Stress and Fat: A Complicated Relationship

I have stress

Today we are watching a video from a class given by Dr. Elissa Epel at the University of California San Francisco, where she is a faculty member in the Department of Psychiatry. She and her colleagues have been studying the ways in which stress can lead to early onset of age-related disease processes. This episode is part of a series called “UCSF Mini Medical School for the Public,” so even if you’re not a health professional, feel free to jump right in. The presentation is nearly an hour long — you can skip the introduction — but it’s worth taking the time. Dr. Epel is easy to listen to. One of her sayings is,

It’s not just what you eat but what is eating you.

You will end up knowing a great deal about how a person’s food choices are affected by stress. For starters, the stress response is regulated by the same hormones that regulate where our bodies choose to store fat, of which visceral adiposity is the worst kind. Here is the interesting conclusion that Dr. Epel has reached: Someone who is only stressed, or only fat, might coast, or at least avoid the most serious health consequences. But high stress exposure in combination with overweight is a recipe for accumulating dangerous abdominal fat and metabolism gone haywire, and, ultimately, premature aging. We learn the roles of cortisol, insulin, and opioid receptor antagonists; the disadvantage of being a high reactor; how lab rats binge, and what telomere length has to do with cellular aging.

Dr. Epel does a lot of work with family caregivers, a class of people who live in chronically stressful situations and who are very prone to stress eating. Some people seem to handle it well, or at least without succumbing to self-destructive habits. Dr. Epel is interested in where the difference lies, and in what factors, whether genetic, psychological, or physiological, come into play to make that difference.

It’s easy enough to understand why someone charged with the constant care of an ailing relative would experience plenty of stress. But what’s up with the kids? Isn’t youth supposed to be the carefree stage of life, when responsibilities are few and a good time is had by all? We wish! Unfortunately, the world seems to weigh as heavily on the young and supposedly free as on anyone else.

One of Dr. Pretlow’s polls asked the question, “Has stress in your life increased over the past 3 years?” Four out of five kids who responded said yes. But why? Among the reasons they gave were: school, family, money, relocation, peer relationships, and competition. Which all goes to explain why stress eating is so prevalent among children and teenagers, and is one of the major causes of juvenile obesity.

In Overweight: What Kids Say, Dr. Pretlow makes a good argument for classifying stress eating as an actual addiction. It’s a behavior that continues despite the fact that the person knows it causes problems in every area of life, and a behavior over which the person does not exercise control, which is one way of defining addiction. But whether you want to go that far or not, it certainly is a serious and difficult problem. Fortunately, the book also includes remedies.

Your responses and feedback are welcome!

Source: “Coping With Stress – Stress Eating and Premature Aging,”, 05/05/10
Source: “Elissa S. Epel, PhD,”
Source: “Overweight: What Kids Say,”
Image by Migraine Chick, used under its Creative Commons license.

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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