Oh yes, we feel you, cortisol—that uncomfortable rush that happens when a jerky driver cuts us off or our boss puts us on the spot. It is called the stress hormone for a reason. (It’s not all negative, though. Did you know that cortisol also helps you wake up in the morning, alerts you of danger, keeps your heart pumping, and regulates your metabolism, immune, and inflammatory response?)
For those with obesity, the downside of cortisol is more than just that aaahhhhhhh! feeling. The hypothalamic-pituitary-adrenal (HPA) axis is the interaction between the area of your brain called the hypothalamus and the pituitary and adrenal glands. The HPA axis regulates the release of cortisol in the body. Excess weight has been associated with increased cortisol and an overactive HPA axis which can negatively affect sleep, appetite, and weight.
This isn’t to say that all people with obesity have elevated cortisol levels. (We also want to point out that short bouts of stress are a normal part of life.) We’re talking about chronic stress. Too much cortisol for too long can interfere with the HPA axis and impact insulin levels—leading to high blood sugar and insulin resistance. Interestingly, one 2020 study found that people with obesity who responded to stress with elevated cortisol (not everyone who feels frazzled reacts by pumping out this hormone) consumed more food than those with low cortisol levels.
But your stress response is about more than just cortisol: It also includes your sympathetic nervous system and the hormones adrenaline and noradrenaline. You may be more familiar with this response as the “fight or flight” mode.
Chronic high stress levels can increase your risk for:
Cardiovascular events such as acute coronary syndrome, arrhythmia, and stroke.
Cortisol dysfunction. This may happen when the hormone fails to function properly due to chronic cortisol surges. Cortisol dysfunction is associated with pain and inflammation.
Poor sleep—including difficulty falling asleep and staying asleep. Not enough or poor shut-eye can seriously affect your health and weight care. Read more here about sleep and weight.
Excess weight in the midsection. High cortisol levels can lead to visceral fat in the abdominal area. This belly fat is linked to heart disease and type 2 diabetes.
Insulin interference. As we mentioned earlier, cortisol can inhibit insulin production. It does this by stopping the release of insulin during the stress response.
Now let’s back up for a sec and take a broader look at what cortisol does.
Normally, cortisol naturally peaks in the morning—giving you the energy to get out of bed—and drops at night so you can sleep. After the initial a.m. peak, cortisol slowly declines, fluctuating throughout the day.
The release of cortisol sends a signal to shut down systems like digestion because there are bigger priorities at hand (hello, hungry predator!). This surge in cortisol provides you with the energy necessary to escape danger. It’s a hardwired response from the days when we had to be ready to flee from, say, a saber-toothed tiger. These days, though, stress is not so much a wild beast as it is a surprise bill in the mail or an argument with your spouse. So what can you do about it—especially if you have obesity and are already prone to chronically high levels?
The golden ticket to managing cortisol is—ca-ching!—lifestyle changes.
1. Get movement in
Good news: Regular exercise may reduce the hormonal stress response and, for some, cortisol levels too. (Don’t go overboard because too much exercise—super long or intense bouts—can trigger a stress response.)
2. Make sleep a priority
Since sleep can be affected by high cortisol levels in people with obesity, it’s important to get not just enough Zzzs (at least seven hours a night) but good quality rest, too. Get off devices at least 30 minutes before bedtime (the blue light they emit is a known sleep wrecker). Keep your room coolish. And employ a white noise app or machine if needed.
3. Eat a healthy diet of whole foods
A recent study found that eating single-ingredient foods (whole foods) while increasing carbohydrate intake could help reduce cortisol levels for people with overweight or obesity. Participants ate a whole foods diet consisting of 56% carbohydrates, 18% protein, and 26% fat based on the Dietary Guidelines for Americans (whole grains, fruits, veggies, low-fat dairy, and polyunsaturated fats), which resulted in decreased cortisol levels. The researchers also found that the increase in carbs had the largest impact on lowering cortisol.
4. Try mind-body practices
Several studies show that regular meditation and yoga may significantly decrease cortisol levels. Even laughter yoga (yes, it’s a thing) can reduce your body’s response to stress—time for some giggles and namaste.
5. Spend time outdoors
Exposure to green spaces—a city park or backwoods trail—has been found to lower cortisol levels. In fact, research shows that just 15 minutes of walking in a forest can reduce feelings of stress. Nature FTW.
6. Think positive thoughts
Easier said than done, right? But it’s true that how you perceive your stress plays a part. The evidence is mixed, but visualizing a positive future each day has been associated with better stress responses and lower cortisol levels for some. It’s about sitting back and imagining things going well for you in the future. Pretty neat mind trick, right?
These everyday moves can help prevent chronic stress. But do check with your doctor if you think you may have a condition affecting your cortisol patterns, like Cushing’s or Addison's disease.
And remember: It’s important to keep up with stress reduction even when you’re not feeling frazzled. Why? Because it helps build resiliency—your mind and body can better adapt and reset when you do get overwhelmed. Because while stress isn’t always in your control, how you handle it is.
Found is among the largest medically-supported weight care clinics in the country, serving nearly 200,000 members to date. To start your journey with Found, take our quiz.