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 The Stress-Fat Connection: The Thick and Thin of Your Figure 
The following is one in an ongoing series of columns entitled Mind Over Matter by . View all columns in series
If you've ever found yourself nervously munching away on a snack while anticipating a stressful event, what you're about to learn could make a great difference in your future and your waistline.

A fascinating research study recently performed at Yale University is helping us to understand the important relationship between stress and fat. In the September/October 2000 edition of the Journal of Psychosomatic Medicine, researcher, Elissa Epel, PhD and colleagues reported a unique relationship between what is termed "central fat" and responsiveness to life stress.

Central fat, (you know the stuff) located primarily around our mid-sections, is considered unhealthy as it appears to be commonly associated with heart disease and diabetes. Particularly sensitive to cortisol, a circulating hormone typically released as part of the biological stress response, central fat literally increases with perceived distress.

Let's take a few moments to review the typical biological stress response that may actually be adding inches to our waists. First it's important to recognize that anything serving to disrupt or challenge our inner sense of balance is recognized as stressful. With this in mind, it's obvious that stress varies considerably from person to person. In fact, what stresses one person may bring comfort to another. As an example, consider an incredible 12 inch high ice cream sundae smothered in chocolate and caramel, covered with nuts and overflowing with whipped cream and a cherry on top. For some of us, it's a welcome delight, while for others, it's a major threat in the battle of the bulge.

With this example in mind, (my mouth is watering yet my belt is snug) assume for a moment your stress response is already set in motion. Chemical messengers from key areas of your brain are sending distress signals to your adrenal glands (pyramid shaped structures above the kidneys) to release cortisol, a well-known and studied stress hormone. As a result, cortisol actually triggers a fat build-up particularly around your waist. Are you loosening your belt yet? ... only kidding!

Getting back to the research, 59 women were included in the study. Half had a high waist to hip ratio (WHR). A high WHR basically signifies increased fat storage at the waist.

The normal WHR for women is less than 0.8
The normal WHR for men it is less than 1.0
(please note: according to the American Heart Association, a high-risk waistline is defined as more than 35 inches for women and 40 inches for men)

In practical terms, a woman with equal waist and hip measurements of 34 inches would have a 1:1 ratio, signifying a high WHR. Women with high WHRs are often referred to as "apple" shaped, as opposed to women with low WHRs who are referred to as "pear shaped." Please note that a high WHR does not equate with obesity. A thin person can also have high WHR.

All participants in the study were given puzzles and speech tasks designed to evoke stress. As a result, women with high WHRs (both in the overweight and lean groups) secreted more cortisol in response to stress than women with low WHRs. The high WHR group was typically more threatened by the stressful activity, performed relatively poorly on the stress tests, and reported higher levels of daily stress than their low WHR counterparts.

In addition, overweight women in the high WHR group seemed to adapt to laboratory stress, while lean women with high WHRs did not. Well into the study, the lean women in the high WHR group continued to secrete more cortisol than their lean counterparts with low WHRs. Based upon these findings, it is likely that different mechanisms come into play for the overweight and lean high WHR groups.

As the image of our delicious chocolate sundae slowly fades from our sight and taste buds, it's now time to get to the bottom line. Essentially there appears to be a significant association between a woman's figure and the way she perceives and handles stress.

Yet don't be fooled into believing the importance of this association is purely cosmetic. According to a study published in the Journal of the American Medical Association, (JAMA) December 2, 1998, WHR and waist circumference in women are both clearly associated with a significantly increased age-adjusted risk of coronary heart disease.

While one cannot discount the roles of genetics, hormones, behavior and underlying metabolic abnormalities related to central fat, the stress-fat association appears to have notable merit. Future research is necessary to help us decipher the mysteries associated with maintaining an optimal body weight and shape. We also need to learn more about how men handle stress in the context of optimal risk factor reduction.

From this physician's perspective, we now have another key element of support for including "whole person" stress reduction and coping skills training in every rational weight management program. Yet the good news doesn't end here. Consider it a bonus knowing that smoking, alcohol and lack of exercise increase central fat as well. So if you really want to tone that waist, get in shape and prevent some serious illnesses, forget the gadgets and the infomercials. There’s no better time than the present to settle in, relax, and make some important lifestyle choices - Mind Over Matter!

© 2000 Barry Bittman, MD all rights reserved

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 About The Author
Barry Bittman, MD is a neurologist, author, international speaker, award-winning producer/director and inventor. As CEO and Medical Director of the Mind-Body Wellness Center, a......moreBarry Bittman MD
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