Cause Abdominal Fat Buildup in Slender Women
Lean women who are vulnerable
to the effects of stress may be more likely to accumulate excess abdominal fat, increasing
their risk for certain diseases, suggest the results of a preliminary study.
"Our findings support the idea that greater life stress and stress reactivity can
contribute to central fat, especially among lean women," said lead author Elissa
Epel, PhD, a member of the UCSF Health Psychology Program in the department of Psychiatry
who conducted the study while working as a research scientist at Yale University. The UCSF
Health Psychology Program is also affiliated with the Center for Health and Community.
The study is reported in the September/October issue of the journal Psychosomatic
Research has shown that people with diseases that cause extreme exposure to the stress
hormone cortisol -- such as Cushing's Syndrome -- have excessive amounts of central or
visceral fat. This type of fat is unhealthy, as it is linked to greater heart disease and
diabetes. Epel and colleagues investigated whether the relationship between cortisol and
central fat is found among healthy people as well.
Central fat tends to be highly sensitive to the effects of circulating stress hormones
like cortisol. This type of fat responds to cortisol's presence by increasing in size --
thus heightening the risk of diseases such as high blood pressure, heart disease, stroke
Although everyone is exposed to stress, according to the researchers, some people may
secrete more stress-induced cortisol than others. Further, some people may secrete
cortisol every time they face the same difficult situation, rather than adapting to it.
Epel and colleagues predicted that people who react to the same stressor each day by
secreting cortisol would have greater central fat.
The researchers noted study limitations, such as the homogeneity of the study
participant group. "We do not know whether the current results would generalize to
other ethnicities," said Epel. "We also don't know whether stress actually
caused the central fat accumulation or whether they are parallel phenomena. Only
longitudinal studies can determine this."
The researchers gave 59 white women laboratory stress tests over several days to
examine cortisol responses over time. Approximately half of the women had a high
waist-to-hip ratio (WHR), and the other half had a low WHR. A high WHR indicates fat
storage at the waist, and a low WHR indicates fat storage at the hips more than the waist.
Women with a high WHR, both those who were overweight and those who were lean, appeared
more vulnerable to stress: they were more threatened by the laboratory stress tests, made
less effort on them over time, performed more poorly on them, and secreted more cortisol
than women with a low WHR, the researchers found. In addition, the higher WHR women
reported more stress from their daily lives.
As the study progressed, Epel and colleagues noted a difference among members of the
high WHR group. Those who were overweight appeared to adapt to the laboratory stresses
(puzzles and speech tasks that were similar in nature). Lean women with a high WHR,
however, did not adapt. On the second and third days of the study they continued to
secrete significantly more cortisol than lean women with a low WHR did.
The high WHRs of lean and obese individuals may have different causes, suggested Epel.
The lean high WHR women's psychological profiles revealed the most vulnerability to
stress. This may have led them to overreact to stress in their daily lives. Greater
cortisol exposure, in turn, may have caused them to accumulate greater abdominal fat.
"For lean women, central fat may indicate an underlying sensitivity to stress rather
than being in part a result of obesity," she said. "However, genetics also play
a role in shaping both stress response and fat distribution."
"In addition, future research needs to better define levels of risk and
appropriate treatments based not only on one's girth but also on the multiple causes of
central fat, such as genetics, behavior, general obesity, and chronic stress," said
"Many factors besides cortisol influence central fat, such as sex hormones and
lifestyle factors. Smoking, alcohol, and lack of exercise increase it, whereas sufficient
sleep and exercise may decrease cortisol levels and central fat," said Epel.
This study was funded by the John D. and Catherine T. MacArthur Foundation Research
Network on Socioeconomic Status and Health, the National Institutes of Health/National
Center for Research Resources, the Woodrow Wilson Grant in Women's Health, and the
American Psychological Association.