Chronic stress can not only add inches to your waistline but can also make you diabetic. When you are stressed your body secretes stress hormone called cortisol. Cortisol is part of a class of steroid hormones called glucocorticoids (glucose+cortex+steroid) that are produced in the adrenal cortex. It plays a key role in carbohydrate metabolism. Prolonged cortisol stimulation raises glucose levels and, subsequently insulin. This increase in insulin is responsible for the weight gain and onset of type 2 diabetes.

Acute and Chronic Stress

Stress is a physical response to danger or threat. It is subjective in nature so what may be stressful to you may not be stressful someone else.

Acute Stress – Primitive Fight or Flight Response  

In olden times, people faced what is called an acute stress in the wake of an attack by a predator or waring tribe member. Cortisol was essential in preparing the body for action – to fight or flee.

Once released, cortisol substantially enhances glucose availability to the muscles helping a person to run and avoid being eaten. All available energy is directed toward surviving the stressful situation. Other physical activities like growth, digestion, and metabolic functions are put on a back burner. Proteins are broken down and converted into glucose in a process called gluconeogenesis to provide an additional source of glucose for vigorous physical exertion. Once the threat has abated, the body returns to its state of equilibrium. The body is well designed to face short-term physical threats.

Chronic Stress

The problem occurs in long-term psychological threat or chronic stress situation. Our body is not designed to withstand constant stress. Even though our modern lives are beset with many non-physical stressors that increase our cortisol levels. For example, marital issues, inability to meet work targets, teenage children problems and sleep deprivation are all serious stressors, but they do not result in vigorous physical exertion needed to burn off the excess glucose made available by the cortisol. Since chronic stress does not abate the way acute stress does, the body remains in highly strung state for long period of time causing damage to our health. 

Chronic Stress leads to long-term increase in glucose levels

Since the modern-day chronic stress situation does not lead to the use of excess energy made available by stress hormone to the body it leads to constant high blood glucose levels. These high glucose levels cause the pancreas to secrete more insulin to wipe away excess blood glucose. If no resolution to stressors happen the elevated cortisol leads to elevated insulin levels. A 1998 study showed that cortisol levels increased with self-perceived stress levels, strongly linked to increasing levels of both glucose and insulin. Since high insulin levels or hyperinsulinemia is a primary driver of obesity, people under chronic stress face increased body mass index or BMI and abdominal fat.

Journey of high cortisol to insulin resistance

The persistent high glucose levels and resultant high insulin secretion eventually cause impairment of the body’s ability to process insulin. The body becomes resistant to insulin or develops glucocorticoid-mediated insulin resistance. This increased insulin resistance leads back to elevated insulin levels and a vicious cycle is set in motion. The liver in the presence of high insulin converts excess carbohydrates and fructose into triglycerides. These fatty acids get deposited in the liver and other tissues as visceral fat. While the production and deposit of fat increases in the body, the retrieval of fat for energy slows down resulting in weight gain.

To read more on how high insulin causes weight gain read SoulGuru’s article Solving the Weight Loss Puzzle

Cortisol-led obesity

The proof of cortisol led obesity lie in the study of those patients who are given prednisone. Prednisone is a synthetic version of human cortisol and is prescribed in the treatment of diseases such as asthma, lupus, rheumatoid arthritis, psoriasis etc. One of the consistent side effects of the long use of prednisone is weight gain. In case of Cushing’s disease where due to a tumor in the pituitary or adrenal the secretion of cortisol increases, weight gain is a primary symptom.

Even in people who do not suffer from any disease, cortisol excretion rates are strongly correlated to BMI and waist measurement. High cortisol levels are seen in heavier people. Cortisol-related weight gain, particularly abdominal fat deposits, results in an increased waist-to-hip ratio, a more dangerous form of weight gain.

Cortisol and Type 2 diabetes

High cortisol leads to high insulin and insulin resistance. The vicious cycle of insulin resistance can lead to the onset of type 2 diabetes. Cortisol also plays an indirect role in type 2 diabetes by increasing the inflammation in the body. Inflammation, many studies have shown, increases the risk of developing type 2 diabetes and also increases the severity of complications associated with diabetes.

Therefore chronic stress is a bane for our health and well-being. Indulge in stress relieving activities like exercises,  Yoga, and meditation to keep the cortisol levels under control. Also read our Article on how to overcome worry, anxiety, and stress.

.