reduce perceived stress (even cortisol levels) with simple attitude shifts like managing expectations and writing gratitude lists (36)!   
  1. EDUCATE YOURSELF — There are an infinite number of podcasts and a few books I recommend on the topic:  Revive by Frank Lipman, M.D. and Woodson Merrell, M.D.’s The Source are just a few. Make sure that the information you’re receiving is from a qualified professional and read/listen to a variety.  All data is subject to interpretation and there are many conflicting opinions on the topic, so it’s best to read a variety of viewpoints.
  1. WHEN ALL ELSE FAILS — Sometimes, all the above work isn’t enough and a major lifestyle shift like a career change or a change in marital status becomes necessary.  Unfortunately, I find that typically clients really have to hit rock bottom with their health before considering something that drastic.  If you can keep the stress in check before it gets to that point, you’ll be in better shape.

When I talk about the impact of stress on weight and overall health, people’s eyes tend to glaze over.  It goes in one ear and out the next.   I think it’s because it feels like the stress in our lives is manifesting itself and therefore out of our control.  Food and fitness are tangible; we can more easily get on board with the idea that we are responsible for prioritizing movement and making healthy food choices  every day —  whereas we don’t feel responsible or in control of the behavior of our children, death, divorce, demanding employers, etc. 

So, it’s not a popular post, but if you’ve been accurately and consistently tracking your food, fitness, and sleep — and you have made all the appropriate adjustments and your weight is still stuck then it’s time to look at the stress.  

Block JP, He Y, Zaslavsky AM, Ding L, Ayanian JZ. Psychosocial stress and change in weight among US adults. Am J Epidemiol. 2009;170(2):181–192. doi:10.1093/aje/kwp104

https://pubmed.ncbi.nlm.nih.gov/11020091/

https://www.frontiersin.org/articles/10.3389/fendo.2021.626427/full

https://link.springer.com/article/10.1007/s10571-010-9606-9

https://pubmed.ncbi.nlm.nih.gov/11070333/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214609/#__ffn_sectitle

https://www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00385-0/fulltext

https://www.mdpi.com/2072-6643/10/2/176

https://www.hindawi.com/journals/jobe/2011/651936/

https://www.jandonline.org/article/S0002-8223(10)01644-5/fulltext

https://www.sciencedirect.com/science/article/abs/pii/S0889159121000192

https://www.sciencedirect.com/science/article/abs/pii/S0165032713007337

https://link.springer.com/article/10.1186/1743-7075-8-74

https://pubmed.ncbi.nlm.nih.gov/15820973/

https://www.ncbi.nlm.nih.gov/books/NBK538239/

https://academic.oup.com/sleep/article/40/6/zsx064/3746974?login=true

https://www.mdpi.com/970576

https://www.sciencedirect.com/science/article/pii/S0013935121017485

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808483/

https://pubmed.ncbi.nlm.nih.gov/23724462/

https://www.tandfonline.com/doi/abs/10.1080/17437199.2020.1760727

https://www.mdpi.com/1660-4601/19/3/1231/htm

https://journals.sagepub.com/doi/full/10.1177/19417381211044739

https://journals.humankinetics.com/view/journals/ijspp/16/7/article-p965.xml

https://www.sciencedirect.com/science/article/abs/pii/S2666506921000080

http://article.scisportsscience.com/pdf/ajssm-9-1-4.pdf

https://www.tandfonline.com/doi/abs/10.1080/17461391.2020.1748116

https://www.mdpi.com/1660-4601/19/4/2228

https://www.tandfonline.com/doi/full/10.1080/02640414.2021.1918362

https://www.tandfonline.com/doi/abs/10.1080/02640414.2013.792952

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219460/

https://www.sciencedirect.com/science/article/pii/S0195666318306330

https://repository.arizona.edu/bitstream/handle/10150/632795/azu_etd_hr_2019_0045_sip1_m.pdf?sequence=1