This content is not medical advice and is provided for informational purposes only.
Many of you have been talking to me lately about cortisol and weight gain. So let’s talk about it.
What Is Cortisol?
Cortisol is a hormone produced by your body by small glands located above your kidneys (the adrenal glands) (1).
What Is the Role of Cortisol?
Cortisol helps regulate your energy levels. Its secretion follows a natural daily rhythm (circadian rhythm): it increases in the morning upon waking to help provide energy and wakefulness, then gradually decreases throughout the day, reaching its lowest level in the evening to support sleep (2).
Cortisol also helps regulate your body’s stress response, blood sugar levels (glycemia), inflammation, and blood pressure (1).
How Cortisol Is Regulated in the Body
The body has a well-organized system to regulate cortisol.
The brain (the hypothalamus and pituitary gland) controls cortisol production by the adrenal glands (3).
In cases of acute (short-term) stress, cortisol levels can temporarily increase to support alertness and energy. Once the stress has passed, cortisol levels typically return to balance.
How This Mechanism Works (3)
When the body needs to adjust cortisol levels:
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The hypothalamus (a region of the brain) releases a hormone called CRH.
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CRH sends a signal to the pituitary gland, a small gland located at the base of the brain.
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The pituitary gland releases another hormone called ACTH.
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ACTH stimulates the adrenal glands, which then produce and release cortisol.
To maintain balanced cortisol levels, the brain and adrenal glands must function properly together.
In some cases, cortisol secretion can become unbalanced.
As discussed, if stress increases cortisol during the day, under normal conditions, cortisol decreases once the stress passes. However, with constant, repeated, and chronic stress (4), some individuals may experience dysregulation of the cortisol rhythm (3).
Possible Effects of Long-Term Cortisol Dysregulation
When cortisol secretion becomes unbalanced over time, it may potentially have negative effects on the body, including (2):
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Weight gain (promoting fat storage, particularly in the abdominal area)
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Sleep difficulties
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Mood changes (anxiety, depressive mood)
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Reduced bone strength
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Headaches, digestive issues, concentration or memory difficulties, and possible impact on heart health (3)
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Menstrual cycle imbalance and more intense PMS symptoms (4)
This does not necessarily mean the body produces too much cortisol. Instead, it suggests that the regulation of cortisol secretion — the body’s “ON/OFF” switch — is not functioning optimally.
Cortisol and Weight
When cortisol secretion is dysregulated, it can promote weight gain, especially around the abdomen.
The body may store more fat, metabolism may slow down, and insulin sensitivity may decrease (meaning the body has more difficulty using blood sugar). This can lead to blood sugar fluctuations, sugar cravings, and increased visceral fat accumulation.
Cortisol can also influence hunger hormones, making appetite control and maintaining a healthy weight more challenging.
Differentiating Medical Conditions from Cortisol Dysregulation
There are medical conditions that can cause excessive or insufficient cortisol levels, independent of chronic stress (4).
In these cases, it is not simply stress-related dysregulation but an actual medical condition diagnosed by a healthcare professional that alters normal cortisol production.
Excess Cortisol: Cushing Syndrome (4)
Causes may include:
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Hormonal issues related to the pituitary gland
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Problems affecting the adrenal glands
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Certain medications
Associated symptoms may include:
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Abdominal weight gain
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Elevated blood sugar levels
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High blood pressure
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Osteoporosis
Cortisol Deficiency: Addison’s Disease or Hypopituitarism (4)
Possible causes include:
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Addison’s disease
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Underactive pituitary gland
Associated symptoms may include:
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Unintentional weight loss
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Fatigue
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Loss of appetite
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Low blood pressure
How Do You Know?
If your doctor suspects a condition such as Cushing syndrome or Addison’s disease, specific medical tests will be prescribed to confirm the diagnosis. These conditions require medical monitoring and appropriate treatment and are not simply related to daily stress management.
How to Support Natural Cortisol Regulation
If your healthcare provider indicates that your cortisol levels are elevated or dysregulated, but not linked to a medical condition, it may be possible to help your body restore its natural rhythm.
These recommendations are not new, and you may already be familiar with them, but they are essential to implement consistently in daily life (3)(4).
Prioritize Quality Sleep
Aim for 7 to 9 hours of sleep per night.
Move Daily
Engage in at least 30 minutes of moderate physical activity each day.
Stimulate the Parasympathetic Nervous System
Practice deep breathing, laughter, spending time in nature, and taking time for yourself.
Optimize Nutrition
Eat enough to maintain energy throughout the day, space meals regularly, and choose nutrient-dense foods (fruits, vegetables, protein, fiber, etc.).
Address Sources of Stress
Seek psychological support if needed and maintain healthy personal and professional relationships (4).
Supplements
Certain supplements may sometimes help support cortisol regulation. Always consult a healthcare professional (pharmacist, physician, or dietitian/nutritionist) before taking supplements (5).
Conclusion
Cortisol is an essential hormone that supports you throughout the day. It is not the enemy of your weight or energy.
Often, the issue stems from cortisol dysregulation rather than a true medical condition.
Before concluding that your cortisol is “too high” and responsible for fatigue or weight gain, it is important to:
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Consult your physician to rule out serious medical causes.
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Meet with a dietitian to identify potential lifestyle influences.
References
Cleveland Clinic. (2025, February 17). Cortisol. Cleveland Clinic.
https://my.clevelandclinic.org/health/articles/22187-cortisol
Torrance Memorial. (2024, December 10). Cortisol and your waistline: The unseen battle. Torrance Memorial.
https://www.torrancememorial.org/healthy-living/blog/cortisol-and-your-waistline-the-unseen-battle/
WebMD. (2022, December 13). Cortisol: What it does & how to regulate cortisol levels. WebMD.
https://www.webmd.com/a-to-z-guides/what-is-cortisol
Familiprix. (2025, January 16). Cortisol: L’hormone du stress. Familiprix.
https://www.familiprix.com/fr/articles/cortisol-l-hormone-du-stress
Yetman, D. (2024, June 6). What’s the difference between Addison’s disease and Cushing syndrome? Healthline.
https://www.healthline.com/health/addisons-disease-vs-cushings
Loria, R. (2016). Physiology, cortisol. In StatPearls. PubMed.
https://pubmed.ncbi.nlm.nih.gov/27055824/