Your Cortisol Levels May Be to Blame for Your Recent Weight Gain

Madeleine Haase
·7 min read
Your Cortisol Levels May Be to Blame for Your Recent Weight Gain


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When you’re feeling stressed out, you may not feel great in your body. Turns out, the stress hormones in your body could be to blame for your fatigue, irritability, and even putting on a few extra pounds. But don’t make matters worse by worrying; the cause and effect relationship between cortisol and weight gain can be balanced with a few lifestyle changes.

Meet the Experts: Maria Teresa Anton, M.D., endocrinologist and educator at Pritikin Longevity Center; Florence Comite, M.D., endocrinologist and founder of The Comite Center for Precision Medicine & Healthy Longevity; Andres Splenser, M.D., endocrinologist with Memorial Hermann; Avantika Waring, M.D., endocrinologist and chief medical officer at 9amHealth.

First, know that “cortisol imbalance” is not a legitimate medical diagnosis and instead comes from misinformation, says Maria Teresa Anton, M.D., endocrinologist and educator at Pritikin Longevity Center. “Many patients are misled by this description.” So before we get into how to manage your cortisol levels yourself, our experts will explain exactly what the stress hormone does, why it affects our weight, and signs of high cortisol to look out for.

What is cortisol?

Cortisol is one of the main hormones your body releases to manage stress, says Avantika Waring, M.D., endocrinologist and chief medical officer at 9amHealth. “It is always naturally present in the body, but levels increase and decrease depending on the time of day, and depending on your overall stress levels,” she explains.

Cortisol affects blood pressure as well as blood sugars, adds Dr. Waring. “When your body is under stress it needs more energy, cortisol stimulates your liver and your muscles to make and release glucose (or sugar) into the bloodstream to meet that need.” Cortisol also raises your blood pressure, so your heart can pump more blood quickly to your muscles, helping you kick into gear for stressful situations, she notes.

Cortisol levels will fluctuate during the day depending on many factors, says Andres Splenser, M.D., endocrinologist with Memorial Hermann. Normal cortisol production starts early in the morning before we wake up as our body’s way of getting the system ready for the day and starts to come down in the late afternoon and evening when we are not stressed, he explains. “The human body likes to run on a circadian rhythm starting with sunrise and ending with sunset, so think of cortisol as a hormone that peaks during the daytime hours and comes down after dark when we are going to sleep and not stressed,” he explains.

When the body is stressed by illness, poor diet, sleep deprivation, or other external factors, cortisol production will increase for short periods of time, Dr. Splenser notes. Cortisol rises and falls throughout the day as well; levels are affected by exercise, stress, infection, obesity, and medications, says Florence Comite, M.D., endocrinologist and founder of The Comite Center for Precision Medicine & Healthy Longevity.

How does cortisol affect weight?

Under normal circumstances and in the normal state, cortisol should not affect your appetite, says Dr. Splenser. “However, when we are stressed by different factors like sleep deprivation or excess worrying, cortisol production can increase and lead to excess hunger,” he notes. Prolonged exposure to high cortisol can predispose someone to weight gain, insulin resistance, higher risk of type 2 diabetes, and high blood pressure, adds Dr. Splenser.

Cortisol can influence weight in several ways, says Dr. Anton. One of the primary mechanisms is its role in metabolism. “When cortisol levels are elevated for prolonged periods, it can lead to increased appetite, particularly for high-calorie foods, and storage of excess fat, particularly in the abdominal region,” Dr. Anton explains. Additionally, cortisol can interfere with the body’s ability to efficiently use insulin, which can contribute to insulin resistance and weight gain, she adds.

In other words, when under high stress, your body wants to maintain as many calories and fat as it can to fight any incoming illnesses or injuries, says Dr. Waring. “High cortisol levels released during stress can increase appetite, and also increase glucose production by your body. When glucose levels are high, your body has to release more insulin, and that results in the extra glucose being stored as fat.” So high cortisol levels increase weight, in particular by adding fat in certain places like the stomach, she explains.

How to know when cortisol levels are high

Firstly, it’s important to know that there’s a difference between stress-related high cortisol levels, and when the body overproduces cortisol consistently, says Dr. Waring. “When cortisol is consistently overproduced, people can experience weight gain in the belly and around the face and neck, acne, muscle weakness, certain skin changes, and headaches.” If your doctor suspects serious cortisol overproduction problems, they will likely perform blood, saliva, and urine tests, Dr. Waring notes.

When cortisol is temporarily high because of stress, people can feel fatigued and have trouble shedding pounds despite diet and exercise, continues Dr. Waring. “In these cases, formal cortisol testing is not recommended, and lifestyle changes can often help reduce overall stress,” she advises.

Per Dr. Anton, here are common signs of high cortisol levels to watch for:

Constant exposure to high levels of cortisol in your body can lead to Cushing’s syndrome, which is characterized by such symptoms as a fatty hump between the shoulders, a rounded face or purple stretch marks on the skin, says Dr. Comite. “Cushing’s syndrome can instigate high blood pressure, bone loss, and diabetes,” she notes.

To effectively measure levels of cortisol, you’ll need to undergo blood, urine, and saliva tests, says Dr. Comite. “Because cortisol rises and falls throughout the day, the saliva test, taken four times during a day to notice patterns, is among the most accurate,” she adds.

Keep in mind that low levels of cortisol are also a cause for concern and may indicate Addison’s disease, a chronic autoimmune condition, says Dr. Comite. “Symptoms of Addison’s disease include low glucose, low blood pressure, weight loss, dehydration, muscle weakness, abdominal pain, among others.”

How to balance cortisol levels

There are a few ways you can balance or lower your cortisol levels on your own, says Dr. Waring. These include “getting enough sleep each night, exercising regularly, practicing mindful breathing and meditation, eating a balanced, nutritious diet, and more.” In particular, eating healthy, colorful fruits and vegetables that are high in antioxidants can reduce inflammation and therefore lower total body stress, so increasing your intake may help you, Dr. Waring advises.

Managing your stress levels through restorative practices such as meditation, yoga, massage, or simply going for a walk can help you sleep better and reduce stress and its negative effect on glucose, says Dr. Comite. It’s also essential to establish boundaries, prioritize self-care, and seek support when needed, adds Dr. Anton.

How to prevent and combat weight gain due to cortisol levels

It’s important to recognize that while cortisol can contribute to weight gain, it’s just one piece of the puzzle, says Dr. Anton. “Weight management is a multifaceted process that involves various factors, including genetics, metabolism, lifestyle habits, and environmental influences.” By addressing stress and cortisol levels in conjunction with adopting a balanced lifestyle, individuals can better manage their weight and improve overall well-being, she notes.

Note that if your high cortisol levels are due to excess cortisol production by the adrenal glands, then medical evaluation and treatment are the only way to combat weight gain, says Dr. Splenser. “However, for most individuals, cortisol levels will increase slightly with stress from work or from lack of sleep, but long-term can contribute to weight gain and difficulty losing weight.” It is important to realize that if you are gaining weight due to this cause, it is likely a reflection of your lifestyle, diet, sleep habits, and overall health is not optimal, he explains.

It is never too late to try to correct these factors and start by focusing on getting at least 7-8 hours of sleep per night, eating a healthy diet (mostly Mediterranean or plant-based), and to add 30 minutes of exercise five days per week, Dr. Splenser advises.

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