Cortisol Belly (Stress Belly): 7 Tips to Help Reduce the Fat

Have you noticed stubborn belly fat that just won’t go away? While there are a number of potential causes for abdominal fat — from a poor diet and a lack of exercise to alcohol consumption and menopause — one overlooked culprit is the hormone cortisol.¹

What Is Cortisol Belly? 

The term “cortisol belly” or “stress belly”  is used to describe the tendency for excess fat to accumulate around the stomach due to prolonged high levels of cortisol, often known as the stress hormone.¹

While cortisol is essential for managing various bodily functions, chronic stress can lead to elevated cortisol levels, which can increase appetite and sugar cravings as well as impact fat storage patterns, particularly in the abdominal area. This can result in added subcutaneous abdominal fat, which is located just under the skin, as well as an increase in visceral fat, which is the fat nestled around the abdominal organs.²

Common causes

There are several factors that can cause an increase in cortisol levels, which may lead to cortisol belly.³

• Disrupted sleep. Poor sleep quality or an irregular sleep schedule can interfere with your body’s natural cortisol rhythm, making it harder for your body to manage stress effectively.

• Emotional distress. Dealing with past trauma, PTSD, anxiety or depression over an extended time is another culprit that can keep cortisol elevated, affecting both your mental and physical health.

• Excessive caffeine or alcohol. Overdoing it on alcohol or caffeine through coffee or energy drinks can also disrupt your body’s natural stress response and push your cortisol levels higher than usual.

• Ongoing stress. If you find yourself maintaining high levels of regular tension from work, relationships, your health or other stressors, it can keep your body in a constant heightened state and push your cortisol levels high.

• Overexercising. While exercise acts as a way for your body to practice handling cortisol, overdoing it with excessive cardio or regular high-intensity workouts without adequate recovery can also cause cortisol levels to stay elevated.

• Prolonged use of steroid medications. Certain steroid medications, such as prednisone, can raise cortisol levels, which may lead to side effects like weight gain, mood swings and elevated blood pressure.

• Sedentary lifestyle. Exercise is a natural way to regulate your cortisol levels, so a sedentary lifestyle that lacks regular physical activity can cause an increase in your body’s cortisol levels in reaction to everyday stressors.

• Underlying health conditions. Medical conditions like Cushing’s syndrome, adrenal gland disorders or thyroid issues can lead to abnormally high cortisol levels regardless of the level of stress in your life.

• Unhealthy diet. Diets that are regularly high in sugar, caffeine and processed foods can lead to inflammation and spike cortisol, throwing off your hormonal balance.

Cortisol belly vs. other types of fat 

Cortisol weight gain usually differs from other weight gain in its location and underlying cause.²

While overall weight gain might include an accumulation of fat throughout the body, including the stomach, arms, face, thighs and buttocks, cortisol weight gain is primarily focused just in the abdominal region.¹

The cause of weight gain also differs with cortisol belly. Weight gain due to cortisol belly may occur even if you have been exercising regularly and maintaining a balanced diet, although these two elements of a healthy lifestyle often also suffer during stressful periods.¹ 

Tips to Treat and Prevent Cortisol Belly 

If you are looking to prevent or treat cortisol belly, your aim should be to pinpoint the potential cause and then implement steps and strategies to reduce your risks.

1. Manage stress

If your elevated cortisol is due to stress, there are a variety of tools you can try to implement. From meditation or yoga to trying a new hobby, exploring the benefits of therapy or just grabbing coffee with a favorite friend, you can try out stress-busting strategies to increase your inner calm and decrease your cortisol production. Keep in mind it may take some time to find which strategies work best for you.³

2. Prioritize quality sleep

If you usually treat a good night’s sleep as an afterthought, take active steps to improve your sleep hygiene and prioritize getting quality rest. Turn off screens at least an hour before bedtime and consider developing an evening ritual to help signal to your body that it’s time for sleep. Keep your room dark and cool, and consider a white noise machine or earplugs if outside noise or a noisy bed partner are preventing you from getting quality shuteye.¹

3. Reassess your diet

Moving toward a balanced, anti-inflammatory diet can help cortisol levels in two ways. First, limiting processed foods can help to decrease cortisol spikes, and second, when cortisol levels are under control, you will be less likely to crave sugary and fatty foods. Keep yourself satiated with nutrition that focuses on whole foods, lean proteins, healthy fats and plenty of fiber such as a Mediterranean-style diet.⁴

4. Consider supplements

Certain key nutrients can help your body manage stress and keep cortisol levels from spiking. If you aren’t able to get adequate levels from your diet alone, you may want to consider adding nutritional supplements such as magnesium, vitamin B, omega-3s or probiotics.⁵ Check with your healthcare provider before starting any supplements.

5. Regular, but moderate, physical activity

Exercise is a double-edged sword when it comes to cortisol. Don’t move enough, and cortisol can increase, but exercise too aggressively, and that can cause cortisol to spike too. The goal is to aim for what is called a “zone 2” heart rate. Zone 2 is characterized by moderate-intensity effort or roughly 60 to 70% of your maximum heart rate. This sweet spot of exercise intensity relies on aerobic metabolism, which uses fat as fuel and has been shown to help your body reduce cortisol levels and regulate blood sugar.⁶

Activities like brisk walking, cycling and rowing can all be adapted to help you settle into a zone 2 intensity. A fitness watch or tracker can help you learn to gauge what zone 2 feels like for you.⁶

6. Limit caffeine and alcohol

While caffeine and alcohol on their own can cause cortisol levels to increase, they can also be found in beverages like sodas, sugary coffee drinks or cocktails that also pack in extra calories. Cutting back will help you to limit empty calories and prevent unwanted cortisol spikes.¹

7. Manage underlying health issues 

If your cortisol belly is due to a medical condition like Cushing’s syndrome or long-term steroid medication use, talk with your doctor about treatment options. Oftentimes, a multi-tiered treatment plan will be needed that may include medication, lifestyle changes and in some cases surgery. Talk with an endocrinologist or your primary care doctor to explore options and create a treatment plan to meet your needs.⁷

The Science: How Does Cortisol Cause Belly Fat? 

So, how does high stress cause cortisol to increase the accumulation of belly fat? Let’s explore the science of stress.

How stress triggers cortisol release 

Cortisol itself is not bad, and in fact serves a vital function in the body’s response to stress. During a stressful event, the hypothalamus and pituitary gland in the brain signal the adrenal glands to release cortisol. This hormonal response is part of the body’s fight-or-flight mechanism, increasing energy availability and priming the body to effectively manage perceived threats.⁵

How high cortisol levels lead to belly fat

However, when your body is regularly experiencing high levels of stress, elevated levels of cortisol in your body impact abdominal weight gain in a variety of ways.⁵

• Increased appetite. Chronic stress can boost cravings for sugary, fatty foods.

• Insulin resistance. Long-term high cortisol may impair insulin function, causing higher blood sugar and more fat storage.

• Muscle breakdown. High cortisol can break down muscle for energy, lowering your metabolism and making it easier to gain fat.

• Poor sleep. Stress-related sleep problems can raise cortisol even more, reducing energy and increasing mindless snacking.

Together, these elements create a snowball effect of abdominal weight gain.

Common Signs and Symptoms of High Cortisol

When cortisol levels stay high for too long, your body may begin to signal that something’s off. The specific signs of elevated cortisol levels can vary, whether it is due to stress or an underlying medical condition:³

High cortisol from stress

Systemic stress due to poor sleep, diet or recurring emotional or physical pain can cause elevated cortisol levels, leading to a variety of symptoms:¹

• Abdominal weight gain

• Anxiety

• Irritability

• Fatigue

• Sleep issues

• Sugar cravings

High cortisol from hypercortisolism

Hypercortisolism, a condition where the body produces an excess of cortisol, is a medical condition often caused by a tumor in the pituitary or adrenal glands called Cushing’s syndrome. It can also occur with the long-term use of steroids. Symptoms of high cortisol due to hypercortisolism can differ compared to symptoms due to stress and include:¹

• Easy bruising

• Fat accumulation on the back of the neck between the shoulder blades

• High blood pressure

• High blood sugar

• Muscle weakness

• Puffy face known as “moon face”

• Purple stretch marks

• Rapid weight gain (often in the face or torso)

• Thinning skin

If you notice that you are experiencing one or more of these signs of high cortisol due to stress or hypercortisolism, you may be at a higher risk of developing cortisol belly.

When to See a Doctor 

To help understand the root causes of your cortisol belly, it may be helpful to see a medical professional. It might be time to see a doctor if:⁸

• Persistent symptoms of high cortisol significantly impact your daily life.

• You are experiencing symptoms in addition to cortisol belly, like a puffy face, muscle weakness and bruising, which could indicate Cushing’s syndrome.

• You’re on long-term steroid medication.

• You’ve tried lifestyle changes to improve your stress, diet and sleep, but your symptoms haven’t improved after a few months.

Tests for high cortisol

Testing for excessive cortisol offers challenges since cortisol levels naturally vary throughout the day. Doctors may use different types of tests or multiple tests in order to diagnose, including:⁹

• Blood tests

• MRI imaging, if Cushing’s syndrome is suspected

• Salivary tests

• Urine tests

Treatment options

Depending on the findings, your doctor may recommend a variety of treatment options to address your cortisol belly. Stress reduction and lifestyle changes to diet, exercise and sleep are commonly recommended.¹ 

If your cortisol belly is due to Cushing’s syndrome, your doctor may discuss additional treatment steps including:⁹

• Bilateral adrenalectomy (BLA) or removal of the adrenal glands

• Medications to inhibit the adrenal gland’s production of cortisol

• Radiation to shrink the tumor from the adrenal or pituitary gland when surgery is not an option

• Surgery to remove a tumor from the adrenal or pituitary gland

Next Steps for Dealing With Cortisol Belly  

If you’re tired of dealing with cortisol belly, now is the time to take steps to address it. Try implementing stress reduction and lifestyle changes to reduce cortisol levels. Consider using a habit tracker app or enlist a friend to help hold you accountable. If those methods haven’t worked or you’re concerned your symptoms may indicate Cushing’s syndrome, contact a medical professional for testing and analysis.

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Author Bio

Kate Bayless is a health and wellness freelance writer with 15 years of experience. Her work has appeared in Parents, Women’s Health, Beachbody and OpenFit.