Cortisol belly is an increase in body weight in the abdominal area, which is sometimes called abdominal obesity, caused by an excess of the stress hormone cortisol. It can happen to anyone with chronic stress.
Other factors can also contribute to the accumulation of belly fat. Abdominal obesity is common: about 53% of adults in the United States suffer from this condition, and it is more common in people with a uterus.
Cortisol therapy often requires individuals to identify stressors and reduce them. Avoiding smoking, getting enough sleep, and seeking mental health care can help.
Cortisol in the stomach is often called “stress belly” because of the weight in the stomach area during times of increased stress. You may first notice a change in your appearance and not the other symptoms associated with it.
However, belly cortisol can cause a number of symptoms that you may not immediately notice and increase belly fat. People with cortisol deficiency may experience the following symptoms:
- Weight gain in the abdomen
- Stretch marks
- Anxiety and depression
- Increased appetite and food intake
- It’s easy to spoil
- Muscle weakness
- High blood pressure
Other symptoms of excess cortisol can include a round face (sometimes called a moon face), excess fat above the collarbone and between the shoulder blades, diabetes and osteoporosis (brittle bones).
Excess belly fat can increase the risk of heart disease, diabetes and other health conditions. Belly weight gain is complicated, so if you have concerns about a change in your appearance, talk to your health care provider about possible diseases, including cortisol belly.
When you are under stress, your body adapts to a perceived threat in a response known as the fight or flight response. Your heart rate and blood pressure increase, your body releases more glucose to fuel your muscles, and you become more aware of your surroundings.
When this happens, your body also releases a stress hormone called cortisol from your adrenal glands, located above your kidneys. These responses often help your body overcome stress immediately.
However, when you face a period of long-term stress (eg, divorce, chronic illness, school), the constant release of cortisol can have negative effects on your body. For example, it can:
- It suppresses another hormone called leptin, the hormone that makes you feel full after eating
- Increase the food you eat and raise your blood sugar
- It affects your fluid balance and increases blood pressure
- It affects your mental health and makes you feel anxious, irritable or depressed
- Make it difficult for your immune system to function properly
Cortisol belly is another sign of having too much cortisol in your body, possibly due to prolonged stress.
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Anyone can have a cortisol crisis, but it is more common in adults who have a uterus. Risk factors for having excess cortisol in the body that can lead to cortisol in the stomach include:
- A history of long-term depression
- Childhood exposure to trauma
- Constant pain
- Foods high in sugar
- Frequent alcohol consumption
- Insomnia (not sleeping enough or sleeping well)
- Mental health conditions
- Use of steroid drugs
- Smoking tobacco
There are tests available to help detect excess cortisol in your body. If you have unexplained weight gain, your health care provider will ask about your medical history as well as your diet, lifestyle and general health.
They will then ask you to describe how much weight you have and when you first noticed it. Your provider will also ask you about any stress you have and whether your stress is recent or if you have had stress for a long time.
To understand if your abdominal pain is caused by cortisol, your health care provider will need to check the cortisol levels in your body. Cortisol is not released at a constant rate—your body produces more cortisol in the morning and less in the evening. Cortisol tests are designed to take that into account.
Cortisol tests come in several forms, including:
- Hair analysis: This test checks the long-term levels of cortisol in your hair.
- Urine test: This test measures the amount of cortisol in your urine throughout the day and night. You may need to urinate one or more times a day for 24 hours or remove small cards each time you go to the toilet.
- Saliva test: This test measures cortisol in your saliva. You may need to give one or more samples over a 24-hour period. In some cases, your provider will ask you to take a saliva sample around 11:00 pm at night. three different ones to measure your level.
- Blood test: Your provider will take a blood sample in the morning and afternoon to measure blood cortisol levels at these times. This helps them determine if your body is making cortisol when needed.
- Dexamethasone stress test: This test tries to temporarily stop your adrenal gland from producing cortisol by using the synthetic steroid dexamethasone to determine if your body is producing too much cortisol. Your provider will instruct you to take a low or high dose of the medicine at 11:00 pm, and they will measure your cortisol levels at 8:00 am the next day.
Often, excess cortisol is a symptom of Cushing’s syndrome. This disease occurs when small tumors in your pituitary gland, the area in your brain that helps make cortisol, increase the amount of cortisol your body produces. Your health care provider may also check your adrenal glands to see if they are working properly. If your provider suspects Cushing’s syndrome or a problem with the adrenal glands, they may order additional tests.
Cortisol levels are often a symptom of a long-term stress response. To treat cortisol stress, your health care provider will first recommend lifestyle changes to help reduce stress. Some lifestyle changes can help reduce stress and excess cortisol and support your overall health, including the following:
- Get more than six hours of sleep each night
- Increase your physical activity, such as walking or practicing yoga
- Support mental health
- Practice mindfulness and meditation
- Limit your alcohol consumption
- Avoid smoking
Your health care provider may recommend medication in some cases for high cortisol. For example, high cortisol medications are often used to treat Cushing’s syndrome, which is a rare cause of too much cortisol in the body. These medications work by reducing the amount of cortisol produced by the adrenal glands.
Treatment of Cushing’s syndrome may also include stopping or avoiding the use of steroid medications. Your provider may also recommend taking certain vitamins or minerals, such as magnesium, to help lower cortisol levels.
Many things, including excess cortisol, can affect weight gain. The best way to prevent cortisol is to prevent your body from making and releasing too much cortisol.
If your high cortisol is caused by a health condition such as Cushing’s syndrome, treating that condition can help reduce cortisol levels and improve or prevent cortisol secretion.
However, in most cases, stress management is the best way to help control cortisol levels. Strategies include the following:
- Do activities and hobbies that you like
- Get enough sleep
- Increase your physical activity
- Support mental health
- Talk to loved ones
- Eat a balanced diet
Increased levels of cortisol associated with abdominal cortisol can have several long-term problems. Excess weight in the abdomen is associated with an increased risk of cardiovascular disease (a group of risk factors, such as obesity and high blood pressure, which can increase the risk of heart disease, stroke and diabetes).
An increase in cortisol in your body can also put you at greater risk of developing the following conditions:
- Osteoporosis, a condition that causes weak and broken bones
- Chronic fatigue syndrome
- Rheumatoid arthritis
- Mental health conditions such as depression or anxiety
Life with cortisol will vary greatly from person to person. Weight gain caused by excess cortisol can look different for everyone. For some people, it can affect their physical appearance. In addition to appearance, excess cortisol can alter other aspects of your health that can affect your quality of life.
For example, prolonged stress can make it difficult for you to deal with stressful situations and can have a negative impact on your mental health. You can often control your cortisol levels by implementing lifestyle changes. Talking to your health care provider is the first step to improving your cortisol symptoms.
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