Dr. Wall Says

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Eating clean, working out and still not losing weight?


I was talking to a member of the gym who was frustrated that their efforts both physical and dietary were yielding little to no results in terms of body fat loss. Their diet is dialed in, their exercise regimen is demanding, but not excessive, and they are in a body fat bracket that is still high enough that changes should come relatively easily, so why are they not losing fat? My very educated, and strongly supported opinion… STRESS!

This scenario is not uncommon among some of our longer term athletes, the ones who have already reaped the benefits of initial lifestyle changes, and have a good handle on diet. Yet, I swear most of the time when I mention stress I get a quick and dismissive response. Usually, it comes with an acknowledgement that life is stressful, that they should be getting more sleep and making personal changes or doing something differently, but really what they want to know is what can they do with their diet or exercise programming to get things moving along. I think this occurs because the link between stress and weight gain has been tossed around quite a bit, but most people don’t understand it well. Luckily for them and me, there are several people who have written very eloquently on the topic (they are referenced at the end of this post). But since most of us are busy and may only have the time to read one or two posts today here is the low down on stress and fat.

Running from a mountain lion is preferable to worrying about bills.

  • The stress response is designed to address acute physical and environmental threats. When the body senses a threat (such as a predator) it secretes:
    1. adrenaline to give you a quick boost of energy (so you can escape or fend off the threat)
    2. corticotropin releasing hormone (CRH) which reduces your appetite (no one needs to feel hungry while out running a predator), immediately improves memory and attention (so you can remember how to avoid said threat in the future) and drives the release of cortisol.
    3. cortisol’s intended function is to help the body recover after an acute stress by increasing appetite, helping regulate the body’s use of macronutrients, which in this case means that it encourages the consumption of carbohydrates and helps metabolize them into fat. This response is excellent in the face of short term acute stressors and makes tons of sense.
  • You are not running away from a mountain lion – you are seated 10 hours a day and your stress comes from bills, a screaming two year old, or trying to make sense of why you didn’t get invited to the that party your friend posted about on Facebook.This means, that you are not using the rush of adrenaline to run or fight, instead it’s just coursing through your body making you feel jittery and on edge. You’re not eating regularly because of the CHR, but when you do get hungry, you are starving and it’s never the healthy stuff you crave. Your body doesn’t really need to recoup through increased carbohydrate intakes and fat storage, but it still goes through the motions, which means you crave foods that are high in simple carbs and fat, and you efficiently store that fat (mostly around your abdominal area), instead of burning it off.
  • Your stress is chronic: and that means that the effect of cortisol are prolonged.  What  does a long term excess of cortisol really do? It slows the production of testosterone which eventually leads to decreased muscle mass. It triggers appetite and  increases blood sugar availability, which then increases insulin production, which overtime can cause insulin resistance. It inhibits the body from burning fat for energy and promotes fat accumulation. And finally it can damage serotonin sites, which means you tend to feel down and in the dumps.​

Ben & Jerry are not your therapists!

  • Biomechanics coupled with learned behaviors is only compounding the problem. That is right folks, despite the fact that under stress your body is clamoring for simple carbs, stuffing your face with a box of your local “gourmet” doughnuts is not the solution. Yet, we are raised to use food as medicine, and the combination of physical drives and learned behaviors makes the impact of our stress response even more problematic.
  • In addition to leading to weight gain and, under stress, a build-up of visceral fat (which is associated with cardiovascular diseases and diabetes) ingesting a bunch of carbs also leads to a spike in dopamine, natural occurring opioids and serotonin. Overtime, the excess levels of these neurotransmitters leads to a down regulation of their receptors, which means that you become less sensitive to them and require higher levels to create an equal response. In simpler terms, this means that initially when you eat all those yummy simple carbs you feel happier, more at peace, but overtime you are forcing your body to adjust to your binging. You then need to eat even more sugary, crunchy, doughy crack to get the same feel good experience. Long term this leads to increased depression, anxiety and insomnia (see Robb Wolf’s links for a more scientific and elaborate description of this process).
  • What is good therapy? Dealing directly with the stressors you face by problem solving, getting enough rest, getting enough sleep, getting enough exercise (but nothing too strenuous since that might lead to more stress), eating healthy satisfying food that will help your body repair itself. Check out these links herehere and here for more tips.

So how about our healthy athlete?

  1. If you are stressed the response in your body is still the same, which means that you will not burn fat efficiently, actually you will hold on to it, and you will find yourself craving foods that may not be helpful to you. You are also likely to feel fairly tired, down and spent much of the time.
  2. Chances are in this state of pain with no gain you have decided that the solution is to double up on your efforts and work out more while adopting drastic dietary measures. This will not work. If you are exercising too strenuously or too frequently without proper recovery you are stressing your body, see item (1) in this section for effects. The same goes for dieting, a few studies have shown that people (in these studies women) who were on strict diets had higher cortisol levels and made less gains than women with more reasonable eating patterns. So feed your body smartly, and if you know that what you are doing is appropriate for your fitness and daily functioning needs don’t tighten things up too much.
  3. What you can do… SLEEP MORE, don’t drink coffee in response to fatigue it will only increase your cortisol levels, unplug and go off grid a bit, get some real down time, figure out where your stress is coming from and do as much about it as you can, engage in more active recovery. If you don’t believe me, read all the links below, maybe the advice of other experts will convince you.


Women’s Healthy Magazine

Hi Five Baby – a pretty nice list of to dos and tips for losing weight and self care as a new parent.

Mark’s Daily Apple:

Robb Wolf:

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Hi! I'm Dr. Alessandra Wall

I help smart driven women and forward-thinking companies bridge the gap & build real conversations.

Here on the ‘Dr. Wall Says’, I share tools, tips, and insights about speaking up, getting heard and how women can take up space and thrive in the 21st century.



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