What Is ‘Cortisol Belly’? How Stress Leads to Abdominal Fat — and How to Reduce It
Whether you’ve heard it called “cortisol belly,” “hormone belly,” or “stress belly,” these catchy terms for an overabundance of abdominal fat are being touted all over social media. Truthfully, “cortisol belly” (among other variations) is a trendy, nonmedical phrase that’s partially accurate but may be misleading.
Excess fat in your midsection can be dangerous for your health. A waist circumference greater than 35 inches for women and 40 inches for men is associated with a higher risk of heart disease and diabetes. So it’s worth addressing the reasons why you may have this fat — stress being one of them.
Influencers on TikTok and Instagram are stoking concerns about “cortisol belly” while offering advice on what to do (and what not to do) to reduce belly fat, including supplements, diets, exercise advice, special massages, and more. These posts often straddle the line between health misinformation and body-shaming, which is why we’ve talked to experts about what cortisol belly really is, what contributes to visceral fat, and the lifestyle shifts that really matter.
First, it’s important to clear this up: “‘Cortisol belly’ is not a medical term used by physicians,” says Scott Isaacs, MD, of the Diabetes & Endocrinology Clinic of Georgia in Atlanta, and the president of the American Association of Clinical Endocrinology. “This term, which is popular with social media, refers to abdominal fat that’s supposedly caused by stress and chronically elevated cortisol levels,” he says.
Cortisol is a hormone that serves many functions in the body, including regulating your response to stress.Overall though, while stress does play a role in the accumulation of abdominal fat, ‘cortisol belly’ is an oversimplified term, as there are many factors that can contribute to fat gains in the midsection, Dr. Isaacs explains. “High stress may slightly contribute to visceral fat,” he adds.
A more accurate term for ‘cortisol belly’ is visceral fat, he says. This is a type of fat that hugs your organs and can increase your risk for disease.
Visceral fat differs from subcutaneous fat, which is fat that is underneath your skin. (Think of this as “pinchable fat.”) Although subcutaneous fat helps control your body temperature and cushions your insides, too much of it can be a marker for high visceral fat and is linked to diseases like cancer, fatty liver, heart disease, sleep apnea, and more.
When it comes to visceral fat, the following symptoms and physical traits are often associated with what people call cortisol belly or conditions associated with it.
Apple-shaped body
Difficult-to-control diabetes or blood pressure
Wide, dark red or purple stretch marks (more than 1 centimeter)
Muscle weakness, especially difficulty standing up from a chair
Fatigue
Increased thirst or hunger
Frequent urination
Blurred vision
Darkened skin on the armpit, neck, knuckles, armpits
So many things in life cause stress. Some stress is positive, but chronic stress is not. There are direct and indirect impacts of stress when it comes to belly fat.
Stress triggers cortisol to activate your body’s fight-or-flight nervous system response. And while cortisol is essential for normal body functioning, chronic stress is a problem. It increases your appetite, contributes to insulin resistance, and promotes muscle breakdown. (Note: muscle mass is essential for a well-functioning metabolism.)
Cortisol has a specific impact on your abdominal area, because it causes your body to store fat around your midsection.
But it’s also about the way stress affects your daily habits. Psychological stress can affect the regulatory processes in your brain, changing the way you eat (a colloquial term for this is ‘stress eating’), as well as contribute to sleep problems and more sedentary behaviors, which can have downstream effects on weight and fat gain.
Typically, it’s not just one thing that causes an accumulation of belly fat. Other factors, such as your diet, sleep habits, activity, and hormonal changes can contribute — and often multiple factors can be at play. Here’s what to consider.
Unbalanced Diet
“Food is a great stress reliever. And it works, but there are side effects to that,” says Isaacs. Namely, choosing higher-calorie items that are linked to fat gain. Food cravings change in response to stress, causing people to go for foods that are high in fat, sugar, and salt, he points out.
Inadequate Sleep
Not sleeping enough has multiple ramifications, including for your waistline. Research suggests that sleep restriction may contribute to visceral fat because of the impact to areas of the brain involved in food choices and appetite regulation, with weight-related benefits topping out at eight hours of sleep per night.
Irregular or No Exercise
Researchers found that a sedentary lifestyle was associated with visceral fat, whereas standing and walking was linked to less belly fat. Equally important as formal exercise, your activity throughout the day and how much time you spend sitting or lying down also factors into body-mass index (BMI) and belly fat.
Hormonal Shifts
Males are more likely to accumulate visceral fat than premenopausal females. Males have more areas to store this visceral fat (females tend to store more fat in their thighs and hips for a “pear shape”). Lifestyle, such as diet or lack of exercise, is the main contributor to excess visceral fat.
Hormonal shifts change this. For females going through menopause, the natural decline in estrogen causes your body to store belly fat, which is one reason why heart disease risk increases after menopause.
Certain Medical Conditions
In addition, there are also medical conditions associated with elevated cortisol, which can affect your body composition. Endocrinologists are looking for evidence of Cushing’s syndrome, a condition that’s the result of chronically elevated cortisol. Symptoms include abdominal obesity, pink or purple stretch marks, weight gain in the face, and a fatty lump between the shoulders.
Genetics
You can inherit genes that affect where your body prefers to store fat — including belly fat. There’s also evidence that those who have genes that predispose them to abdominal obesity are also more likely to regain fat in their midsection after they’ve lost weight.
Although some factors (like hormones or genes) may feel as if they’re working against you, your lifestyle makes a big impact on where you store fat — and can also help buffer you against the effects of stress. Here are five healthy habits to focus on.
Eat Nutrient-Rich Foods
A balanced diet is one that is plant-based and fiber-rich, says Lauren Harris-Pincus, RDN, the founder of Nutrition Starring YOU and the author of The Everything Easy Pre-Diabetes Cookbook, based in Basking Ridge, New Jersey. Focus on eating fruits, vegetables, legumes, nuts, seeds, whole grains, lean proteins, and healthy fat (like olive oil). Limit added sugar and ultra-processed foods. Following this pattern of eating offers several benefits. “This will keep energy levels more stable, keep you more satisfied and less likely to overeat, give you energy to exercise, and promote good sleep,” she explains.
Improve Your Sleep Hygiene
Adequate, restful sleep is the key to managing both stress and weight, says Harris-Pincus. One place to start is with sleep hygiene, or the habits you keep during the day and before bed that promote good sleep, such as avoiding caffeine later in the day, maintaining a regular bed and wake time, exercising regularly, and avoiding screens at least 30 minutes before shut-eye.
Exercise Regularly
Physically activity triggers the release of feel-good neurotransmitters called endorphins that help regulate your mood. It also improves your cardiovascular health to decrease the ill effects of stress on your body and relieves symptoms of depression and anxiety.Research suggests that high intensity interval exercise (HIIT) and aerobic exercise are effective at reducing visceral fat for people who are overweight or obese.
Manage Stress With Mind-Body Practices
Practices that connect your mind to your body, such as yoga, tai chi, qigong, and meditation may reduce anxiety and depression, improve your sleep, reduce stress, and refine your coping skills. These approaches have also been shown to be safe for most people. Plus, other types of stress-busting strategies are quick and can be incorporated into small windows in your day.
Speak to Your Doctor or Registered Dietitian
A registered dietitian can create a personalized plan for you based on your lifestyle, food and cultural preferences, cooking skills, medical history, and ability to afford and access healthy food, says Harris-Pincus. “This is not a one-size-fits-all plan you can find online,” she adds.
In addition, your doctor can evaluate you for underlying medical conditions and prescribe treatments for hormonal changes, such as menopause. Endocrinologists can also advise on medications and supplements that may be needed, though Isaacs points out that there are no supplements proven to be safe and effective for cortisol — and supplements are not regulated by the U.S. Food and Drug Administration (FDA), so it’s best to speak with your provider before starting any supplement for any reason.
“Cortisol belly” is a popular, nonmedical term that refers to the accumulation of excess belly fat. Doctors typically refer to this as visceral fat, a type of fat that sits deep within your belly and surrounds your organs.
Stress triggers the release of cortisol, your body’s fight-or-flight hormone. When chronically elevated, cortisol encourages the storage of fat around your midsection.
Stress also promotes unhealthy habits, such as a diet of high-fat, high-sugar foods and sedentary behavior, and it impairs sleep, all of which can contribute to weight gain and increased belly fat.
Lifestyle strategies that decrease stress and promote healthy weight management (reduced belly fat) include a balanced diet, regular exercise, quality sleep, and mind-body practices.
