The Hypothalamic-Pituitary-Adrenal Axis, Obesity, and Chronic Stress Exposure: Foods and HPA Axis

Abstract

The prevalence of overweight and obesity has increased worldwide to epidemic proportions. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and chronic stress exposure are hypothesized to contribute to obesity development. In this review, we discuss the potential role of the HPA axis for energy balance regulation, with particular attention to energy intake. We present evidence from human and animal studies that highlight the bidirectional relationship between HPA axis functioning and energy intake. Of particular interest is the association between dysregulation of the HPA axis and altered homeostatic and non-homeostatic food intake regulation. Lastly, we discuss a model depicting a role for a hyperactive HPA axis in overeating and the development of obesity, suggesting chronic stress as a major risk factor for excessive weight gain and (visceral) obesity.

High/low cortisol reactivity and food intake in people with obesity and healthy weight

“…A further possible explanation in view of the mechanism of stress-induced eating might be the alterations of the hypothalamic-pituitary-adrenocortical (HPA) axis in obesity, as the latter cortisol metabolism with regard to basal level and stress reactivity 19 . A disturbed feedback loop of the HPA axis may lead to resistance of adiposity signals in different body areas 21 . With regard to the selfish brain theory 37 , one possible mechanism might be altered signals from the HPA axis to the brain, resulting in failing regulatory processes of the energy balance and eating behavior.…”

“…Based on the study by Epel et al 6 , we hypothesized that healthy weight HCR would tend to eat more in response to acute stress than the low reactors (hypothesis 1). Given the greater cortisol reactivity of people with obesity 19 and the effect of cortisol on food intake 21 , we hypothesized that obese HCR would show greater stress-induced food intake compared to low reactors (hypothesis 2). With regard to the link between basal cortisol level, cortisol reactivity, and eating behavior 6,22 , we hypothesized that healthy weight HCR would exhibit higher basal cortisol levels than the low reactors (hypothesis 3).…”

Reduced morning cortisol concentration in saliva was associated with obesity: Evidence from community‐dwelling adults in papua new guinea

“…Emerging research suggests that the hypothalamic‐pituitary‐adrenal (HPA) axis plays an important role in metabolism and fat distribution and that the excessive stimulation of the HPA axis in response to an increased amount of stress contributes to the development of obesity (Rutters et al, ). A rise in morning cortisol among healthy adults is regarded as a physiological indicator of the HPA axis' stress responsivity (Pruessner et al, ) and is expected to be positively associated with obesity.…”

The potential crosstalk between the brain and adipose tissue in Obesity

“…It is found that increased plasma cortisol level is directly related to weight (Bose, Olivan, & Laferrere, 2009;Rutters et al, 2012). This relationship is well seen in patients with hyper or hypoadrenalism where one of the symptoms include weight gain and weight loss respectively.…”