Stress, Overeating, and Weight:Understanding the Connection

December 15, 2015

Dawn Noe, RDN, CDE

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Example from Michele May, M.D

“Recipe” for Overeating

“Recipe” for Instinctive

EatingExample from Michele May, M.D.

“Recipe” for Instinctive Eating

Example from Michele May, M.D

Stress and Overeating

Stress, stress related hormones, and the effects of

high-fat, sugary “comfort foods” can push people

toward overeating.

Researchers have linked weight gain to stress, and

according to an American Psychological Association

survey, about one-fourth of Americans rate their stress

level as 8 or more on a 10-point scale.

Focus on Stress – Don’t Ignore it!

- To change our stress and how we respond to it, we must be aware of the stress and our reactions

- Take a minute to consider how (or if) you manage stress…

• Power through

• Stick your head in the sand

• Procrastinate (move on to something less stressful and avoid the actual current problem?)

• Overwork, smoke, OVEREAT, drink alcohol to excess, isolate yourself, or take out frustration on others?

- The above behaviors tend to make the stress worse.

- Do you pause and take a few deep breaths? If not, we’ll practice this today.

What is Your Stress Response?

Does Stress Causes Changes in Your Routine?

• Food Choices: Eat stress foods for comfort

• Schedule: Change your meal schedule (skip meals, mindless snacking, eat on the run?)

• Sleep: Have trouble sleeping.

- Lack of sleep can increase hunger and appetite.

• Physical Activity: Exercise less

SLEEP

Broussard et al. 2015. Elevated Ghrelin Predicts Food Intake During Experimental Sleep Restriction.

SLEEP

7-8 hours a night

Broussard et al. 2015. Elevated Ghrelin Predicts Food Intake During Experimental Sleep Restriction.

• Physical Stress

- Fatigue and sleep deprivation, poor nutrition, lack of physical activity, illness, pain, and others.

• Emotional Stress and Depression

- Boredom, loneliness, anger, frustration, happiness, depression, etc.

- Emotions provide information and it is important to practice noticing what you’re feeling without judging it.

• Stressful Thinking

- How you think about stress and how you react to it can actually increase the stress.

- Stress can be a result from your perception and interpretation of life’s events.

Explore Your Stresses

Stressful Thinking

Example:

Speaking in public is a great example of how each of us

thinks and responds to stress differently. For one person,

public speaking could cause a pounding heart, dry throat,

and an increase in stress. To another person, it is an

exciting opportunity to share information with others.

Stress Response:

Stressed people also lose sleep, exercise less, and

drink more alcohol, all of which can contribute to

excess weight.

Stressful Thinking

• Thoughts that can increase stress include:

- “I feel like everything is out of control!”

- “I have to get this perfect.”

- “I can do it all, have it all, and be it all!”

• A more realistic thought response to stress:

“I’m feeling overwhelmed and tense. I can’t do everything on my to do list, but no one

could. I’m doing my best.”

Reacting to stress in a realistic manner is like imagining yourself at the center of the

tornado. You are centered while everything whirls around you.

Accept the Stress So You CAN Manage It!

• The demands in life for our time and energy can lead to:

- Unrealistic expectations

- A sense of urgency

- More stress

- Stressful thinking

• When you accept the stresses you can’t control you can choose how you react to the stresses you CAN control

• Everyone has stresses, strengths and limitations

- At times, we’ll need to use self-compassion about what we do well.

- We may need to ask for help and that’s okay.

- Saying no to someone else is saying yes to yourself.

- As with all behavior changes, setting boundaries and expectations (with ourselves and with others) takes practice and gets easier over time.

Stress in the Short Term:

• Hypothalamus

- Produces a hormone called

corticotropin-releasing hormone,

which suppresses appetite

• Brain

- Signals the adrenal glands to

increase the hormone epinephrine

also called “adrenaline”

- When you are in this “fight-or-flight”

stage - eating is put on hold until

the stress goes away

If stress persists: adrenal gland releases a hormone called cortisol which actually

increases the appetite

Once stressful episode is over cortisol will drop unless stress persists it can leave the

cortisol levels stuck on “on” and stay elevated

Stress in the Long Term:

http://fitness.makeupandbeauty.com/stress-hormone-cortisol-and-weight-gain/

o Physical or emotional distress has

been shown in animal studies to

increases the intake of food high in

fat, sugar, or both

o High fat and sugar-filled foods

may reduce the stress affect in parts

of the brain that produce and

process stress and related emotions

o Treating the stress with food may

“turns off” the stress response.

o THIS MAY INCREASE OUR STRESS -

INDUCED FOOD CRAVINGS!

o High cortisol levels, in combination

with high insulin levels, may be

responsible vs ghrelin, a “hunger

hormone,” may have a role

Research Findings

• Harvard researchers have found that:

- Stress is associated with weight gain, but only in people who were overweight at the beginning of the study period

- One theory is that overweight people have elevated insulin levels, and stress-related weight gain is more likely to occur in the presence of high insulin levels

• In 2007, British researchers found that:

- People with high cortisol levels were more likely to snack in response to daily hassles compared to low-cortisol responders

- How much cortisol people produce in response to stress may be a factor

• Some research suggests a gender difference in stress-coping behaviors

- Women more likely to turn to food

- Men more likely to turn to alcohol or smoking

Food Behaviors and Stress• Do you know which foods you tend to eat due to stress?

• Do you know how much you eat? (Is it a portioned amount or until the bag or container is empty)

• Tips for changing stress-related eating behaviors:

- Try replacing comfort foods (think: potato chips or ice cream) with these nutritious snacks:

• Nuts

• small amount of fruit

• Crunchy veggies and dip

• Soup broth

• If you crave carbs, try complex carbs like air-popped popcorn or whole grain English muffin

- Portion out the food instead of eating from containers – OR purchase pre-portioned foods (ex. 100 calorie snack packs of nuts)

- Keep tempting comfort foods out of the house

- Even better, try using non-food related stress reducing activities instead

Stress Management and Weight Loss

• National Weight Control Registry

- Tracks over 5000 participants

• Lost 30 pounds and kept it off for at least 1 year

• Most exercised by WALKING for 1 hour per day =

8,000-18,000 steps depending on the intensity (light

walk to running)

• Most of these people use a stress management

technique

Non-Food Ways to Manage Stress

• Meditation

- Reduces Stress

- May help people become more mindful of food choices.

- There’s an app for that!

• Cleveland Clinic Stress Meditations (iPhone)

• Relax Melodies, Headspace, Take a Break! (both Android and iPhone)

• Exercise

- Low-intensity exercise seems to reduce cortisol levels

- Some physical activities, such as yoga and tai chi, have elements of both exercise and meditation.

- Increases your brain's feel-good neurotransmitters, called endorphins.

- Can improve your mood and increase self-confidence

- Improve your sleep, which is often disrupted by stress.

iPhone iPhone and Android devices

Meditation Apps

Non-Food Ways to Manage Stress

• Social Support- Friends and family seem to have a buffering effect on the stress

that people experience.

• Forgive Others- Holding grudges leads to psychological stress and higher heart rates

• Therapy or Counseling - Helpful for reshaping our thoughts about daily stresses

- Managing depression/emotions

- Experts in behavior change

Thoughts

Create

Feelings

Behaviors

Reinforce

Thoughts

Feelings

Create

Behaviors

Stress Busters

Great Ways to Manage Stress

Positive Self Talk • I will do the best I can.

• I don’t have 45 minutes for the gym, but I can go for 20 minutes. I’ll burn more calories than if I didn’t go at all and I’ll feel better too.

• I haven’t lost as much weight as I had wanted, but I have lost some and have been able to decrease how much medication I need.

Emergency Stress Stoppers

• Take 5 Deep Breaths

• Walk

• Say "I'm sorry" if you make a mistake.

• Break down big problems into smaller parts. Make one phone call or email, etc.

Holiday Stress Busters

• Play it Steady – stick to your current exercise,

medication, and food schedule

• Designate elves – you can’t do it all!

• Go solo – consider staying in a hotel while

visiting family if you think you’ll need a break

• Treat yourself – to a massage, a nap, or music,

time with friends

• Keep the peace – meditation and relaxation

• Journal to help you stay on track – Exercise

and keep track of your food

Diabetic Living Winter 2015

Great Ways to Manage Stress

Stress Busters

Take 15 Minutes Every Day for Something You Enjoy

• Read a book or magazine

• Start an art project (paint/draw, create a scrap book, sew, knit, or

crochet)

• Spend time with friends or children

• Journal

• Do something for someone else – it’ll make you feel good!

• Listen to music

• Take a nature walk — listen to the birds, identify trees and

flowers.

• Make a list of everything you still want to do in life.

Great Ways to Manage Stress

Stress Busters

Learn How To Relax and Practice Often

Let’s Do Some Deep Breathing Today!

1. Sit in a comfortable position with your feet on the floor and your hands in

your lap or lie down. Close your eyes.

2. Picture yourself in a peaceful place. Perhaps you're lying on the beach,

walking in the mountains or floating in the clouds. Hold this scene in your

mind.

3. Inhale and exhale. Focus on breathing slowly and deeply.

4. Repeat for 5-10 minutes.

Great Ways to Manage Stress

Questions?

Sources

• Adams CE, et al. “Lifestyle Factors and Ghrelin: Critical Review and Implications for Weight Loss Maintenance,” Obesity Review (May 2011): Vol. 12, No. 5, electronic publication.

• Manzoni GM, et al. “Can Relaxation Training Reduce Emotional Eating in Women with Obesity?” Journal of the American Dietetic Association (Aug. 2009): Vol. 109, No. 8, pp. 1427–32.

• Mathes WF, et al. “The Biology of Binge Eating,” Appetite (June 2009): Vol. 52, No. 3, pp. 545–53.

• Spencer SJ, et al. “The Glucocorticoid Contribution to Obesity,” Stress (Feb. 6, 2011): Vol. 14, No. 3, pp. 233–46.

• Vicennati V, et al. “Stress-Related Development of Obesity and Cortisol in Women,” Obesity (Sept. 2009): Vol. 17, No. 9, pp. 1678–83.

• http://amihungry.com/stress-management-101/

• http://www.health.harvard.edu/newsletter_article/why-stress-causes-people-to-overeat