NEW YORK (Reuters Health) - Being under stress — including worrying about paying bills in today’s economy — may make overweight and obese people gain more weight, although stressed-out normal-weight individuals don’t have this problem, new research in the American Journal of Epidemiology shows.
“Where you start in terms of your weight seems to matter in how stress is associated with weight gain,” Dr. Jason Block of Harvard Medical School in Boston, who conducted the research as a Robert Wood Johnson Foundation Health & Society Scholar at the Harvard School of Public Health, told Reuters Health.
While psychosocial stress may increase people’s risk of many health problems, from high blood pressure to cancer, less is known about how it might influence weight gain over time, Block and his team note in their report.
To investigate, they looked at data on 1,355 men and women 25 to 74 years old in 1995 who were followed for nine years as part of the Midlife in the United States study. All had completed a telephone survey to assess their levels of psychosocial stress and identify psychiatric problems at the study’s outset.
The higher a person’ body mass index (BMI) — a measure of the ratio between height and weight — at the beginning of the study, Block and his colleagues found, the more weight they gained in response to stress.
And the effects varied by gender. While having trouble paying the bills and experiencing heavy job-related demands were linked to weight gain for men and women, lack of control over one’s life and strained family relationships influenced weight gain in women, but not men. For men, having less autonomy on the job and less opportunity to use skills and learn new things also boosted the likelihood of gaining weight.
Both men and women with generalized anxiety or depression who were heavy at the beginning of the study put on more weight over time than heavy people who weren’t anxious or depressed.
While his study didn’t look at how stress might cause weight gain, Block noted, there are a couple of ways that make sense. Social subordination and stress up levels of the so-called stress hormone cortisol in people and animals, while high levels of the hormone also are associated with abdominal obesity. And eating causes the brain to release feel-good chemicals called endogenous opiates, he added, so certain people may rely on eating as a way to soothe themselves and release stress. “It appears to be a kind of comfort-eating thing as well as a cortisol thing.”
People should be aware that times of stress may be risky times for weight gain, the researcher said, especially if they are already heavy, and prepare themselves accordingly. “If you can prevent that weight gain it’s a lot easier than having to deal with it after you’ve already gained the weight,” Block noted.
One main weapon against stress-induced weight gain, he added, is taking steps to cope with stress. “It’s something that I talk to patients about all the time.”
He said he advises patients to do two things: make sure they have some time to themselves each day to meditate, exercise or even just have a break from family and work demands; and be sure to get enough sleep.
“Sleep deprivation by itself has been linked to weight gain, and sleep deprivation is also related to higher levels of stress and higher levels of depression and anxiety,” Block said. “Getting enough sleep can really help from multiple standpoints.”
Finally, he added, people with anxiety or depression should get help, and take medication if they need it. While some antidepressant and anti-anxiety medications can cause weight gain, Block pointed out, others don’t have this side effect. “If weight is an issue for someone it’s something they can discuss with their doctor to choose a medication that’s less linked to weight gain than some of the others.”
SOURCE: American Journal of Epidemiology, July 15, 2009.