Is High Cortisol Making It Difficult to Lose Weight?

Is High Cortisol Making It Difficult to Lose Weight?

You've been watching your diet and exercising, but the number on the scale just won't budge? Here's what might be happening.

You've cut down on sugary foods, controlled your portion sizes, exercised regularly and tried to get enough sleep. Yet, when you step on the scale, the number remains unchanged. Sometimes, your weight even increases.

The truth is, body weight is not determined by diet and exercise alone. Prolonged stress can also influence hormones, appetite and the way the body manages energy.

According to Dr Chan Pei Lin and Dr Ida Ilyani Adam, Consultant Physicians specialising in Endocrinology and Medicine at Sunway Medical Centre Damansara (SMCD), the hormonal system plays an important role in weight management.

One hormone commonly associated with stress is cortisol, which is produced by the adrenal glands.

During short periods of stress, cortisol helps the body prepare energy by ensuring that glucose is available to the brain. However, when stress occurs repeatedly and persists over a prolonged period, its effects can be different.

“Prolonged excess cortisol can contribute to insulin resistance and increased blood glucose levels. Cortisol also promotes protein breakdown and alters fat metabolism,” explained Dr Pei Lin.

When this occurs alongside insulin resistance and excessive calorie intake, fat is more likely to accumulate around the abdomen.

More importantly, abdominal fat is not merely a cosmetic concern. Visceral fat, which accumulates around the internal organs, is associated with insulin resistance, high blood pressure and cholesterol problems.

This is why waist circumference is an important measurement alongside body weight and body mass index (BMI).

However, cortisol should not automatically be blamed. The human body operates through a complex hormonal system. Insulin helps regulate blood sugar and energy storage, while leptin sends signals of fullness to the brain.

Abdominal Obesity

According to Dr Ida, resistance to these hormones can be influenced by excess abdominal fat, insufficient physical activity, an unhealthy diet and inadequate sleep.

Genetics, age, medications and underlying health conditions can also play a role.

“These changes are not simply a matter of willpower or self-control. Weight management is influenced by various biological and environmental factors,” she said.

Weight-related health issues are a significant concern in Malaysia. The National Health and Morbidity Survey (NHMS) 2023 found that 54.4% of adults were overweight or obese, while 54.5% had abdominal obesity.

An underactive thyroid can indeed cause fatigue and some weight gain, but it is not the underlying cause in most cases.

Doctors may also assess for Cushing's syndrome, a condition caused by excessive cortisol levels.

However, weight gain alone is insufficient to confirm the condition. Other signs include increased fat accumulation around the abdomen and face while the arms and legs remain relatively thin, easy bruising, purple stretch marks, muscle weakness, high blood pressure or changes in blood glucose levels.

“What matters is the combination and pattern of symptoms, rather than any single sign,” said Dr Pei Lin.

For most people, managing stress does not mean looking for a quick fix to “lower cortisol”.

Instead, it means returning to realistic fundamentals: getting quality sleep, maintaining a balanced diet, staying physically active and finding healthy ways to manage stress.

Simple activities such as walking, engaging in enjoyable hobbies, spending time outdoors or practising relaxation techniques can be a good starting point.

“Changes that can be practised consistently and sustained over the long term are generally more beneficial than extreme approaches that are only followed for a short period,” advised both specialists.

So, if the number on the scale has not decreased, do not be too quick to blame yourself.

If your weight increases rapidly or continues to rise over several weeks or months, particularly when accompanied by extreme fatigue, muscle weakness, easy bruising or changes in blood pressure or blood glucose levels, seek a medical assessment.

Sometimes, your body is not asking you to try harder. There may be other signals that need to be investigated.

You've been watching your diet and exercising regularly, yet losing weight still seems difficult? Don't immediately blame yourself. Prolonged stress can also affect your hormones, appetite and metabolism.

*Originally published in SinarPlus