Elsevier

Nutrition

Volume 23, Issues 11–12, November–December 2007, Pages 887-894
Nutrition

Review
Relationship between stress, eating behavior, and obesity

https://doi.org/10.1016/j.nut.2007.08.008Get rights and content

Abstract

Stress is thought to influence human eating behavior and has been examined in animal and human studies. Our understanding of the stress-eating relation is confounded by limitations inherent in the study designs; however, we can make some tentative conclusions that support the notion that stress can influence eating patterns in humans. Stress appears to alter overall food intake in two ways, resulting in under- or overeating, which may be influenced by stressor severity. Chronic life stress seems to be associated with a greater preference for energy- and nutrient-dense foods, namely those that are high in sugar and fat. Evidence from longitudinal studies suggests that chronic life stress may be causally linked to weight gain, with a greater effect seen in men. Stress-induced eating may be one factor contributing to the development of obesity. Future studies that measure biological markers of stress will assist our understanding of the physiologic mechanism underlying the stress-eating relation and how stress might be linked to neurotransmitters and hormones that control appetite.

Introduction

A complex array of internal and external factors influences appetite and consequently the amount and types of food consumed by humans. Internal factors include physiologic mechanisms that regulate appetite, with hormones such as neuropeptide-Y stimulating food intake [1] and leptin reducing food intake [2]. Many external factors can also influence food intake and include environmental factors (e.g., economic, food availability) [3], social factors (e.g., influence of others) [4], and the palatability of foods [4]. It is a commonly held belief that stress can alter eating patterns [5]. When an acute stress is experienced, such as a threat to personal safety, there is an instant physiologic response, the “flight or fight” response [6], which results in the suppression of appetite [7]. Exposure to chronic psychological stressors, e.g., job pressures, is one of many mental health disorders that contribute to the global burden of disease [8]. For many, the typical response to these chronic stressful situations is not to avoid food but may be to seek out and consume energy-dense foods [9], [10]. Obesity is a global epidemic and is increasing at an alarming rate, and can be attributed to a myriad of genetic and environmental factors [11]. If stress causes some individuals to consume food in excess of requirements, then this may culminate in weight gain and obesity.

Our aim is to review the evidence from animal and human studies on the effect of acute and chronic stress on eating behavior, and how stress-induced eating may contribute to the development of obesity. First, we describe how stress can alter total food intake. Second, we discuss how stress can promote consumption of nutrient-dense foods, specifically a preference for sweet foods, which has been the recent focus of our research work. Third, we present evidence to support the hypothesis that stress-induced eating may result in future weight gain and ultimately obesity. Fourth, we discuss how the physiologic responses to stress may interact with processes involved in appetite regulation.

Section snippets

Stress response

Stress can be defined as “the generalized, non-specific response of the body to any factor that overwhelms, or threatens to overwhelm, the body’s compensatory abilities to maintain homeostasis” [6]. The following stressors can induce a stress response: physical stressors (trauma, surgery, intense heat or cold); chemical stressors (reduced oxygen supply, acid-base imbalance); physiologic stressors (heavy exercise, hemorrhagic shock, pain); psychological or emotional stressors (anxiety, fear,

Stress can alter food consumption: effect of stressor severity

Greeno and Wing [21] outlined the individual-difference model, which suggests there are two ways in which stress may influence eating, resulting in eating or not eating. These opposing responses may be explained by the severity of stress that is encountered.

Stress, nutrient-dense foods, and weight gain

Obesity is a global epidemic that results from energy imbalance, with energy intake exceeding energy expenditure over a long period [11]. The causes of obesity are diverse and complex and can be attributed to physiologic, environmental, and genetic factors [11]. Specifically, weight gain and the development of obesity have been attributed to lifestyle factors, with the early work of Kaplan and Kaplan [44] suggesting that one of the contributing factors to obesity may be due to stress-induced

Conclusions

Our understanding of the stress-eating relation is confounded by limitations inherent in the study designs. Many studies have measured the effect of acute stress on eating behavior in a laboratory setting, which allows close monitoring of food intake. Laboratory studies are limited to the testing of acute stressors, rather than chronic stressors, the latter possibly having a greater effect on eating behavior. Longitudinal studies can investigate the effect of chronic life stress on eating

References (86)

  • M.J. Hansen et al.

    Feeding responses to a melanocortin agonist and antagonist in obesity induced by a palatable high-fat diet

    Brain Res

    (2005)
  • G. Oliver et al.

    Perceived effects of stress on food choice

    Physiol Behav

    (1999)
  • D.R. Ely et al.

    Effect of restraint stress on feeding behavior of rats

    Physiol Behav

    (1997)
  • N.K. Dess

    Divergent responses to saccharin vs. sucrose availability after stress in rats

    Physiol Behav

    (1992)
  • K. Matthews et al.

    Sucrose consumption as an hedonic measure following chronic unpredictable mild stress

    Physiol Behav

    (1995)
  • G.J. Kant et al.

    Effects of chronic stress and time of day on preference for sucrose

    Physiol Behav

    (1993)
  • S.L. Baker et al.

    Behavioral and physiological effects of chronic mild stress in female rats

    Physiol Behav

    (2006)
  • J. Gronli et al.

    Effects of chronic mild stress on sexual behavior, locomotor activity and consumption of sucrose and saccharine solutions

    Physiol Behav

    (2005)
  • E. Epel et al.

    Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior

    Psychoneuroendocrinology

    (2001)
  • J. Laitinen et al.

    Stress-related eating and drinking behavior and body mass index and predictors of this behavior

    Prev Med

    (2002)
  • J. Slochower et al.

    The effects of life stress and weight on mood and eating

    Appetite

    (1981)
  • H. Reznick et al.

    The effects of anxiety and response cost manipulations on the eating behavior of obese and normal-weight subjects

    Addict Behav

    (1977)
  • A.J. Ruderman

    Obesity, anxiety, and food consumption

    Addict Behav

    (1983)
  • P. Bjorntorp et al.

    Obesity and cortisol

    Nutrition

    (2000)
  • A.J. Stunkard et al.

    The night-eating syndrome; a pattern of food intake among certain obese patients

    Am J Med

    (1955)
  • J.M. Rippe et al.

    Obesity as a chronic disease: modern medical and lifestyle management

    J Am Diet Assoc

    (1998)
  • A. Steptoe et al.

    Stress, social support and health-related behavior: a study of smoking, alcohol consumption and physical exercise

    J Psychosom Res

    (1996)
  • A.S. Levine et al.

    Why do we eat?A neural systems approach

    Annu Rev Nutr

    (1997)
  • J.E. Blundell et al.

    Regulation of appetite: role of leptin in signalling systems for drive and satiety

    Int J Obes

    (2001)
  • J. Wardle et al.

    Impact of stress on diet: process and implications

  • L. Sherwood

    Human physiology from cells to systems

    (2001)
  • E. Charmandari et al.

    Endocrinology of the stress response

    Annu Rev Physiol

    (2005)
  • The world health report: 2001: mental health: new understanding, new hope

    (2001)
  • G. Oliver et al.

    Stress and food choice: a laboratory study

    Psychosom Med

    (2000)
  • Obesity: preventing and managing the global epidemic. Technical report series 894

    (2000)
  • B. Folkow

    Physiological aspects of the “defence” and “defeat” reactions

    Acta Physiol Scand Suppl

    (1997)
  • J.I. Cohen

    Stress and mental health: a biobehavioral perspective

    Issues Ment Health Nurs

    (2000)
  • P. Bjorntorp et al.

    Hypertension and the metabolic syndrome: closely related central origin?

    Blood Press

    (2000)
  • L.A.M. Welberg et al.

    Prenatal stress, glucocorticoids and the programming of the brain

    J Neuroendocrinol

    (2001)
  • V. Bhatia et al.

    Stress and the gastrointestinal tract

    J Gastroenterol Hepatol

    (2005)
  • J.C. Halford

    Pharmacology of appetite suppression: implication for the treatment of obesity

    Curr Drug Targets

    (2001)
  • E. Takeda et al.

    Stress control and human nutrition

    J Med Invest

    (2004)
  • L. Mehlum

    Alcohol and stress in Norwegian United Nations peacekeepers

    Mil Med

    (1999)
  • Cited by (1093)

    View all citing articles on Scopus
    View full text