When I listen to my patients, there is one pivotal moment in everyone’s weight journey, Covid-19. Yes, as the world destabilized so did everyone’s waistline in either the upward or downward direction. Intuitively, we all know that stress affects our weight and mental health, but how does this work and how does this translate to our physical health? Pandemic aside, most people experience chronic stress daily in the form of lack of time, loneliness, work and caregiver responsibilities, financial woes, and even body weight for some. Body weight stress, be it a real or perceived concern, manifests from how our weight is or could affect our health, how others perceive how we look, and what we feel we need to do or not do to change our weight. As treatment options expand, so does the stress of what and how this should affect us. With all these stress inputs, how is our chronic stress making weight loss more difficult or leading to weight gain in the first place?
Appetite and food choice is a complex process that is influenced by both internal and external factors. When we are feeling stressed there are various neurotransmitters and hormones released that influence our food choices and sense of fullness. During short-term stress, the physical stress response leads to decreased appetite, which makes sense because if you are physically dealing with a short-term stress like a lion about to chase you, you need to devote all of your energy to the flight or fight response not eating and storing weight. However, when the glucocorticoid stress response is chronically activated, your body starts to develop central (think brain) leptin resistance and insulin resistance. So, what does this mean? As you develop central leptin resistance your brain does not listen as well to the fullness hormone leptin and is “resistant” to its effect. If your brain does not get as full as quickly, you will naturally have a larger appetite and are more likely to overeat. In addition, when you develop insulin resistance, your brain does not turn off the hunger pathways as quickly as well also leading to increased chance of overeating. Insulin also plays a role in the pleasurable dopamine signals from eating rewarding foods such as cookies. Typically, insulin causes decreased dopamine signals as you eat more of a rewarding food. Think of this effect as the progressively decreasing pleasure you get with each additional bite of a treat. With insulin resistance, these brain signals are not suppressed as well, which means you get more pleasure from these comfort, rewarding foods and end up craving them more.
In addition, as the body experiences chronic stress, these hormonal changes lead to increased visceral adiposity, a fancy way of saying storage of fat in unhealthy places like your organs, which can eventually lead to metabolic syndrome. Left unchecked chronic stress and metabolic syndrome are associated with increased risk of cardiovascular disease (heart attacks, strokes, blood flow issues in your legs) and diabetes. In addition, if your anxiety and stress are affecting your sleep you have a double compounding effect from the physical stress from sleep deprivation added to the psychological stress.
Now that we better understand how stress affects not just our mental health but also our physical health and weight, what can we do about it? Stress management starts with a solid foundation in healthy food choices, adequate sleep and sufficient movement throughout one’s day. After addressing the various lifestyle factors, cognitive behavior therapy with the support of a therapist, meditation or yoga, monitoring your news and social media consumption, and increasing connection with others are all great options to address your stress and anxiety. With the increased availability of meditation and mindfulness apps such as Headspace and Calm and the plethora of related videos on YouTube, it is easier now than ever to try out various stress reduction techniques. Often, knowledge is not the issue, and instead we need help taking action or troubleshooting a challenge. In this case, it is helpful to remember how valuable addressing chronic stress is for our health and happiness and invest in tools such as meal delivery, help around the house, and/or a professional such as a therapist, health coach, personal trainer, nutritionist or doctor.
Sometimes stress is related to a specific job or life circumstance, and you cannot simply meditate away an unsustainable situation. While daunting and often the most difficult step to implement, if a particular situation is directly tied to a person’s stress level and anxiety and other techniques are not working, it is not unreasonable to put your health and mental state first, analyze your options and consider making a big change. Before making a big leap, make reasonable plans for your next steps and make sure you have done your due diligence to alter the life or career situation to the best of your ability first. If, however, you have already tried options, take solace in knowing everyone has the power to change and grow. By putting your mental and physical health first, you give yourself the ability to address your health and weight successfully. If you have tried all the typical lifestyle and weight loss options without success, take a look at the stress in your life and decide if this could be the missing piece in the puzzle to finding better health. The journey to a healthy mind and body is a path we’re all navigating, and if you are still getting back up and trying your best, then you are already succeeding. If you need a partner in this journey, please reach out at drparisi@mdweightcare.com, and we’ll be there to support you at every step.
