03/11/2025
Learn how cortisol impacts your weight. Discover expert tips to better manage your stress hormone levels and achieve better health and weight management today!
By, Amy M. Lohman, MD, MPH Obesity Medicine, Family Medicine, Nuvance Health
Cortisol, often referred to as the “stress hormone,” is a critical hormone produced by your body’s adrenal glands. It plays a key role in regulating your body’s stress response, metabolism, blood sugar, inflammation, blood pressure and sleep-wake cycle. However, when cortisol levels become too high due to ongoing stress, it can lead to significant health concerns, including weight gain, particularly in your abdominal area.
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Erica Seebeck, APRN, is a board-certified adult-gerontology nurse practitioner and specializes in obesity medicine.
“Cortisol is a hormone produced by the adrenal glands that helps to regulate your body’s stress response, among many other processes. Our bodies like to maintain even cortisol levels and when that homeostasis is disrupted, we see negative physiological impacts,” she explains.
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Cortisol’s role in weight gain
Elevated cortisol levels are closely linked to the accumulation of visceral adipose tissue, commonly known as belly fat.
“Elevated levels of cortisol can increase visceral adipose tissue, which is the fat that surrounds your internal organs. This is the most dangerous location of fat because it can increase the risk for cardiovascular disease, type 2 diabetes and even some cancers,” Erica said.
Cortisol influences fat distribution by encouraging your body to store fat in your abdomen rather than under your skin. You can tell the difference between subcutaneous fat, which is found right under your skin and you can pinch between your fingers. Visceral fat which lies deep inside your body and surrounds your vital organs. Visceral fat can be neither seen nor felt.
How high cortisol levels and your diet impact your weight
The shift in fat storage due to higher levels of cortisol is not only a cosmetic concern but also a significant health risk. Additionally, cortisol can impact appetite and food choices, Erica explains.
“Cortisol increases your appetite and enhances the pleasurable effect of highly palatable foods. This means comfort foods like sweets or salty snacks taste even better when you are stressed out.”
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According to the National Institute of Health, chronic stress and elevated cortisol levels can disrupt your metabolic processes, leading to increased cravings for high-calorie foods and a tendency to overeat. This creates a cycle where individuals turn to food as a coping mechanism of stress, further exacerbating an endless cycle of weight gain through emotional eating, also called stress eating.
Balancing cortisol levels for better weight management
Managing cortisol levels is essential for maintaining overall health and supporting weight loss efforts. Erica emphasizes the importance of starting small:
“Often, I tell patients who are experiencing high levels of stress to pick one element to focus on first. When stress levels go down, they can start incorporating other aspects.”
Sleep: The U.S. Centers for Disease Control and Prevention recommends adults get seven to eight hours of quality sleep each night. Good sleep hygiene practices, such as maintaining a consistent bedtime routine, keeping the bedroom dark and cool and avoiding screens before bed, can help improve sleep quality.
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Exercise: Regular physical activity, as supported by the American Medical Association (AMA), can reduce stress and cortisol levels while also enhancing sleep.
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Deep breathing: Techniques like deep breathing stimulate the parasympathetic nervous system, which helps calm your body and lower cortisol.
Cognitive behavioral therapy (CBT): Working with a therapist can help identify stress triggers and develop effective coping skills, as recommended by the U.S. Department of Health and Human Services.
Learn more about the benefits of compassionate behavior healthcare at Nuvance Health.
Meditation and mindfulness: These practices, though challenging to adopt, are proven to reduce stress, improve anxiety and alleviate depressive symptoms, according to the National Institute of Health. Erica also highlights the importance of addressing the root cause of elevated cortisol:
“The best interventions to improve elevated cortisol are lifestyle changes. The target is addressing the root cause.”
Testing cortisol levels for stress and weight management
While cortisol testing is not routinely performed for stress-related concerns, it may be necessary in certain cases. Erica explains:
“We don’t commonly check cortisol levels as it relates to stress. Before ordering tests, I always ask, ‘Will this information change my treatment plan or guide treatment approaches?’”
However, if a patient exhibits clinical signs of hypercortisolism, such as those seen in Cushing’s Syndrome, testing is warranted.
“If a patient has clinical signs of hypercortisolism, levels should be tested, and the individual should be referred to an endocrinologist for evaluation,” Erica said.
Cortisol levels fluctuate throughout the day, so tests like late-night salivary cortisol, blood tests or urine tests may be used to assess levels accurately, as outlined by the National Institute of Health.
The bottom line: Cortisol is a vital hormone that helps your body respond to stress and maintain balance. However, chronic stress and elevated cortisol levels can lead to weight gain, particularly in the abdominal area and increase the risk of serious health conditions.
By incorporating lifestyle changes such as improved sleep, regular exercise, stress management techniques and professional support, individuals can better manage cortisol levels and support their overall health.
“The key to managing cortisol is addressing the root cause of stress and making sustainable lifestyle changes. Small steps can lead to significant improvements over time,” Erica said.
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