ReviewRelationship between stress, eating behavior, and obesity
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
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