Cortisol overexposure is well-known in the scientific literature to increase appetite and promote fat storage in the abdominal area. The holidays are often cited as a stressful time of the year (Thanksgiving to New Year’s Day) ñ and a time during which many people gain weight. Our hypothesis was that a comprehensive lifestyle program would attenuate stress and weight gain in this group of “stress-eaters.”

1. Effect of a Lifestyle Program on
Holiday Stress, Cortisol & Body Weight
S. Talbott, A. Christopulos, & E. Richards
Treehouse Athletic Club & SupplementWatch, Inc.
Salt Lake City, Utah

2. Conflict of Interest Statement
SupplementWatch, Inc. - none
TreeHouse Athletic Club - none
Shawn Talbott - author, The Cortisol Connection &
supplement industry consultant

3. BACKGROUND
• The literature strongly suggests that stress/cortisol exposure
is associated with increased appetite, weight gain, and
specifically with increased abdominal adiposity1-3
• The literature also suggests that weight gain is significant4-6
and weight loss difficult7-9 during the 6-week holiday period
• Anecdotal reports and subjective assessment of holiday
weight gain may be high
1. Epel ES, et al. Psychoneuroendocrinology 2001;26:37-49.
2. McLean JA, Barr SI, Prior JC. Am J Clin Nutr 2001;73:7-12.
3. Bjorntorp P, Rosmond R. Nutrition 2000;16(10):924-36.
4.Yanovski JA, et al. NEJM 2000; 342:861-7.
5.Thompson C, et al. J Affect Disord 1988;14:257-64.
6.Rosenthal NE, et al. Ann NY Acad Sci 1987;499:216-30.
7.Boutelle KN et al. Health Psychol 1999;18:364-8.
8.Silverstein LJ et al. J Am Dietetic Assoc 1996;96:Suppl.A:30
9.Baker RC et al. Health Psychol 1998;17:367-70.

4. Elevated Cortisol, Obesity & Metabolic Syndrome
• High cortisol secretion is associated with abdominal fat
• Abdominal fat is most highly associated with illness and death from:
• cardiovascular disease, diabetes, and metabolic syndrome, including hypertension, hyperlipidemia,
hyperinsulinemia, & insulin resistance
Abdominal Obesity Stress-related cortisol
24 P<0.05 0.5 P<0.05
22.5
0.34
23 ±3.7 0.4 ±0.5
21.5
cm 22 ±4.1 nmol/L 0.3
20.6 0.15
21 ±2.2 0.2 ±0.6
0.04
20 0.1 ±0.3
19 0
<10 11-20 >21 <10 11-20 >21
Years in work
Peeke PM, Chrousos GP. Ann NY Acad Sci 1995;771:665-76. / Bjorntorp P, Rosmond R.
Nutrition 2000;16(10):924-36. / Rosmond, et al. Obes Res 2000;8:445-450.

5. Elevated Cortisol and Appetite
• Women with high cortisol response (compared to low responders):
• consumed more calories
• ate significantly more sweet foods
• had more negative moods
• High dietary restraint is associated with high urinary cortisol excretion
• Dietary Restraint = Consciously trying to limit food intake
to achieve or maintain a desired body weight
1. Epel ES, et al. Psychoneuroendocrinology 2001;26:37-49.
2. McLean JA, Barr SI, Prior JC. Am J Clin Nutr 2001;73:7-12.

6. PURPOSE
• We conducted an 8-week lifestyle program to
evaluate effects on measures of stress/mood,
cortisol, body weight, and body composition
• Subjects were self-identified as “high stress” with
historical holiday weight gain
• Program was conducted from week prior to
Thanksgiving to week after New Year’s Day
– (against our better judgment!)

7. METHODS
• Fifty subjects started the program (42 women and 8 men) and
46 completed the program (40 women and 6 men).
Baseline Age (y) BW (kg) BF (%) Waist (cm) BMI
Characteristics
N = 46 44 + 7 78.5 + 16.3 32.4% + 6.9% 86.7 + 11.2 28.8 + 4.8
• Participants met weekly for group educational seminars
– Stress management - yoga, guided imagery, deep breathing, etc.
– Exercise - customized by CPT - 5d/wk (3 aerobic/2 strength)
– Nutrition - based on RMR for no more than 500 kcal/d deficit
– Supplementation - multivitamin/mineral, green tea, 5-HTP, theanine,
citrus flavonoids…
– Evaluation - identification of stressful events and interventions

8. The Cortisol Connection Diet
Lean Protein
Fruits & Veggies
Added Fat
Concentrated Carbs
Metabolic Controllers

9. METHODS
• Before and after the 8-week program, we measured:
– Body weight
– Body fat percentage (BIA via RJL system)
– Waist circumference
– Profile of Mood States
– Salivary cortisol (Salimetrics, State College, PA)
• Paired Student’s t-tests were used to assess differences
between pre/post measures. Statistical significance was
accepted at P < 0.05. Data are expressed as mean + SD.

10. RESULTS
Global Mood State & Salivary Cortisol
Global Mood State (POMS) Salivary Cortisol (ug/dL)
-18.7%
-19.7%
Both, p < 0.05 compared to pre value

11. RESULTS
Profile of Mood States (POMS)
+29%
-41% -40% -41%
-19% -14%

12. RESULTS
Body Weight & Waist Circumference
Body Weight (kg) Waist Circumference (cm)
-0.6kg -1.3cm
p = 0.03 p = 0.01

13. RESULTS
Body Composition
Fat Mass & Lean Mass (kg) Body Fat (%)
+1.3kg
-5.0%
p < 0.05
-1.9kg

14. CONCLUSIONS
• Cortisol/stress exposure has been associated with
increased appetite, obesity, and abdominal adiposity.
• Control of cortisol/stress would be expected to reduce
appetite and enhance weight loss (metabolic effect) - and
perhaps to improve compliance with the 8-wk diet and
exercise regimen (behavioral effect).
• Results of this 8-week weight loss program suggest that a
comprehensive stress management, exercise, nutrition,
and supplementation regimen (SENSE) delivers positive
changes in mood, cortisol, body weight, body fat, and
waist circumference - even during the “high-stress”
holiday period - and that weight gain during this time of
year is not “inevitable”

15. GOOD
HEALTH!