Stress May Cause Fat Around the Midsection in Lean Women

Sept. 22, 2000 (New York) -- They may look thin, but even some slender women have problems with fat. A new study finds that lean women who are stressed-out may be more likely to have "spare tires" around their midsections -- which increases their risk of certain diseases, including heart disease and diabetes.

"Our findings support the idea that greater life stress and stress reactivity can contribute to central fat, especially among lean women," says study author Elissa Epel, PhD. "For lean women, central fat may indicate an underlying sensitivity to stress rather than being in part a result of obesity." Epel, who was a research scientist at Yale University in New Haven, Conn., when the study was conducted, is now with the Health Psychology Program at the University of California, San Francisco.

The study, which appears in the journal Psychosomatic Medicine, looked at 59 women. Half had a high waist-to-hip ratio, indicating an apple-shaped body with fat accumulating around the waist; the other half had a low waist-to-hip ratio, with more fat around the hips.

Overall, the women with high waist-to-hip ratios were more vulnerable to the effects of stress, as measured by standard tests over a four-day period. But overweight women with high waist-to-hip ratios seemed to adapt to the tests by the second and third days, while lean women with high waist-to-hip ratios continued to secrete higher levels of the stress hormone cortisol in response to the tests.

The findings confirm some earlier work by Pamela M. Peeke, MD, MPH, a former senior scientist at the National Institutes of Health in Bethesda, Md., and an associate clinical professor of medicine at the University of Maryland School of Medicine in Baltimore.

Calling fat in the central part of the body "toxic weight," Peeke tells WebMD that "it is the only fat on the human body that is associated with death and dying from heart disease, hypertension [high blood pressure], diabetes, stroke, and some forms of cancer."

Central fat tends to be highly sensitive to the effects of circulating stress hormones like cortisol, and prolonged exposure to cortisol causes an accumulation of "toxic weight," says Peeke, the author of Fight Fat After 40.

According to Peeke, the three factors that affect central fat are poor lifestyle, declining levels of the hormone estrogen, and chronic stress. She describes chronic stress as "not just the irritation of sitting in a traffic jam, but the type of stress that is associated with hopelessness, helplessness, and a feeling of defeat -- such as a micromanaging boss that makes your life miserable, or an ailing mother."

When you have chronically elevated levels of the stress hormone cortisol, you crave carbohydrates and fats, and these extra calories make a beeline to the inner abdomen, she explains.

As levels of the female hormone estrogen change as women age, fat goes to the abdominal area instead of the hips and thighs, where it was formerly needed to support reproductive functions, Peeke says.

To reduce abdominal fat and stress, Peeke recommends a three-pronged approach, encompassing mind, mouth, and muscle.

"Get a grip and cope with stress on a day-by-day basis and don't forget your own self-care," she says. And "get yourself moving: Physical activity increases endorphins [brain chemicals that control mood], which are the most powerful human neutralizers of the stress response."

Accruing 45 to 60 minutes of exercise daily can help neutralize stress hormones, she says.

As for diet, Peeke suggests eating foods that are high in fiber and other important nutrients and not those that are high in fat or sugar or are otherwise nutritionally lacking.