Knoxville Medical Spa, Serving Farragut & Surrounding East TN Areas

The effect of chronic stress on energy balance

Key points

The stress response is a biological process that takes place to promote behavioral adaptation under such circumstances. However, when stress exposure becomes prolonged, the stress response becomes maladaptive and can lead to physical and physiological disease. The primary health consequence of stress is depression which nowadays affects over 120 million people worldwide and is projected to be one of the leading causes of death by 2030.

The association between stress and obesity

Stress is a normal biological response that activates under acute threatening conditions (e.g., a barking dog chasing you). Specifically, acute stress mobilizes the body’s energy stores, such as glycogen, so we can respond rapidly and face any threats. Once the threat has passed, the body returns to its baseline state.

However, modern life stressors are not typically physical but psychological, such as financial worries, work problems, health concerns, etc. In this context, the stress response ceases to be beneficial and instead becomes harmful. This type of stress is characterized as chronic stress because the psychological stressor never really passes, and the stress response cannot be regulated adequately. Chronic stress has consistently been linked to obesity in epidemiological studies and meta-analysesObesity is a rapidly growing pandemic with significant consequences for public health. It has been directly linked to severe health conditions such as cardiovascular disease, type 2 diabetes, and cancer, among the most common causes of morbidity and mortality worldwide.

As stated in one of our previous Blogspots, obesity is caused by an imbalance between the energy intake of the diet and the body’s voluntary (e.g., physical activity) and/or spontaneous (e.g., resting metabolic rate) energy expenditure.

This imbalance progressively leads to excessive fat accumulation in the body, to an extent where body health is impaired, and health complications like those mentioned above arise.

Multiple pathways are activated during chronic stress, some of which have been recognized as playing a role in the development and maintenance of obesity.

Chronic stress is mainly linked to central obesity and visceral fat accumulation, namely the fat that piles up around organs in the abdominal area and is responsible for the cardiometabolic consequences of obesity, such as type-2 diabetes, hypertension, and cardiovascular disease. From a survival perspective, this is logical since the constant activation of the stress response can be interpreted as living in a continuously unsafe environment, for which it is beneficial to store easy-to-use central fat.

How is a chronically elevated stress response eventually associated with weight gain and obesity?

The chronic stress cascade

Α repeated stress response may lead to obesity through different pathways. These pathways implicate (neuro)physiological, behavioral, physiological, metabolic, and biochemical adaptations.

Weight stigma as a component of the chronic stress vicious cycle

One common but often overlooked aspect of obesity is that obesity is a stressful state in itself. In other words, obesity per se can lead to increased chronic stress to varying degrees, depending on the individual’s personality. It has been found that people experiencing weight stigma are at risk of experiencing chronic stress and its resulting cascade of negative consequences.

Some studies link weight stigma to exercise avoidance or decreased physical activity. The evidence also shows that weight stigma predicts future weight gain and a greater likelihood of obesity. Consequently, the vicious cycle of chronic stress is fueled by so many factors that are also interrelated and all favor an obesogenic state.

Are some people steered to be eternally knocked by stress? 

Early life stress exposure likely shapes the risk for later obesity and/or unhealthy fat deposition patterns (visceral fat) through biological pathways deep in our gastrointestinal tract. Gut microbiota or gut microbiome, i.e., the genetic makeup of the community of microbes that inhabit the human body, differs between children with obesity or overweight and children with average weight. Also, specific characteristics of infant gut microbiota predict early weight gain.

Moreover, different gut microbiota compositions can affect how prone and responsive to stress an organism is and affect the levels of the orexigenic (appetite-stimulating) hormones ghrelin and NPY.

These data are pretty novel and, at the moment, can just manifest how complicated and inextricable the relationship between chronic stress and obesity is.


Key takeaways

Stress is a normal biological process that protects us from physical and psychological threats. However, it can become detrimental when its effectors are constant, and the stress regulation systems cannot turn it down anymore.

The relationship between chronic stress and obesity is rather complex and is fueled by different pathways, which all end up in a toxic fat deposition pattern in the abdominal area. Therefore, chronic stress creates a metabolically unfavorable body fat accumulation, which harms cardiovascular health.

However, healthy dietary behavior and regular physical activity can help someone escape the vicious cycle of chronic stress and its consequences.

Remember, the energy balance is a somewhat workable equilibrium, and it’s never late for someone to try and tip it over.

If you would like to speak to our health and wellness coach regarding metabolic testing, please call us at 865-218-9000 or book a free consult at


Medi Spa At Choto 1606 Choto Markets Way Knoxville, TN 37922 865-218-9000

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