Cortisol Belly: Causes and Symptoms
"Cortisol belly" is a popular term used to describe weight gain mostly around your belly area, or abdomen. Sometimes it's called "hormonal belly." It's not a medical term or diagnosis, but it could be a sign of something else happening in your body.
Why Does Cortisol Belly Happen?
The term "cortisol belly" describes increased levels of the hormone cortisol playing a role in where and how much fat you gain. But different things play a role in weight gain. The cause of weight gain around your belly isn't as straightforward as popular science makes it sound.
Causes of weight gain
Different things affect your weight, including your diet, the amount of exercise you get, medical conditions you have, your quality and quantity of sleep, and your genetics. Another key factor in fat buildup is hormones present in your system. These include sex hormones (androgen, progesterone, and estrogen), insulin, thyroid hormones, and cortisol.
The levels of these different hormones can affect where and how much fat gathers in your body.
For example, premenopausal women tend to have a higher share of fat in their thighs, hips, and buttocks. Women who've gone through menopause and lost much of their estrogen may have more fat in their abdomen and upper body.
Weight gain at your abdomen can be just below your skin (subcutaneous) or deep inside your body around your organs (visceral). Too much visceral fat increases your risk of certain health conditions such as metabolic syndrome, diabetes, and heart disease.
Cortisol and Weight Gain
Cortisol is a hormone doctors sometimes call the "stress hormone." Your adrenal glands make it, along with the hormone adrenaline. Both hormones play a role in your response to stress. Adrenaline is your "fight or flight" response that allows you to have energy to fight or run away from a threat. Cortisol follows up your adrenaline rush to help you stay alert for longer.
"The idea is that chronic stress leads to high cortisol levels that drives excess abdominal fat accumulation, but this concept is not supported by evidence," says Rexford Ahima, MD, PhD, director of the Division of Endocrinology, Diabetes, and Metabolism at Johns Hopkins Medicine.
But there are medical conditions that cause abnormally high cortisol levels, and one side effect of these conditions is weight gain around the belly.
Cushing syndrome
This condition causes your body to make too much cortisol. You may get it because of a tumor, or as a side effect of certain medications. One of the most common symptoms of Cushing syndrome is weight gain in your belly (while your legs and arms stay slim).
If Cushing syndrome is the cause of your belly weight gain, you may also have:
Weight gain in the face (sometimes called moon face)
A fatty lump between the shoulders (sometimes called a buffalo hump)
Pink or purple stretch marks on the stomach, hips, thighs, breasts, and underarms
Thin, frail skin that bruises easily
Slow wound healing
Acne
Metabolic syndrome
Metabolic syndrome is a cluster of symptoms that increases your risk of type 2 diabetes, heart disease, or strokes. People with metabolic syndrome typically have apple-shaped bodies. That means you carry more fat in your abdomen.
Signs of metabolic syndrome include:
A waist circumference of more than 35 inches for people assigned female at birth (AFAB) and more than 40 inches for people assigned male at birth (AMAB)
High blood pressure of 130/80 mm Hg or higher
Elevated blood sugar levels
High triglyceride levels (more than 150 mg/dL)
Low HDL cholesterol (less than 40 mg/dL for men and less than 50 mg/dL for women).
A doctor can make a diagnosis of metabolic syndrome when you have three or more of these signs.
"Metabolic syndrome is more common in older people, post-menopausal women, and is associated with insulin resistance and chronic inflammation," says Ahima. "However, we don't fully understand what specifically causes metabolic syndrome. Genetic factors, excessive intake of high-caloric, low-quality ultra-processed foods, inadequate sleep, low physical activity, and psychosocial stress contribute."
What does cortisol belly look like?
"Cortisol belly" typically refers to weight gain that's mostly in the belly and less so in other places. If your weight gain in your belly is due to Cushing syndrome, you'll notice that your arms and legs stay slim as your belly gains fat.
How to Get Rid of Cortisol Belly
Lowering your stress levels (and therefore your cortisol levels) won't necessarily make you lose belly weight. But it's a healthy practice that improves overall health that may include weight loss. Try these practices:
Get regular exercise. Do something that you enjoy so you look forward to it and make time in your schedule for it. Ahima recommends getting at least 8,000 steps a day and including resistance exercises into your weekly routine. And don't overdo it – too much exercise without enough downtime for rest between workout sessions can make cortisol go up.
Prioritize sleep. Tweak your sleep habits so that you're getting quality ZZZs each night. Stick to a consistent sleep/wake schedule, aim for eight hours a night, and keep your room cool, dark, and distraction-free for restful slumber.
Promote body and mind relaxation. Certain relaxation techniques such as meditation, breathing exercises, tai chi, and mindfulness help regulate your nervous system and send your body signals to relax, lowering stress.
Go outside. Studies show that just 20 minutes in green spaces outdoors such as parks or woods can significantly lower your cortisol levels.
Don't smoke. Along with causing overall health harm, some research shows that smoking can raise your cortisol levels and disrupt healthy sleep.
Cultivate relationships. Social interaction with people who bring you a sense of calm and contentment can help improve your emotional well-being and mood.
If your belly fat is being caused by a medical condition such as Cushing syndrome, your doctor can prescribe treatment that will reduce your cortisol and ease symptoms.
"Cortisol blockers can decrease cortisol levels in patients with Cushing syndrome who may not be able to have surgery," says Ahima. "However, there is no proven evidence supporting the use of cortisol blockers as dietary supplements in common forms of obesity."
In fact, Ahima warns against companies that claim to be able to cause weight loss by controlling cortisol. These treatments are specific to these conditions – you shouldn't try them to reduce belly fat if you don't have a medical diagnosis.
"While psychosocial stress and cortisol have been linked to central obesity in the media, research findings do not support a cause-and-effect relationship between cortisol and central fat accumulation in most people with obesity," he says.
Is There a Detox Diet for Cortisol Belly?
There's no specific "cortisol belly diet," but there are diet patterns you can adopt for nutritious eating to help reduce inflammation and slow cortisol production in your body. Research shows that certain types of foods can help lower cortisol, such as:
Foods high in magnesium: avocados, bananas, dark chocolate, broccoli, and spinach
Foods high in omega-3 fatty acids: fish (anchovies, salmon, tuna), chia seeds, flax seeds, and walnuts
Foods that promote a healthy gut: Greek yogurt, kombucha, and sauerkraut
A diet high in high-sugar foods and drinks, alcohol, and caffeine can spike your cortisol levels.
A Mediterranean diet is a smart template for healthy, low-inflammation eating, and it may lower your cortisol levels. A Mediterranean diet focuses on healthy fats and plant-based eating:
Plenty of fruits and vegetables
Beans, lentils and nuts
Whole grains, like whole-wheat bread and brown rice
Extra-virgin olive oil (EVOO) as your primary cooking and dressing oil
Fish rich in omega-3 fatty acids
Cheese and yogurt in moderate amounts
Protein from chicken, turkey, fish, and beans
Little to no red meat
Little to no sweets, sugary drinks, or butter
Wine only in moderation (or not at all)
Are there cortisol belly supplements?
Supplements aren't a cure-all for stress and cortisol levels. "You can get all of the vitamins and minerals you need from healthy food," says Ahima. 'There are no proven supplements to reduce 'cortisol belly.' "
One study on stress levels in health care workers suggested there are some herbs and supplements that may lower cortisol. (This doesn't mean they will promote weight loss.) These include:
Ashwagandha
Rhodiola
Lemon balm
Chamomile
Keep in mind that more research needs to be done before any of these herbs could be recommended. You should always talk to your doctor before trying any herbs or supplements.
Takeaways
"Cortisol belly" is a non-medical term some people use to describe weight gain in the abdomen. The idea is that weight gain is linked to high cortisol levels, often due to chronic stress. But there's little scientific evidence that cortisol is a primary cause of belly fat in most people. Abdominal fat can result from many things, including diet, stress-eating, genetics, hormone levels, sleep quality, and medical conditions like Cushing syndrome. Healthy weight loss generally involves a balanced diet, regular exercise, getting enough sleep, stress reduction, and avoiding smoking and too much alcohol.
Cortisol Belly FAQs
What does "cortisol face" look like?
"Cortisol face" is a popular term on social media platforms that is used as a description of a swollen, puffy face. There's a condition called moon face (moon facies) that some people call cortisol face. Moon face is a buildup of fat deposits in the sides of your face that causes severe swelling. You can get this when you use corticosteroids, or from medical conditions such as Cushing syndrome or hypothyroidism. If this happens to you, fat deposits on the side of your skull can make your face so round you can't see your ears from the front.
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