The document discusses stress-induced overeating and its physiological and psychological causes and consequences. It outlines how stress activates the body's stress response systems like the HPA axis and causes increases in cortisol that can lead to visceral fat accumulation and insulin resistance over time. Chronic stress has been shown to shift food preferences towards calorie-dense "comfort foods" high in fat and sugar. Human studies discussed found that stressed individuals, especially women and restrained/emotional eaters, tend to overeat high-calorie foods and have worse metabolic outcomes. Recommendations to prevent stress-induced overeating include cognitive-behavioral counseling to change eating behaviors and thoughts, as well as increasing physical activity which can help modulate stress responses and

1. Done by: Stephanie Nehme
Tutor: Ms. Zeina Nakat

2. Outline
I. Stress-induced overeating in
today’s world
II. Types of stressors and their
physiological responses
III. Causes and consequences of
stress-induced overeating
IV. Human studies, results
and analysis
V. Preventions,
recommendations and
solutions
VI. Conclusion

3. I. The Thrifty Gene Hypothesis
• During evolution: a set of genes linked with fat storage
has been selected to ensure survival in environments
with limited food supply.
• Contemporary environments: modernization and
unlimited food availability promote a sedentary
lifestyle and overeating.
The thrifty genes are still activated to increase energy
storage for a different reason:
Psychosocial stress is a new feature of modern societies.
Increased prevalence of obesity. Siervo , Wells, and Cizza, “The
Contribution of Psychosocial
Stress to the Obesity Epidemic:
An Evolutionary Approach”, 2009

4. I. Malnutrition During Stressful Periods
20% do not change
their eating habits
80% change their eating habits
> 40% increase
caloric intake
< 40% decrease
caloric intake
Those who are at the
upper range of
normal, are
overweight, or are
restrained eaters
Those who are of
normal- or
underweight
 The difference between the weight gainers and losers might be a
consequence of higher insulin concentrations in people with higher body
mass index.
Dallman ,"Stress-induced obesity and the emotional
nervous system“, 2009

5. I. A Shift in Food Intake toward ‘Comfort Foods’
Stress typically favors those foods with increased fat and/or sugar
content.
Dallman, "Stress-induced obesity and the emotional nervous system“, 2009

6. II. Types of Stressors
The following stressors can induce a stress response:
• Physical stressors
• Chemical stressors
• Physiologic stressors
• Psychological or emotional stressors
• Social stressors
Stressors can be short term (acute stress)
or occur on daily basis (chronic stress).
Torres & Nowson, "Relationship between stress, eating behavior, and obesity“, 2007

7. II. Physiological Responses to Stressors
Hypothalamus–Pituitary–Adrenal (HPA) Axis
Adam & Epel, "Stress, eating and the reward system“, 2007

8. II. Physiological Responses to Stressors
Two of Cortisol's Primary Functions in the Body are:
- Increasing blood sugar through gluconeogenesis
- Aiding in fat, protein, and carbohydrate metabolism
 Cortisol Counteracts Insulin by:
- Contributing to hyperglycemia
- Inhibiting the peripheral utilization of glucose = insulin
resistance  further lipid accumulation
 Vicious circle:

9. III. The Causes of Stress-Induced Overeating
Calorically-dense food intake:
High stress reactivity
Increase in cortisol
Greater intake of calories
Decrease the feeling of
stress
Reinforcing subsequent
eating of comfort food
Adam & Epel, "Stress, eating and the reward system“, 2007

10. III. The Consequences of Stress-Induced Overeating
Visceral Fat Accumulation:
EXCESS [CORTISOL]  visceral fat accumulation
Why?
1- glucocorticoid metabolism
due to receptor density
in intra-abdominal adipose
tissue compared to other
regions
2- physiological [cortisol]
whole body lipolysis
However:
Cortisol + INSULIN  lipid mobilization and lipid accumulation
Adam & Epel, "Stress, eating and the reward system“, 2007

11. IV. Human Studies, Results and Analysis
First Study:“Stress and Food Choice:
A Laboratory Study”:
• Aim: To investigate experimentally whether
acute stress alters food choices during a meal.
• Design: 68 healthy, non obese, non smoking
volunteers (27 men and 41 women).
• Methodology: Anticipation of a speech
performance (of 4-minutes) was used as the
stressor for the students, after which they
were provided with a buffet lunch in the
laboratory.
Oliver , Wardle, & Gibson , ”Stress and Food Choice: A Laboratory Study”, 2000

12. IV. Human Studies, Results and Analysis
First Study:“Stress and Food Choice: A
Laboratory Study” (cont’):
• Results:
No evidence of a hypophagic stress response
on men nor a hyperphagic stress response on
women
Stress did increase intake of sweet and/or
fatty foods in emotional eaters
Women scored more highly on emotional
eating than men, as is typically found
There is evidence that snack consumption may
be more susceptible to stress than meals
Oliver , Wardle, & Gibson , ”Stress and Food Choice: A Laboratory Study”, 2000

13. IV. Human Studies, Results and Analysis
Second Study:“Food Selection Changes Under Stress”:
Experiment I:
• Aim: To stress whether stressed females subjects will eat
more of the foods normally avoided compared to
unstressed female subjects
• Design: Two groups of female subjects (total # 34), one
stressed and one control
• Methodology:
 Ten solvable or ten unsolvable five-letter anagrams
 Snack foods were provided
 Restrained scale questionnaire
Zellner, Loaiza, Gonzalez, Pita, Morales, Pecora, Wolf, “Food selection changes under stress”, 2006

14. IV. Human Studies, Results and Analysis
Second Study:“Food Selection Changes Under Stress”
(cont’):
Experiment I RESULTS:
Stressed subjects ate more of the unhealthy high-caloric
sweet choice and less of the healthy sweet choice than did
the unstressed subjects
No difference in intake of the salty snacks was observed
because: women preferred the sweet foods to the salty ones
or both salty snacks were high in fat.
Zellner, Loaiza, Gonzalez, Pita, Morales, Pecora, Wolf, “Food selection changes under stress”, 2006

15. IV. Human Studies, Results and Analysis
Second Study:“Food Selection Changes Under Stress”
(cont’):
Experiment II:
• Aim: To investigate the proportion of restrained eaters.
• Design: 169 undergraduate student volunteers (128
females, 41 males).
• Methodology: “The Eating-When-Stressed
Questionnaire” was administered to subjects to find out
about their eating behavior under stress.
Zellner, Loaiza, Gonzalez, Pita, Morales, Pecora, Wolf,
“Food selection changes under stress”, 2006

16. IV. Human Studies, Results and Analysis
Second Study:“Food Selection Changes Under Stress”
(cont’):
Experiment II RESULTS:
 Women (46%) > Men (17%) when
stressed
Most people who report overeating
when stressed were restrained eaters (71%) (women (75%) >
men (43%))
Restrained eaters exhibit disinhibition of their diet and eat
foods they normally avoid: high calorie “junk food” (it made
them feel better or because they tasted good).
Zellner, Loaiza, Gonzalez, Pita, Morales, Pecora, Wolf, “Food selection
changes under stress”, 2006

17. IV. Human Studies, Results and Analysis
Third Study:“Perceived Stress, Depression and Food
Consumption Frequency in the College Students of
China Seven Cities”:
• Aim: To evaluate the association between perceived stress,
depression and food consumption frequency
• Design: Cross-sectional data used from China Seven City
Study survey. Of the 2579 college students, 98.5% provided
consents
• Methodology:
Depression scale, perceived stress scale and FFQ
Liu, Xie, Chou, Koprowski, Zhou, Palmer, Sun, Guo, Duan, and Sun, Johnson, “Perceived stress, depression and food
consumption frequency in the college students of China seven cities”, 2007

18. IV. Human Studies, Results and Analysis
Third Study: “Perceived Stress, Depression and Food
Consumption Frequency in the College Students of
China Seven Cities” (cont’):
• Results:
Negative correlation of frequency
of fresh fruit consumption with
perceived stress
Positive correlation of frequency of
ready-to-eat food and snack food
consumption with perceived stress
Liu, Xie, Chou, Koprowski, Zhou, Palmer, Sun, Guo, Duan, and Sun, Johnson,
“Perceived stress, depression and food consumption frequency in the college
students of China seven cities”, 2007

19. IV. Human Studies, Results and Analysis
Fourth Study: “Are Stress Eaters at Risk for the
Metabolic Syndrome?”
• Aim: To examine the effects of self-reported stress-eating
tendencies (more-eaters vs. less-eaters) on changes in cortisol,
insulin, adiposity, and lipid levels as well as food intake from
baseline to exam periods
• Design:
- Population: 131 medical students (55% women, 45% male).
- Duration: two exam periods over 1 year.
• Methodology: Students were asked to report stress-eating
tendencies and were assessed on body mass index (BMI), waist-
to-hip ratio (WHR), nocturnal urinary cortisol, and insulin
Epel, Jimenez, Brownell, Stroud, Stoney, and Niaura, “Are Stress Eaters
at Risk for the Metabolic Syndrome?“, 2004

20. IV. Human Studies, Results and Analysis
Fourth Study: “Are Stress Eaters at Risk for the
Metabolic Syndrome?” (cont’)
• Results:
 Increased weight, BMI, nocturnal cortisol and insulin, and
lipid profile (total/HDL cholesterol ration) during exam
periods in more-eaters compared to less-eaters
Metabolic Syndrome
 Increased WHR in more-eaters but
only among women
Epel, Jimenez, Brownell, Stroud, Stoney, and Niaura, “Are Stress Eaters
at Risk for the Metabolic Syndrome?“, 2004

21. IV. Human Studies, Results and Analysis
- Relation between stress, cortisol/insulin and overeating
of comfort food is proven
- Personality characteristics play a role: stress more-
eaters vs. stress less-eaters vs. stress no-change eaters
- Emotional eaters or restrained eaters are more prone to
stress-induced eating of foods that are usually avoided
- Women are more affected than men
- Metabolic Syndrome can be the result

22. V. Preventions, Recommendations and Solutions
1) Counseling:
A. Changing Eating Behavior:
ABC Framework:
Antecedents (stimuli or cues)
Behavior (response itself or eating)
Consequences (reinforcement or reward) of the behavior
• The dietetic professional and the client must find ways to regulate
the ABC Framework by:
 Analysis of ANTECEDENTS to control or limit them
 Exploration of the eating BEHAVIOR
 Efforts are made to arrange CONSEQUENCES that will maintain
desirable behaviors. Holli, Calabrese, & Maillet, "Communication and education skills for dietetics professionals"

23. V. Preventions, Recommendations and Solutions
B. Cognitions:
Cognitive events are conscious thoughts that occur in a person’s
stream of consciousness
 This self- talk can be (+), (-) , or neutral
• Cognitive distortions:
The (-) thoughts that inhibit behavioral change
• Cognitive Restructuring:
- Techniques involved with modifying the
client’s thinking and the assumptions and
attitudes underlying these cognitions
- The focus is on the false thoughts and deductions
Holli, Calabrese, Maillet, "Communication and education skills for dietetics professionals"

24. V. Preventions, Recommendations and Solutions
• Phases of Cognitive Behavior
Modification:
Help the client to:
The first phase: Understand the nature of
the problem.
The second phase: Explore the cognitive
problem and find a solution to disrupt the
negative self-talk.
The third phase: Make actual change
+ follow up with the counselor is crucial for
long-term modification.
Holli B. B., Calabrese R. J., Maillet. J. O., "Communication and education skills for dietetics professionals"

25. V. Preventions, Recommendations and
Solutions
2) Physical Activity:
• Affects directly the modulation of the stress response
• Improves insulin sensitivity
• Enhances oxidative capacity of skeletal muscle
• Improves psychological well-being and self-confidence
(serotonin)
• Improves sleep patterns
• Influences health-related behaviors (e.g. nutrition)
• Helps coping with life’s stresses, particularly among high-risk
individuals.
Chaput, Klingenberg, Rosenkilde, Gilbert, Tremblay, and Sj¨odin "Physical Activity
Plays an Important Role in Body Weight Regulation“, 2010

26. VI. Conclusion
YES!
OK sometimes, but always: NO
Or else
VS

27. Q&A

29. References
Articles:
• Adam T. C., Epel E. S. (2007). Stress, eating and the reward system. 449–458. University of California, San
Francisco, Department of Psychiatry, United States.
• Chaput J., Klingenberg L., Rosenkilde M., Gilbert J., Tremblay A., and Sj¨odin A. (2010). Physical Activity
Plays an Important Role in Body Weight Regulation. 1-11.
• Dallman M. F. (2009). Stress-induced obesity and the emotional nervous system. 159-165.
• Epel E., Jimenez S., Brownell K., Stroud L., Stoney C., and Niaura R. (2004). Are Stress Eaters at Risk for the
Metabolic Syndrome? 208-210.
• Liu C., Xie B., Chou C., Koprowski C., Zhou D., Palmer P., Sun P., Guo Q., Duan L., and Sun X., Johnson D.
(2007). Perceived stress, depression and food consumption frequency in the college students of China
seven cities. 748-754.
• Oliver G., Wardle J., and Gibson L. (2000). Stress and Food Choice: A Laboratory Study. 853- 865.
• Siervo M., Wells J. C. K., and Cizza G. (2009). The Contribution of Psychosocial Stress to the Obesity
Epidemic: An Evolutionary Approach. 761-770.
• Torres J. T., Nowson C. A. (2007). Relationship between stress, eating behavior, and obesity. 887–894.
• Zellner D. A., Loaiza S., ZGonzalez Z., Pita J., Morales J., Pecora D., Wolf A. (2006). Food selection changes
under stress. 789–793.
Book:
• Holli B. B., Calabrese R. J., Maillet. J. O. Communication and education skills for dietetics professionals. 1-
379; Fourth Edition.
Site:
www.wikepidia.org