Today’s Biggest Health Problem?

Most medical experts cite obesity as our most urgent health problem. More than 65% of Americans are overweight to obese, and the numbers are still on the rise. This is in spite of the fact that we have spent billions of dollars on clinical research aimed at solving problems like diabetes, heart disease, high blood pressure, cancer, sleep apnea, and many others – all of which are associated with obesity.

Obesity increases free fatty acids, which leads to dyslipidemia, hypertension, and insulin resistance. This condition, collectively called metabolic syndrome, can progress to type 2 diabetes and/or cardiovascular disease.

Obesity also causes mechanical stress to the body, resulting in sleep apnea, osteoarthritis, low back pain, and shortness of breath.

Finally, all the hormones in the body become imbalanced as a result of excessive weight, and that can lead to multiple disruptions in hormone-dependent physiological processes, which in and of themselves contribute to further weight gain.

The Bad News is Getting Worse

In 1970, 45% of Americans were obese. If you think that sounds bad, read on.

Current projections are that 74% of Americans will be in this category by the year 2020. What happened? Where did we go wrong? Is it that our lifestyles have changed so drastically? Are we eating differently? Is it the sugar consumption and/or processed foods? Are we not as physically active as we used to be before? Are there any changes in our work habits that we need to look at carefully? Do we have increased lifestyle stress?

The answer probably lies in a combination of all these factors, as people pay less and less attention to how their habits and lifestyles contribute to their health.

But what can be done to rein in the escalation? And, as a practical question, how can we lose weight?

Weight loss should be very simple according to the rule of calories consumed and calories burned: if we burn more calories than consume, we should be able to lose weight very easily.

Weight loss should not be too difficult for a motivated person who is willing to change their eating and exercise habits and reach a goal.

Unfortunately, even with our best efforts, a lot of the time, weight does not come off!

How Stress Impacts Weight Management (The Science Stuff)

For proper weight management, it is extremely important to understand the role of the Hypothalamic-Pituitary-Thyroid-Adrenal (HPTA) axis. Any type of stress can lead to HPTA dysfunction and related disorders like Cushing’s syndrome, chronic stress, panic disorders, hypothyroidism, adrenal insufficiency, chronic fatigue syndrome, fibromyalgia, etc.

Dysregulation of the HPTA axis is a leading cause of metabolic problems that can contribute to body fat accumulation.

The goal of the stress response, a key function of the HPTA axis, is to maintain effective blood supply to brain, heart, and skeletal muscle, and to increase production of energy by stimulating gluconeogenesis (endogenous glucose synthesis) and ATP (energy) production, needed for the short term response to any chemical or mechanical stress to the body. The main components of the stress response system are the HPTA axis and the sympathetic nervous system.

During a stress response, both CRH (Corticotropin-releasing hormone) and AVP (Arginine vasopressin) are secreted. AVP activates the noradrenergic neurons of the Locus Coeruleus/norepinephrine (LC/NE) system and CRH activates adrenocorticotrophic hormone (ACTH) release by the pituitary.

The LC/NE system is responsible for the immediate “fight or flight” response, whereas ACTH drives the production of cortisol from the adrenal cortex. When high levels of cortisol are present, a negative feedback loop stops this pathway.

The glucocorticoid hormone cortisol is a major player in the stress response because of its role in temporarily shutting down all long-term metabolic processes to facilitate immediate survival and maintain homeostasis.

Think about that: Cortisol shuts down metabolism and will continue to until the stressor is resolved or removed.

Cortisol’s main job is to increase gluconeogenesis, decrease insulin sensitivity, reduce growth hormone production, lower thyroid hormones, and inhibit the immune response, while increasing fat and protein mobilization for energy needs.

And it will keep doing this until the stress is gone.

Acute cortisol secretion by the adrenals during stress mobilizes peripheral

The Bottom Line on Stress and Weight

To summarize, acute stress causes a short term increase in glucocorticoid release, which induces fatty acid mobilization and decreased food intake; whereas chronic stress is associated with sustained cortisol secretion, which leads to redistribution of subcutaneous fat stores to visceral adipose tissue, resulting in central obesity and several metabolic and endocrine abnormalities.

And until we resolve or remove these stressors (whether they be physical, emotional, or chemical) we will continue to bathe our system in stress hormones and halt our metabolism of stored fat.

So: do yourself a favor and de-stress. Get some sunlight; exercise vigorously; visit your counselor and journal, journal, journal; have some great sex – all of these are simple ideas to lower your stress and, therefore, lower your weight.

Until next time, please, Be Well. — jb

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