Anxiety and weight gain
Obesity has become a worldwide public health problem. Worldwide obesity has been on the rise for the past 35 years and its numbers keep increasing. According to the CDC (2018) [1], 73.6% of the American adult population is either obese or overweight; 42.5% is obese. According to the World Health Organization (WHO, 2016) [2], more than 31% of Canadian adults and 28% of Mexicans adults suffer from obesity.
Obesity has been associated with higher health risks, as people with obesity are more prone to developing life threatening diseases like type 2 diabetes, hypertension, sleep apnea, heart disease, osteoarthritis and more.
But why are people all over the world gaining more and more weight? There are many factors. Most of them have to do with changes in our modern day to day life. But one key factor that has been proven to lead to weight gain is stress.
Stress is a part of most people’s daily life. Financial struggles, problems at work, family issues, repairs needed around the house; there is definitely plenty of things to feel anxious about and our body certainly takes a toll. The COVID-19 pandemic has also contributed to the increase of stressful events in our daily lives. The American Psychological Association (APA) has been studying the impact of stress in the lives of Americans since 2007, and in their report of 2020 [3], for which they surveyed 2,171 adults and 1,136 teens living in the United States, they found out that nearly 8 in 10 adults (78%) say the coronavirus pandemic has been a significant source of stress in their daily life, and 2 in 3 adults (67%) say they have experienced increased stress over the course of the pandemic.
Stress is a risk factor that triggers many psychological and physiological problems, one of which is related to an increase of appetite which can make us either overeat or choose unhealthy foods and later hold on to fat as a response of our bodies against long-lasting stressors.
The APA’s “Stress in America” study of 2010 [4] reported that 40% of those surveyed said that they used food to cope with anxiety. Their most recent survey of 2021 [5] reports that 61% of adults experienced undesired weight changes –either weigh gain or weight loss– since the COVID-19 pandemic began. Of those, 42% gained more weight that they intended, the average weight gain being of 29 pounds.
The relations between stress, overeating, weight gain and even weight loss have been fully established in a series of different scientific studies. Stress may lead to comfort eating, which involves the intake of high-calorie, high-sugar, or high-fat foods; emotional eating, where eating is a response to emotional states like sadness or anger; binge eating, the disinhibition of eating behavior, and/or an increase in unhealthy eating [6]. Being under the influence of stress can also make us eat with little awareness of quality or quantity, and without ever feeling truly satiated.
Which are the mechanisms that underlie the relation between stress and weight gain or weight loss?
- Cortisol, a hormone that is secreted by the adrenal gland reacts to stress and triggers other reactions in response, such as changes in eating behaviors.
- Ghrelin, a hormone that activates appetite has also been shown to be released in response to psychological stress.
- Leptin, a hormone that signals satiety is also released in response to stress, but this hormone leads to a decrease in the intake of high calorie foods. In this case, the person dealing with a stressful situation losses appetite and skips meals.
Although most people tend to gain weight when dealing with long-term stress, others tend to lose weight. Decreased food consumption in response to stress has been observed to be more common in men than in women, and in unrestrained eaters than among restrained eaters [6].
But weight gain seems to be an adaptative behavior that our genetic memory learned as a strategy to survive stress caused by dangers and threats.
At first, a stressful event may cause a loss of appetite, but when stress becomes chronic the exact opposite can happen. Our neuro-endocrine mechanism (involving brain and hormones) of fight or flight served us well as a species in the Paleolithic era, when human beings lived in an extremely hostile environment full of predators and with little food; but even though the reasons that give us stress have changed, the mechanism remains intact and it makes us hold on to fat.
The hormonal response of the body to a stressful event helps us to fight or flee before our stressors and the immediate result is in fact a reduction in our appetite, but the effect does not last long. The hormone known as cortisol for example tends to remain elevated once the stressful event has passed and it may lead us to overeating. Very often we turn eating into our anxiety coping activity.
It is a fact that high levels of stress are directly related with more abdominal fat, increased cravings for high sugar foods and simple carbohydrates and with a weaker disposition to exercise.
The good news is that there is a lot we can do to break this vicious circle between stress and weight gain. Here are some recommendations of what you could do to mitigate stress and to avoid overeating and unhealthy habits [7]:
- Identify unhealthy habits like overeating and pay special attention to who you feel after you overeat. Make a conscious plan to substitute overeating with another activity that will allow you to feel better.
- Set specific goals to achieve healthy habits. These goals shouldn’t be too easy, but they should be attainable.
- Find an accountability buddy that can help you stay on track and keep a record of your progress.
- Eat a balanced diet and do not skip meals. Have three adequate meals and two snacks a day to avoid spikes in blood sugar levels, thus reducing the production of insulin (the “fat trapping” hormone) and eventually of cortisol (a stress hormone). If you find it hard to commit to your three daily meals, try setting an alarm or designating special times for eating in your calendar.
- Identify healthy snacks and keep them within reach in your office or house kitchen. Each time you identify stressful situations that make you want to overeat, reach for those healthy snacks instead.
- If you have been experiencing stress and weight gain, instead of focusing on losing weight, start by maintaining your current weight by not overeating and staying active. This could be a stepping stone to developing healthier habits later.
- Find time for physical activity. Exercise is a great stress reducer. It not only burns calories and works the cardiovascular system; it also produces biochemical substances that counteract some of the negative effects of stress. Also, exercise helps regulate blood sugar level. If you find it hard to commit to exercise, try walking, raising stairs or even pacing in a closed circuit inside your office or house. You may accumulate 5-minute workouts for a total of 30 minutes a day as a daily goal by taking small breaks between your activities.
- Enjoy a recreational or relaxing activity. Fun or relaxing activities work much like exercise to counteract the effects of stress. Finding an activity that you like and that gives you some peace of mind is an important component in the formula for anxiety and weight control.
- Sleep well. Sleep deprivation alters certain hormones levels which in turn can cause an increase in appetite. Try to sleep 8 hours in approximately the same schedule every day.
- Practice conscious self-care. We know you are busy. But no matter how absorbing your daily routine is, you should always keep some time to take special care of yourself. Make your physical and mental health your priority.
At LIMARP we know first-hand the highly stressful situation that our patients live, that is why our comprehensive care model for obesity includes helping patients cope with stress and anxiety through the expertise of our multidisciplinary team, which is ready to help you. For a free evaluation please call LIMARP International Center of Excellence for Obesity at (619) 270 8823 or fill out a contact form at www.limarp.com.
Bibliography
- [1] Centers for Disease Control Prevention (CDC) (2018). Obesity and Overweight. https://www.cdc.gov/nchs/fastats/obesity-overweight.html
- [2] World Health Organization (WHO) (2018). Noncommunicable Diseases (NCD) Country Profiles. https://www.who.int/nmh/publications/ncd-profiles-2018/en/
- [3] American Psychological Association (APA) (2020). Stress in America 2020: A National Mental Health Crisis. https://www.apa.org/news/press/releases/stress/2020/sia-mental-health-crisis.pdf
- [4] American Psychological Association (APA) (November 9, 2010). Stress in America Findings: Mind/Body Health: For a Healthy Mind and Body, Talk to a Psychologist. https://www.apa.org/news/press/releases/stress/2010/national-report.pdf
- [5] American Psychological Association (March 11, 2021). One year on: Unhealthy weight gains, increased drinking reported by Americans coping with pandemic stress. https://www.apa.org/news/press/releases/2021/03/one-year-pandemic-stress
- [6] Araiza, A. M.; Lobel, M. (2018). Stress and eating: Definitions, findings, explanations, and implications. Soc Personal Psychol Compass 12. https://onlinelibrary.wiley.com/doi/abs/10.1111/spc3.12378
- [7] American Psychological Association (APA) (2021). Stress in America: One Year Later, A New Wave of Pandemic Health Concerns. https://www.apa.org/news/press/releases/stress/2021/sia-pandemic-report.pdf