Cortisol and Weight Gain: Are They Related?

Craig Primack, MD, FACP, FAAP, FOMA

Reviewed by Craig Primack, MD, FACP, FAAP, FOMA

Written by Lauren Panoff

Published 04/09/2024

Cortisol’s reputation as “the stress hormone” is due to its front-and-center role in your body’s stress response. But what’s the connection between cortisol and weight gain?

While cortisol has an essential job in the short term, it can wreak havoc on your health if left to its own devices. For example, when cortisol stays elevated over time, it can lead to unintentional weight gain.

Why does cortisol cause weight gain? We have answers.

We’re digging into the relationship between cortisol levels and weight gain, including signs your cortisol might be elevated, possible underlying factors and how to get your cortisol (and weight management) back on track.

Cortisol is a glucocorticoid (steroid hormone) produced by your adrenal glands, which are located on top of your kidneys.

It’s heavily involved in how your body responds to physical, emotional or psychological stressors. Specifically, cortisol helps regulate processes like metabolism, immune response and blood pressure in the face of a perceived threat.

Cortisol also helps regulate your sleep-wake cycle and maintain stable blood sugar levels while assisting in your body’s inflammatory response.

Cortisol and weight gain — unfortunately — often go hand in hand.

Your body relies on cortisol to do many jobs. Your endocrine system, which controls hormones, usually keeps it tightly regulated.

However, when levels of cortisol are out of balance, it can have negative consequences for your health — including changes in body weight you might not want.

Does high cortisol cause weight gain? It can. Here’s what to know.

How High Cortisol Levels Affect Your Body and Mind

Chronically elevated cortisol from prolonged stress can weaken your immune function and increase your risk of conditions like heart disease and type 2 diabetes. It can also make it harder to stick to healthy eating habits. This could result in overeating to the point that you gain weight.

Additionally, high cortisol levels can result in high blood pressure, mood changes, thinning skin, trouble concentrating, insulin resistance and fatigue.

How Low Cortisol Levels Affect Weight

While ongoing high cortisol levels are associated with numerous negative health effects, that doesn’t mean low cortisol levels are a good thing, either.

Does low cortisol cause weight gain or weight loss? It might.

Lower cortisol levels may reduce appetite and promote weight loss in some cases. But it could also lead to side effects like low blood sugar, fatigue, dizziness, cravings for salty comfort foods, nausea, vomiting and muscle or bone pain.

Elevated cortisol levels can trigger various physical, emotional and behavioral symptoms. (These can indicate other health concerns, though, so keep that in mind.)

Here are some clues your cortisol levels may be imbalanced:

  • Unintentional weight gain. Ongoing stress can lead to cortisol belly fat, as high cortisol levels can promote weight gain around the abdomen. This is due to how the hormone affects fat storage.

  • Disrupted sleep. Out-of-whack cortisol might make it harder to fall asleep or stay asleep.

  • Fatigue. By messing with your normal sleep-wake cycle, chronic stress and elevated cortisol can make you more tired than usual.

  • Anxiety and irritability. High cortisol levels can cause anxiety and irritability because the hormone is involved in your fight-or-flight response.

  • Digestive issues. Cortisol influences digestion and can lead to bloating, indigestion or appetite changes.

  • High blood pressure. Long-term high cortisol can contribute to hypertension (high blood pressure), increasing the risk of cardiovascular disease.

  • Weakened immune system. Cortisol suppresses the immune response, so chronically elevated levels can lead to frequent illnesses, infections or a longer-than-usual recovery time from being sick.

  • Muscle weakness and joint pain. Cortisol imbalance can contribute to muscle weakness, fatigue and joint pain.

  • Skin issues. Elevated cortisol might worsen skin conditions like acne, eczema or psoriasis because of its effects on inflammation and immune function.

  • Trouble concentrating. Chronic stress and high cortisol can affect your brain in many ways like, difficulty focusing, worsened memory or brain fog.

  • Irregular periods. High cortisol can disrupt your menstrual cycle, leading to irregular periods or even amenorrhea (no periods).

  • Low sex drive. Cortisol imbalance could reduce your desire to have sex or contribute to sexual dysfunction because of how it influences the body’s hormonal balance and stress response.

If you’re experiencing any of these symptoms or just feel like something is “off” with your health, it’s always worth talking to a healthcare provider.

They may recommend checking your cortisol levels. This can be done through a blood, saliva or urine test that measures cortisol levels at various times of the day.

Cortisol testing can provide insight into your body’s stress response and point to potential imbalances in cortisol production so a personalized treatment plan can be made.

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Many things can contribute to elevated cortisol levels, even after a perceived threat or stressor is gone, like:

  • Chronic stress. Persistent emotional, psychological or physical stress can keep cortisol levels elevated.

  • Poor sleep. Not logging enough Zs or disrupted sleep patterns (like frequent wake-ups) can mess with how your body regulates cortisol production.

  • Eating habits. Consuming lots of added sugar, caffeine or ultra-processed foods can trigger cortisol release and contribute to chronically high levels. Research shows that following restrictive calorie-controlled diets as well as being underweight can raise cortisol too.

  • Socioeconomic status. Some research suggests there’s more to the link between chronic stress, cortisol and abdominal fat accumulation in women. Factors like race, education, income and even marital status play a role.

  • Alcohol. Excessive alcohol consumption can disrupt cortisol secretion (when it’s released into the bloodstream) and lead to elevated levels.

  • Smoking. Nicotine in cigarettes can stimulate cortisol release, so regular smoking could result in regularly spiked cortisol.

  • Overtraining. Intense physical activity without adequate rest and recovery can elevate cortisol levels. This is called “overtraining syndrome.” It can lead to fatigue, decreased performance and an increased risk of injury.

  • Medications. Some medications, such as corticosteroids (like prednisone), can directly increase cortisol levels. Certain antidepressants and birth control pills may also affect cortisol metabolism (how your body processes the hormone).

  • Medical conditions. Conditions such as Cushing’s syndrome, adrenal tumors, or pituitary gland disorders can cause higher cortisol production. There’s also a link between polycystic ovary syndrome (PCOS) and heightened cortisol, even when women are a healthy weight — though more research is needed to understand why.

  • Chronic illness. Persistent illnesses or chronic conditions can cause an ongoing stress response in the body, leading to elevated cortisol.

  • Environmental factors. Exposure to pollutants or toxins may trigger a stress response and elevate cortisol levels.

  • Mental health. Emotional trauma, anxiety disorders and depression can chronically increase cortisol.

Does cortisol cause weight gain? It can, but there’s more going on in your body to consider.

It can be tempting to latch onto things that promise quick weight loss — but when weight gain is related to elevated cortisol and stress, it’s important to target the root cause(s) first.

Luckily, many things can help optimize cortisol levels and support healthy weight management.

Wondering how to stop cortisol weight gain? Here are some ways to improve stress management and help prevent unintentional weight gain.

Move Your Body More

Regular exercise is vital for fitness, mood and overall well-being. It can also lower your risk for chronic disease and help keep cortisol production in check.

Think about how you can incorporate intentional movement into your everyday routine. This might include things like jogging, biking, swimming, playing sports, joining a group fitness class or doing yoga.

Rest is also key to preventing overtraining and excessive cortisol production. Take at least one day off from physical activity each week and allow yourself to recover fully.

Get Better Sleep

Experts recommend getting seven to nine hours of quality sleep per night — not just for basic wellness but also for healthy cortisol production and hormonal balance. Sleep deprivation can promote imbalances in cortisol, and vice versa.

If this sounds like a challenge, start with one or two things you can do to improve your shut-eye.

For instance, creating a relaxing bedtime routine, designing a comfortable sleep environment, avoiding screens close to bedtime and having a consistent sleep-wake schedule can help you get deeper, more restorative sleep.

These sleep hygiene practices don’t just support normal cortisol levels. They can also help regulate your appetite so weight management isn’t such an uphill battle.

Eat More Nutrient-Dense Foods

Meals and snacks can have immediate and lasting effects on your health, including what your cortisol levels are up to.

The best types of foods for normal cortisol balance are fruits, vegetables, legumes (think beans and lentils), lean proteins, nuts, seeds and whole grains.

These food groups provide various vitamins, minerals, proteins, healthy fats and antioxidants to support overall health and hormone balance.

They’re also rich in fiber, which helps prevent spikes in blood sugar that can otherwise trigger cortisol release.

On the other hand, when we veer more toward ultra-processed foods high in saturated fat, sodium and added sugars, it can encourage cortisol spikes. Plus, as you probably know, these foods tend to encourage weight gain.

Slow Down

In our fast-paced culture, the idea of slowing down can feel counterproductive — but the seemingly lost art of slowing down is crucial for your health.

More to the point, slowing down and prioritizing relaxation techniques can counteract your stress response and help regulate cortisol levels.

Try these ideas for slowing down:

  • Practicing mindfulness with food intake

  • Yoga

  • Doing deep breathing exercises

  • Taking regularly scheduled breaks in your workday

  • Walking around the neighborhood after dinner

  • Making space for leisurely hobbies like painting, playing music, journaling or reading

  • Meditation

New to meditation and mindful breathing? Check out our guide on how to meditate for beginners.

Seek Support

Stress is a burden in more ways than one. Incorporating healthy lifestyle habits is always a good idea, but sometimes, it’s not enough to tackle ongoing stressful situations, messed-up cortisol levels and related weight gain.

If this feels like where you are, you’re not alone.

Friends and family members can offer social support, but seeking support from unbiased professional sources is also beneficial.

For example, a doctor, therapist or registered dietitian can offer personalized guidance and interventions tailored to your physical, mental health and nutritional needs. They can help you identify underlying factors and come up with a plan of attack to get your health on track.

Nobody wants to feel like their health is out of their control. When the hustle of modern life has your stress levels at an all-time high and you’re experiencing unwanted side effects like cortisol weight gain, keep these things in mind:

  • Cortisol has a purpose. In the short term, elevated cortisol is a critical piece of your body’s normal stress response — so the goal isn’t to keep it low all the time but rather to support healthy stress management.

  • Lifestyle is key. Your everyday habits are strongly linked to cortisol and weight loss or gain. Consider ways to boost the nutritional quality of your meals, get more physical activity and get restorative rest.

  • Seek outside support. We were never meant to do life alone. If you need outside help with your physical wellness, weight management or mental health, get in touch with a healthcare provider like a therapist or registered dietitian. That’s what they’re trained to do.

If you’re struggling with weight management and want to learn evidence-based skills, start by taking our free assessment.

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