How Does Stress Cause Belly Fat and Heart Attacks?

TL;DR

Chronic stress raises cortisol, which is pro-inflammatory and signals the body to store visceral fat around the belly that diet and exercise alone cannot shift. Cortisol also drives dry skin, frizzy hair, sleep and digestive problems, and can trigger pre-diabetes or heart attacks even in young, slim, healthy people. Offloading it through exercise or talking reduces the load.

Transcript

Tor you have been a medical doctor psychiatrist executive coach you're a neuroscientist and I think one of the topics that people are talking a lot about these days is stress MH so right at the top I'd love to understand when you hear the word stress what does it mean to you so when you introduce me like that like you know you're ad a psychiatrist ... Read More

Key Insights

• Stress is defined as when the load on your body or mind is too much for you to bear, showing up as cardiovascular strain, mental breakdown, or a whole-body cascade depending on the system affected.
• Cortisol is released by the adrenal glands when the brain perceives a survival threat; it crosses the blood brain barrier, keeps the brain on high alert, and drives a pro-inflammatory state throughout the body.
• Belly fat storage is an ancient survival mechanism driven by cortisol, depositing visceral fat around the abdomen even when a person eats less, exercises more, or does both.
• The physical signs of chronic stress include very dry skin, frizzy hair, a belly you cannot shift, sleep disturbance, and digestive problems, all underpinned by the stress response.
• Stress-induced heart attacks strike people who do not fit the stereotype; Dr. Swart met a young, slim, healthy woman at MIT who had a heart attack while in a busy, stressful job.
• Pre-diabetes can develop from stress alone; one slim patient in her 30s who looked after her diet and exercise saw her blood sugar return to normal within months of addressing job stress.
• There are two main ways to offload stress: physical exercise, which sweats cortisol out of the body, and speaking out loud or journaling, which gets thoughts out of the brain-body system.
• High-intensity exercise spikes cortisol, so type A people in stressful jobs benefit more from gentle exercise than from adding intense workouts on top of an already high stress load.

Questions & Answers

Q: How does stress cause belly fat?

When the brain perceives a survival threat, the adrenal glands release cortisol, which as an ancient survival mechanism encourages storage of fat in the abdominal fat cells. This is visceral fat rather than fat all over the body. Because cortisol drives this deposit, people cannot shift the belly weight even when they eat less, move more, or do both. Many report having to undo their belt a notch and being unable to reverse it.

Q: What is stress according to Dr. Tara Swart?

Dr. Tara Swart defines stress as when the load on your body or mind is too much for you to bear. As a medical doctor she saw it as cardiovascular strain during a heart attack, as a psychiatrist as a breakdown of psychosis or depression, and as a neuroscientist as the brain's perception of a survival threat that triggers a cortisol cascade affecting the whole body.

Q: Can stress cause a heart attack in young, healthy people?

Yes. While teaching a class at MIT, Dr. Swart met a young woman who looked slim and healthy and said she had a heart attack while in a really busy, stressful job. She also worked with a large global bank that was seeing deaths and non-fatal heart attacks on its trading floor, which she linked to the stress shown in their employee engagement survey.

Q: Why does cortisol affect so many organ systems?

Cortisol released by the adrenal glands travels in the blood, crosses the blood brain barrier, and signals receptors in the brain that you are on high alert all the time. This process is pro-inflammatory, so it has knock-on effects on the cardiovascular system, immunity, and the gastrointestinal system. It is also very dehydrating, which shows up on the skin, hair, and scalp, producing dry skin and frizzy hair.

Q: How can you lower cortisol and offload stress?

There are two main ways to offload stress from your system. One is physical exercise, which sweats the cortisol out of your body. The other is speaking out loud, or possibly journaling, ideally with someone so you also get the social connection piece. Instead of ruminating on your thoughts, getting them out of your brain-body system reduces your cortisol levels too.

Q: Do women and men handle stress differently?

In Dr. Swart's experience, men traditionally talk less to each other about stress and mental health, while women put pressure on themselves to be the mom, wife, and career person because of the myth that they are better at multitasking. Research suggests men are good at adaptive stress responses for short crises but then need to recover, whereas women find ways to recoup resilience better during long periods of stress.

Q: Can stress cause pre-diabetes without a bad diet?

Yes. Dr. Chatterjee describes a patient in her 30s who was slim and looked after herself with diet and exercise, yet developed pre-diabetes from stress alone because her job was extremely stressful. When she recognized she needed to address that stress, her blood sugar came back into the normal range within a few months without any change to her diet or exercise.

Q: Why should high-stress people avoid high-intensity exercise?

High-intensity exercise spikes cortisol. Dr. Swart works with type A people such as law firm partners who already have super stressful jobs and then do really high-intensity workouts on top. She tells them they are exactly the kind of person who should be doing more gentle exercise, because their personality type and job stress already keep cortisol elevated, so intense exercise adds to the load rather than relieving it.

Summary & Key Takeaways

• Dr. Tara Swart defines stress as when the load on body or mind exceeds what you can bear. Her roles as doctor, psychiatrist, and neuroscientist each frame stress differently, but the brain's perception of threat is what triggers the cortisol cascade affecting every organ system.

• Cortisol is pro-inflammatory and promotes storage of visceral belly fat as an ancient survival mechanism, so weight stays on despite eating less and exercising more. Doctors estimate 80 to 90 percent of what they see daily is in some way related to stress.

• Stress can cause heart attacks and pre-diabetes even in young, slim people. Women and men handle stress differently, and the two best ways to lower cortisol are physical exercise and speaking out loud or journaling to avoid ruminating on thoughts.