Work stress, weight gain and weight loss: evidence for bidirectional effects of job strain on body mass index in the Whitehall II study

Abstract

Objective: Previous research has focused on overall associations between work stress and body mass index (BMI) ignoring the possibility that stress may cause some people to eat less and lose weight and others to eat more. Using longitudinal data, we studied whether work stress induced weight loss in lean individuals and weight gain in overweight individuals. Design: Prospective cohort study. Subjects: A total of 7965 British civil servants (5547 men and 2418 women) aged 35-55 at study entry (The Whitehall II study). Measurements: Work stress, indicated by the job strain model and measured as job control, job demands and job strain, was assessed at baseline and BMI at baseline and at 5-year follow-up. Results: In men, the effect of job strain on weight gain and weight loss was dependent on baseline BMI (Pp0.03). In the leanest quintile (BMIo22 kg/m 2 ) at baseline, high job strain and low job control were associated with weight loss by follow-up, whereas among those in the highest BMI quintile (427 kg/m 2 ), these stress indicators were associated with subsequent weight gain. No corresponding interaction was seen among women. Conclusion: Inconsistent findings reported by previous studies of stress and BMI have generally been interpreted to indicate the absence of an association. In light of our results, the possibility of differential effects of work stress should also be taken into account.

Interactive Effects of Job Stress and Body Mass Index on Over‐eating

“…These results might not be surprising because they are consistent with many of the aforementioned previous studies [8][9][10][11][12][13][14][15][16][17] . One explanation for the inconsistency in the relationships between stressful situations and BMI is the interactive effects suggested by Kivimäki et al, who proposed that stressful situations are related to decreased body weight in thin men and increased body weight in obese men, whereas no corresponding interactive effects are observed in women 18) . We demonstrated that stressful situations were associated with over-eating more strongly in men with higher BMIs, whereas no corresponding interactive effects were observed in women, which might partially explain the mechanism underlying the interactive effects suggested by Kivimäki et al This study has several limitations.…”

“…A review and a cross-sectional study showed that the association between a stressful work environment and BMI were inconsistent and differed by sex 16,17) . Recent prospective evidence drawn from the Whitehall II cohort implies that stressful situations are related to decreased body weight in thin men (BMI<22 kg/m 2 ) and increased body weight in obese men (BMI>27 kg/m 2 ), whereas no corresponding interactive effects are observed in women 18) . These interactive effects might explain, in part, the aforementioned inconsistent findings, but the mechanism by which these effects operate remains unknown.…”

Interplay between diet-induced obesity and chronic stress in mice: potential role of FKBP51

“…Nevertheless, the relationship between stress and metabolic regulation is very complex and not easily interpreted. For example, in response to stress, some individuals lose weight, whereas others gain weight (Kivimaki et al 2006, Dallman 2010. The seemingly opposite stress-induced metabolic outcomes in humans are also observed in animal models (Weninger et al 1999, Kim et al 2003, Michel et al 2005, Moles et al 2006, Kuo et al 2008, Bartolomucci et al 2009 and highlight the intricate relationship between stress and metabolic regulation.…”

Effect of physical intimate partner violence on body mass index in low-income adult women

“…In fact, this hypothesis is reinforced by evidence that stress increases the baseline metabolic rate and energy expenditure 41,42,43 , a process that can cause weight loss in individuals with adequate or low calorie intake 17 . It would also be worthwhile to consider the debate raised by Seematter et al 42 and Kivimaki et al 44 , suggesting that the impact of stress on weight can vary according to the individual's lifetime nutritional status. The authors propose that individuals with baseline excess weight/obesity would further increase their body weight when exposed to stressful situations.…”