Cortisol belly refers to the accumulation of belly fat caused by chronic exposure to high levels of cortisol. Cortisol, also known as the stress hormone, plays an important role in helping your body respond to stress, reduce inflammation, and regulate blood pressure, blood sugar, and metabolism.
Stress, steroid use, and tumors can all cause cortisol levels to increase. For some people, high levels of cortisol can lead to overeating and weight gain—particularly in the abdominal area. Treatment and management of high cortisol levels focuses on addressing the underlying cause.
This article discusses how high levels of cortisol can influence weight gain and lead to belly fat. It also covers the causes of high cortisol levels, as well as how you can treat and manage this condition.
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Cortisol is a hormone produced in the adrenal glands (located on top of each kidney). Among its many functions, cortisol helps regulate your metabolism and your body's response to stress.
Signs of High Cortisol
Signs of high cortisol levels may include:
- Weight gain (particularly in your face and belly)
- A fatty hump between the shoulder blades
- Wide, purple stretch marks (mostly on the belly, breast, hips, and under the arms)
- Easy bruising
- High blood pressure
- High blood sugar
- Severe fatigue
- Muscle weakness
Excess cortisol stimulates glucose production. This excess glucose is then typically converted into fat, which gets stored in your body. For example, people with serious metabolic conditions that involve excessive cortisol production, such as Cushing's syndrome, have an unhealthy increase in abdominal fat.
A chronically high level of circulating cortisol increases fat storage and raises the risk of obesity. And when you have too much adrenaline, fat cells eventually become less responsive to adrenal stimulation to release fat.
Of particular concern is abdominal weight gain—one of the most dangerous types of obesity, and one that contributes to an increased risk of metabolic syndrome, diabetes, and heart disease.
Some studies have found that stress-induced cortisol levels can cause people to increase the amount of food they eat.
The Health Effects of Abdominal Obesity
Causes of Cortisol Belly
When your cortisol production is repeatedly elevated for a prolonged period of time, this can cause many health effects. Weight gain, particularly in the belly area, can be one of the effects of chronically high cortisol.
Abdominal weight gain includes subcutaneous fat (located just below the skin) and visceral fat (found deep within the abdominal cavity). Having excessive visceral fat can increase the risk of certain health conditions.
High levels of cortisol can be caused by:
- Stress
- Pregnancy
- Intense exercise
- Serious illness
- Hot and cold temperatures
- Underactive thyroid
- Obesity
- Certain medications
Other medical conditions than can cause the body to make too much much cortisol include:
- Pituitary tumors
- Ectopic ACTH syndrome
- Adrenal tumors
Prescription Drugs and Cortisol Levels
The use of long-term, high-dose steroids can cause high levels of cortisol. These include drugs like prednisone, cortisone, methylprednisone, and dexamethasone.
Related Conditions
In addition to just gaining weight, excess cortisol causes other health issues.
Insulin Resistance and Cortisol
Insulin resistance is another potential problem that can develop due to chronically high cortisol levels. Sustained increases in cortisol, such as from taking steroid medications, can result in insulin resistance. Other causes of insulin resistance include genetics, obesity, and lack of physical activity.
In insulin resistance, the brain and some of the body’s cells have decreased responses to insulin, so too much glucose continues to circulate in the bloodstream.
This can lead to type 2 diabetes. Insulin resistance is sometimes called pre-diabetes.
Metabolic syndrome is diagnosed once insulin resistance results in abdominal obesity, low HDL cholesterol levels, high blood pressure, and high fasting glucose levels.
Reducing Cortisol and Belly Fat
There are many ways to reduce cortisol in the body. Treatment strategies primarily focus on addressing the underling cause.
Medication
Reducing cortisol with medication is done slowly and with great care. This process is known as tapering.
For example, if you are prescribed a corticosteroid drug such as prednisone (which raises cortisol), you will be instructed to slowly reduce the amount over a number of days rather than simply stopping the drug.
How to Slowly and Safely Taper Off Prednisone
This is because the feedback loop of the hypothalamic-pituitary-adrenal axis reacts to high cortisol levels by shutting down your body's own production of cortisol, which will take time to ramp up again to provide enough for your necessary metabolism.
An abrupt decrease can result in symptoms such as fatigue, fever, muscle and joint pain, and psychiatric symptoms.
You need cortisol to perform essential metabolic functions, and abruptly blocking cortisol in an attempt at weight management would have unpleasant or dangerous side effects.
Treatment for Underlying Health Conditions
Cushing syndrome is caused by a hormone-producing tumor. Common treatments for these types of tumors include surgical removal and/or radiation therapy.
A cortisol-reducing drug may be given before the tumor is removed. However, these drugs need to be carefully monitored because sudden fluctuations in cortisol can produce significant side effects.
This is because the drugs used to reduce cortisol in Cushing syndrome can cause hyperglycemia, diabetes, and dangerously low potassium levels.
Stress Management
If your cortisol levels are elevated due to chronic stress, it's important to find ways to manage your stress. The Centers for Disease Control and Prevention (CDC) and other health authorities recommend behavioral changes that will reduce your stress level and help reverse insulin resistance.
These include:
- Focusing on becoming stress-resistant: One of the best things to reduce stress and improve insulin sensitivity, for example, is getting regular exercise, even a daily brisk walk.
- Practicing stress-reduction techniques: This includes yoga, tai chi, meditation, breathing exercises, anger management therapy, therapeutic massage, listening to calming music, and more. These sorts of approaches can help reduce your body’s physiological response to daily stressors.
- Getting enough sleep: Chronic sleep deprivation increases stress, reduces immunity, and makes it more likely that you’ll be overweight.
Can Your Diet Affect Cortisol Belly?
Eating a balanced diet and maintaining a healthy weight can help you lose belly fat. Avoiding sugary foods, such as fructose-sweetened drinks, can also provide some benefit. Research suggests that certain foods, like simple sugars (carbohydrates), may actually encourage the accumulation of belly fat.
Supplements and Cortisol Belly
Supplements that claimed to reduce the effects of cortisol in order to promote weight loss were heavily advertised in the early 2000s. One such, CortiSlim, was subject to a Federal Trade Commission (FTC) action over such claims. As a result, the manufacturer changed its advertising and eventually went out of business.
The FDA also notified the manufacturer that their claims that the product controlled cortisol in a healthy range and promoted weight loss were unsubstantiated. According to the FDA, it didn't work. In fact, if it had worked as claimed, it would need to be regulated as a drug.
Other supplements, such as phosphatidylserine, were reported to assist in weight loss by reducingstress, anxiety, and cortisol levels.
It's important to know that weight loss products citing a cortisol-blocking effect are classified as dietary supplements. This means they are not required to undergo testing or research to back up these claims or to determine their safety. If you're thinking about taking any supplements, be sure to speak with your healthcare provider first.
Marketers of supplements that claimed to block cortisol to produce rapid weight loss ran afoul of the U.S. Food and Drug Administration. Targeting cortisol is simplistic, and if products had a significant impact on cortisol levels, they would likely have serious side effects.
When to See a Healthcare Provider
If you experience symptoms of high cortisol levels, it's important to reach out to your healthcare provider. Having high cortisol levels can put you at increased risk for health problems such as:
- Heart attack
- Stroke
- Blood clots in the legs and lungs
- Infections
- Bone loss and fractures
- Depression or other mood changes
That said, untreated conditions like Cushing's syndrome can be fatal.
If you have concerns about your stress levels, reach out to a healthcare professional for help. Stress management may require medical assistance.
Summary
Cortisol belly develops when high levels of cortisol lead to the accumulation of abdominal fat. Cortisol, also known as the stress hormone, helps your body manage many vital functions. Cortisol belly can be caused by chronic stress, certain medications (such as steroids), and a number of health conditions.
Treatment primarily focuses on reducing cortisol levels. Because high cortisol levels can put you at risk for other health problems, it's important to see your healthcare provider right away if you notice any signs or symptoms.
