Article: What if abdominal obesity were first and foremost a response to stress?

By Marc Dellière

The link between stress, cortisol and weight gain is well established in physiology and psychology. When we are exposed to acute or chronic stress, the brain (more precisely, the hypothalamus) triggers a hormonal cascade that activates the adrenal glands. These release cortisol, the stress hormone.

The elevation of this hormone stimulates appetite, particularly for foods rich in sugar and fat, via a direct action on the brain's reward circuits. The resulting emotional hyperphagia is accompanied by a redistribution of fat in favor of visceral adipose tissue, with more fat lodged around organs in the belly, a location associated with increased cardiovascular risk.

Furthermore, chronic stress alters sleep quality, disrupting the secretion of leptin (satiety hormone) and ghrelin (hunger hormone), and thus contributing to caloric over-consumption.

These interconnected pathophysiological mechanisms reinforce the link between stress, abdominal obesity and cardiometabolic diseases.

As part of preventive medicine, it is therefore essential to identify at-risk profiles as soon as possible: patients exposed to chronic stress, with persistent fatigue, sleep disorders, a marked sedentary lifestyle, appetite problems, weight gain - particularly abdominal weight gain -, anxiety, mental overload, or those involved in caring for sick relatives.

Treatment is once again based on a global approach, integrating stress management techniques such as hypnosis, self-hypnosis, meditation, Cognitive Behavioural Therapy (CBT), adapted physical activity, sleep optimization, as well as an anti-inflammatory and anti-oxidant diet, supported by therapeutic education focused on the link between stress and weight.

It's also vital to reassure patients:

What you're going through is not a question of lack of willpower. Your metabolism is responding to a survival alert. It's time to give it what it needs - by choosing what nourishes your body and soothes your spirit, while respecting your freedom.

Learn more about Lactium for stress management!

Sources :

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Dallman MF, Pecoraro NC, la Fleur SE. Chronic stress and comfort foods: self-medication and abdominal obesity. Brain Behav Immun. 2005 Jul;19(4):275-80. doi: 10.1016/j.bbi.2004.11.004.

Epel ES, McEwen B, Seeman T, Matthews K, Castellazzo G, Brownell KD, Bell J, Ickovics JR. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosom Med. 2000 Sep-Oct;62(5):623-32. doi: 10.1097/00006842-200009000-00005.

Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004 Dec;1(3):e62. doi: 10.1371/journal.pmed.0010062.