Let’s Talk About Stress
I want to talk about stress. Specifically the chronic stress caused by weight stigma and discrimination, and its physical and psychological effects. I think it’s funny (and by funny, of course, I mean horrifying) that while we hear about all of the detrimental health consequences of too much stress, we never think to, you know, stop stressing people out about their health.
“Get thin or you’re going to die!!”
“What? Oh shit! I keep trying and it’s not working! I’m so stressed about this!”
“You’re not stressed enough obviously because you’re not thin yet!”
Or something like that.
The fact is that constant stigma and discrimination creates a hell of a lot of stress — chronic stress, which is the bad kind. When you’re stressed, your body puts out hormones like cortisol, adrenaline and norepinephrine, which are part of the body’s fight or flight response. Let’s look at some of the health issues related to chronic stress, shall we?
Heart disease and high blood pressure
Coronary heart disease is more common in people who experience chronic stress. Stress causes an elevated heart rate and increased blood pressure, which creates additional tension on the arterial walls. Combined with the circulation of additional stress hormones, this causes damage and, when the arteries heal, thickening. Stress may also cause changes in the way the blood clots, leading to an increased risk of heart attack. In addition to these physiological effects, it makes people more likely to smoke or eat to manage stress, and less likely to exercise.
Stroke
A stroke occurs when a blood clot blocks an artery. Increased risk of stroke is associated with prolonged self-perceived stress, for the same reasons that it has an increased risk on heart disease — artery walls are damaged and then thicken.
Migraines
Stress is the most common trigger for migraines. The stress chemicals that your body releases can cause changes to the blood vessels which can trigger migraine episodes. If you’ve never had one of these, consider yourself lucky. Chronic stress also contributes to chronic tension headaches which is, as the name suggests, caused by the tensing of muscles in the neck and shoulders — they’re even alternatively called stress headaches. Migraines are painful and debilitating for many people who have them.
Depression
Is it just me or is our society getting more depressed? Nope, it’s not just me. Compared to 50 years ago, five to eight times as many teens and college students suffer from depression. About 9.5% of adults in the US have been diagnosed with depression (keeping in mind that a lot of people never get diagnosed). That’s over 18 million clinically depresse people, and that number jumps to 37 million people when you add in teenagers.
Not only does depression contribute to heart disease, but it’s estimated that by 2020 depression will be the second largest killer in the US after heart disease. Depression is also a leading cause of lower productivity, disability, and the cost of health care. Chronic stress leads to elevated levels of stress-chemicals, such as cortisol, and suppressed levels of happy-hormones, such as seratonin and other neurotransmittes, like dopamine.
Arthritis
I know what you’re thinking. Arthritis? Really? Yeah, well, long-term exposure to stress hormones have all kinds of effects that you don’t really think about. This has to do with cortisol and inflammation. Cortisol is secreted by the adrenal gland and is used to help fight inflammation in the body. When all the cortisol being secreted is depleted by fight or flight responses there’s just not enough left to fight inflammation, causing the body’s repair systems get suppressed.
If that inflammation is in the intestinal tract, or from freely-circulating inflammatory chemicals, the body releases an enzyme called aggrecanase, which will actually eat away at cartilage. While stress isn’t shown to directly cause arthritis, it can definitely make it worse. Although arthritis is as much as 60% genetic, environmental factors can worsen the risk.
Side note — If you’re at risk for osteoarthritis because it runs in your family, think about preventative care by strengthening the muscles in your leg to help better support your knee joints.
Diabetes
I want to emphasize that diabetes is genetic. If you do not have the diabetes genes, you will not get type 2 diabetes, so this is just for people who are already genetically predisposed.
Interestingly, it’s been suspected that stress plays a big role in the development of diabetes for a long time. The first study done on the link was in 1935. Cortisol (Oooh, that little bugger causes all kinds of problems doesn’t it? Well, it’s only meant to be a short-term chemical after all.) triggers the release of insulin meant to give you a burst of energy for running away or fighting for your life, but long-term elevated levels of insulin can cause insulin resistance.
An analysis on nine epidemiological studies were the first to conclude that depression increases the risk for type 2 diabetes by 37%. Additionally, stress tends to lead to poor habits such as smoking, inactivity, and lots of sugary foods (which raise seratonin levels in the brain, as well as stimulating the release of dopamine).
So here we’ve got all of these health issues that are typically associated with obesity, but are also associated with chronic stress. And no one can argue that fat people in our society aren’t under chronic stress! More so, chronic stress tends to lead to weight gain and may even impact things like thyroid function.
Combine that with the fact that weight cycling also tends to result in higher weights and you’ve got to wonder how fat these fat people would actually be if Body Acceptance was the norm: no more chronic stress from stigma and discrimination, better health care and actual treatment for issues, and no more weight cycling.
I would even dare propose that the whole rising number of fat people (up until about 1999/2003) may have had something to do with how we treat fat people. People are getting fatter? Well no shit, look at the stress we put them under! Look at the abuse we encourage against their bodies!
Of course, it just contributes to the evidence that what the obesity epidemic scaremongerers really care about is not our health. In fact they’re absolutely willing to sacrifice our health in order to sell the fantasy of being thin.
- Stress, Behavior and Heart Disease; 2008: Matthew M Burg PhD
- Heart Disease and Health
- Stress and High Blood Pressure
- National Stroke Association
- Science Daily; Can Severe Stress Cause Stroke?
- Headaches, Migraines, and Stress
- Depression Statistics For the United States
- The Dramatic Rise of Anxiety and Depression In Children
- Depression Facts and Stats; Bob Murray PhD, Alicia Fortinberry MD
- Depression and Stress
- The Effects of Stress on Arthritis
- Stress and Arthritis
- Stress and Weight Gain
- Does Emotional Stress Cause Type 2 Diabetes Mellitus? A Review from the European Depression in Diabetes (EDID) Research Consortium
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the question becomes what do we DO about chronic stress? how do we mitigate it?
Become hermits? Don’t read magazines/watch tv/read the news?
well, i think the first step is what we’re all here for- body acceptance! What got me thinking about stress to begin with and the effects it has on the body long term specifically was thinking about the constant stigma that fat people are under- all the stress that society puts on us and that we put on ourselves. I don’t know about anyone else, but fat acceptance has definitely reduced my stress quite a bit! (which is often mitigated by being an activist.. lol)
Stress is America’s dirty little secret. We don’t talk about it as a health issue and we don’t treat it as a health issue, largely because the symptoms are subcutaneous (for the most part). Now, if there were a distinct physical characteristic associated with stress (all stressed people get purple hair), then perhaps we might be more open to discussing the dangers of stress. Instead, we celebrate stress as part of our bootstrap culture… if you’re stressed, it’s a sign of hard work and diligence, right? So you work your ass off for years and years, then take a teeny, tiny one-week vacation, then back at it. But that’s just professional stress, and the Whitehall Study is the most comprehensive stress study ever done on working professionals, and its findings are incredible. Basically, the lower on the ladder you are, the more chronic stress and the more likely you are to have long-term health issues.
And that’s just the effects of work and stress. Chronic stress plagues the poor the most, as your day-to-day survival is a real and present danger to you and your family. Achieving, and maintaining, food security is a daily struggle. And then we throw lack of access to healthcare into the mix and you have a cauldron of poor health that we blame solely on fatness or solely on poor choices, which is all bullshit.
And I bet that if a well-controlled study were to investigate it, they would find a correlation between stress and weight cycling, as weight cyclers get increasingly frustrated with their inability to “control” their bodies. We already know that cardiovascular and all-cause mortality are much higher in weight cyclers, but we don’t really understand the mechanism behind it. I’ve read a few good theories, but I wonder if stress may play an unseen role.
Anyway, great round up, Heather. This is a great resource.
Peace,
Shannon
Great points, Heather. I’ve noticed that even though my husband has his type 2 diabetes under control (for the most part), on days that he’s really stressed by his job, his blood sugar goes through the roof no matter how much insulin he takes.
Shannon, we really need a “Like” button for comments…..lol - yours says it all so much better than I ever could.
My theory is that if everyone was assessed on a lifestyle and actual test result basis then we wouldn’t be told to lose weight for our health, those with eating disorders would be treated faster and a large number of people would be fat, but very few would reach the upper levels of obesity that are becoming more common.
Oh and I wouldn’t spend half my time wanting to swear at insensitive w*nkers in the street…
O:-)
<3 Pyx
“You’re not stressed enough obviously because you’re not thin yet!”
I’m thinking you (or the hypothetical fat-hater you’re quoting) probably meant this in the sense of ‘not being stressed enough about being fat that you actually bother to go ahead and lose some’. There is, though, another aspect to this - the assumption I’ve come across reasonably often, that ‘nervous’ people are skinny and that there can’t be much wrong with you, mentally, if you haven’t lost a bunch of weight from not eating due to stress.
Back in the 90s, during what probably was one of my bouts of depression, I had a doctor insist that I couldn’t be depressed because ‘depressed people lose their appetites’ - he hadn’t asked me about my eating habits, which at the time were unchanged, he just made the assumption from looking at me. (I was seeing him about serious fatigue, which was making me fall asleep during the day, but he also insisted people with depression only suffer from insomnia, not the reverse. These days, when my anxiety’s at its worst - thankfully not often - I do get classic early waking symptoms.) Later doctors have, thankfully, been more astute, and there’s more understanding of what they now call ‘atypical’ depression - but you do occasionally find this attitude, even within the mental health community.
And, thanks for the cortisol/diabetes info - it needs to be more widely known. In fact, I’ve seen medical books from the mid-20C which assumed, as common knowledge, that severe stress could precipitate diabetes (of both types) in a susceptible person. I’d guess that the blame culture around Type II these days is why this doesn’t seem to get mentioned much now.
yes, you’re right, I did mean not stressed enough to lose weight but you bring up a good point too. I’ve definitely gone days or weeks with eating very little from stress or depression without losing any weight (or maybe just losing a couple pounds of water weight- nothing noticeable). He was also ignoring the fact that sometimes depression causes people to comfort eat. Of course, eating habits sometimes don’t change at all! You know,though… i look back at medicine from a decade or more ago and it seems.. well just so outdated.. and it is! That’s good because our awareness of medical conditions and how we treat are always changing but it certainly makes me wonder how people will look back on the way we practice medicine now. As far as the really old info on stress and diabetes- I’m guessing that scare campaigns like “the obesity epidemic” routinely overshadow actual medical information. Yay witch hunts! >.< Anyway, i'm sorry you had to go through that with your doctor. I have a hard time trusting medical professionals.
This is what happens to me too. I will become depressed and not eat. I may lose 5 pounds of water, but that’s all.
What would happen if you female fatties ate 2000 calories a day? Would your bodies mysteriously defy the laws of physics?
Why don;t you sick fucks prove science wrong and call MIT and put your money where your gluttonous lying mouths are?
well i eat about 1200-1700 calories a day.. so if i ate 2000 a day then that’d be an increase! Might be a little difficult though.. sometimes even hitting 1200 is difficult because I often lack an appetite. I’d rather not try to eat more than I’m comfortable with though.
edit: MIT is welcome to run any tests on me that they’d like
At least this guy realized there was more than one law of physics, I guess he’s moving in the right direction.
My dad was not fat when he was healthy, or at least appeared to be healthy. He was under a lot of stress, and it wasn’t even a month after he’d retired from his job as a professor that he had a major hemorrhagic stroke. He was 68 years old. His health declined over the next few years until his death at 74 from congestive heart failure. The congestive heart failure caused him to gain over 100 pounds, most of it fluid. It was horrible to watch.
He had undiagnosed hypertension and was always too busy and too macho to go to the doctor to get things checked out. I would say that stress contributed to his untimely death in a big way.