Inflammatory Bowel Disease. Although stress is not a cause of inflammatory bowel disease (Crohn's disease or ulcerative colitis), there are reports of an association between stress and symptom flare-ups.
Eating and Stress
Stress can have varying effects on eating problems and weight.
Weight Gain. Often stress is related to weight gain and obesity. Many people develop cravings for salt, fat, and sugar to counteract tension. As a result, they gain weight. Weight gain can occur even with a healthy diet, however, in some people who are exposed to stress. In addition, the weight gained is often abdominal fat, which increases the risk of diabetes and heart problems.
The release of cortisol, a major stress hormone, appears to boost abdominal fat and may be the primary connection between stress and weight gain. Cortisol is a glucocorticoid. These hormones, along with insulin, appear to be responsible for stress-related food cravings. Evidence suggests that hormonally induced cravings for "comfort foods" may have a biological benefit for managing stress. Eating comfort foods appears to reduce the negative hormonal and behavioral changes associated with stress, which might lessen the impact of stress on an individual. Carbohydrates in particular may increase levels of tryptophan and large neutral amino acids. This leads to more production of the chemical messenger serotonin, which might improve mood and performance under stress.
There may be a "reward-based stress eating" model. In this theory, stress and tasty, high-calorie foods cause the brain to make chemicals called endogenous opioids. These neurotransmitters help protect against the harmful effects of stress by slowing activity of a brain process called the hypothalamic-pituitary-adrenal (HPA) axis, thus weakening the stress response. Repeated stimulation of the reward pathways through stress-induced HPA stimulation, eating tasty food, or both, may lead to changes in the brain that cause compulsive overeating.
Research finds that overeating may be triggered by different stressors in men and women. Women tend to put on extra pounds when dealing with financial and work problems, as well as strained family relationships. Men gain more weight from lack of decision authority at work and difficulty in learning new skills on the job.
Eating Disorders. Chronically elevated levels of stress chemicals have been observed in patients with anorexia and bulimia. Some studies, however, have not found any strong link between stress and eating disorders. More research is needed to determine whether changes in stress hormones are a cause or a result of eating disorders.
Stress can exacerbate existing diabetes by impairing the patient's ability to manage the disease effectively.
Researchers are attempting to find the relationship between pain and emotion, but the area is complicated by many factors, including the effects of different personality types, fear of pain, and stress itself. Evidence suggests that chronic pain may impair the action of neutrophils, thereby weakening the immune response.
Muscular and Joint Pain. Stress may intensify chronic pain caused by arthritis and other conditions. Psychological distress also plays a significant role in the severity of back pain. Some studies have clearly associated job dissatisfaction and depression to back problems, although it is still unclear whether stress is a direct cause of the back pain.
Review Date: 10/14/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.