Do High Cortisol Levels Prevent Fat Loss From Occurring? [Research Review]
Cortisol is a glucocorticoid (GC) hormone. Glucocorticoids are strong inhibitors of inflammatory processes and are widely used to treat pain and injuries. For example, baseball pitchers and football quarterbacks often get cortisone shots in their shoulders so they can continue playing. Cortisol also helps the body respond to stress by mobilizing nutrients. However, when it comes to body composition, cortisol can cause a redistribution of white adipose tissue to the abdominal region and cause increased appetite with a preference for energy-dense food.
Will Cortisol Cause You To Store Belly Fat…?
Some adults who are chronically exposed to high levels of glucocorticoids, like in Cushing’s Syndrome, or when using high doses of exogenous glucocorticoids, develop abdominal obesity, metabolic syndrome, and cardiovascular diseases. We have to keep in mind that Cushing’s syndrome is a result either from taking cortisol for long periods of time to treat asthma or rheumatoid arthritis, or in more extreme situations it can result from a tumor on your adrenal gland. The best way to deal with those two issues is to either find another drug to treat a chronic issue or have the tumor removed. If you haven’t caught on yet ⸺ high cortisol for long periods is bad. Likewise, cortisol insufficiency (aka Addison’s disease) is also bad.
From a molecular perspective, cortisol binds to the glucocorticoid receptor in the cytoplasm, then moves into the nucleus, where it binds to its DNA response element and modulates transcription from a large battery of genes, leading to changes in the body. Glucocorticoid receptors are present in almost all tissues in the body. Therefore, cortisol is able to affect nearly every organ system. Cortisol can also bind to the mineralocorticoid receptor that regulates water transport by modulating sodium and potassium concentrations. This is one reason why you might retain water when you’re stressed.
In the clinical settings, associations between the use of synthetic cortisol (corticosteroids) are associated with obesity as well as metabolic syndrome. In one study, patients visiting an outpatient clinic for obesity had used corticosteroids in the last 3 months nearly twice as often as non-obese controls. Researchers have also found in a large sample of more than 140,000 adult individuals from the general population that use of both systemic and the local types of glucocorticoids were associated with the presence of metabolic syndrome, as well as higher BMI. However, causality still has to be proven.
Why Cortisol Is Linked To Obesity and Body Fat (Correlation vs. Causation)
In our current society, gaining fat is linked with an increase in factors that enhance cortisol production, such as chronic stress, consumption of comfort food, and a reduced amount of sleep. This causes a dangerous cycle, where increased glucocorticoid action, fat gain, and stress interact and amplify each other. As proof of concept one study gave a seretegogue of cortisol as an infusion to healthy, non-obese participants. It caused only a slight elevation in cortisol, but it significantly increased food intake compared to a placebo injection as measured by both calories and total grams of food consumed. The magnitude of the peak cortisol response to cortisol was a strong predictor of subsequent food intake. These data extend growing evidence of a link between stress response systems and human eating behavior, by suggesting that activity within the HPA axis — our central, neuroendocrine stress response system — is neurobiologically linked to food consumption.
To sum this question up simply:
Cortisol will not prevent fat loss in most people.
There are extreme cases and if you’re in that situation it would be good to see a medical doctor. It’s also important to remember that stress (and cortisol) play a role in normal human physiology, but we still need to keep it under control as much as we can. So although it may not directly cause body fat storage in everyone or may not limit your ability to lose weight or body fat, it’s still very important for general health, longevity, and dietary adherence to manage stress levels properly (which may be linked to long term sustainability of body comp changes, as well).