The Cortisol Weight-Loss Controversy

a woman poking a man's belly

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Something is making Americans fat. And in recent years, they are spending $72 billion a year on weight loss. According to a spate of television ads, the latest villain in the battle of the bulge isn’t one of the usual suspects, like fast food, a sedentary lifestyle or the much-maligned “carb.” No, the culprit is a hormone called cortisol.

What Cortisol Is

Cortisol is a hormone, produced by the adrenal gland when the body is under stress. Your hypothalamus, via the pituitary gland, directs the adrenal glands to secrete both cortisol and adrenaline.

Cortisol is released as part of your daily hormonal cycle, but both hormones can also be released in reaction to perceived stress — both physical and emotional — as part of the body’s fight-or-flight response that is essential for survival.

Adrenaline makes you energetic and alert and increases metabolism. It also helps fat cells to release energy. Cortisol helps your body become even more effective at producing glucose from proteins, and is designed to help quickly increase the body’s energy in times of stress.

It’s not the classic fight-or-flight stress that’s thought to cause weight problems, because in those situations, a stressful event is quickly resolved, and the cortisol released is absorbed into our systems, aided by the increased circulation provided by a pounding heart.

The Effects of Excess Cortisol

Instead, some experts now believe that the problem for many of us is being in a constant state of stress, for various reasons. This leads to a constant state of excess cortisol production. Excess cortisol stimulates glucose production. This excess glucose then typically is converted into fat, ending up as stored fat.

There are a number of research studies that have shown that fat cells can, in the presence of too much adrenaline, become resistant to the effects of adrenaline. Eventually, the fat cells become unresponsive to adrenal stimulation to release fat, but through the presence of high cortisol, they’re more responsive to fat storage.

At the same time, high levels of circulating cortisol increase the risk of obesity and increased fat storage — and particularly, abdominal obesity, one of the most dangerous types of obesity, and one that contributes to an increased risk of metabolic syndrome, diabetes, and heart disease.

Imbalances in Cortisol Levels

One factor we know can cause imbalances in cortisol is the overconsumption of simple carbohydrates. When you have eaten a concentration of simple carbohydrates—a snack of a candy bar and/or a soda, for example—the body generates a strong insulin response, to prevent excess blood sugar.

This large insulin response, in turn, can trigger a dramatic drop in blood sugar—sometimes to levels that are even too low—in the 3 to 5 hours after the simple carbohydrate was eaten.

When blood glucose levels fall, this triggers a surge of adrenal stress hormones, including adrenaline and cortisol. (Sometimes, this can cause nervousness, anxiety, irritability and even palpitations. This is the phenomenon observed in some children when they’ve had “too much sugar.”)

The same up and down pattern of insulin, glucose and adrenal stress hormone levels either doesn’t happen at all, or is severely blunted, after eating a complex carbohydrate, proteins, fats, a balanced meal that includes fats, proteins, and fiber alongside the carbohydrates, because the processes of digestion and absorption are slowed down. Over time, higher blood glucose levels can occur for a number of reasons:

  • Consumption of too many carbohydrates, especially simple, refined carbohydrates
  • Eating too many calories, so those excess calories are being stored as fat and then released as glucose
  • Very high stress levels are stimulating cortisol production
  • Other dysfunctions in the metabolic and hormonal systems

What Insulin Resistance Is

What can happen then is something known as “insulin resistance.” In insulin resistance, the brain and some of the body’s cells fail to react to the presence of insulin in the bloodstream.

It may be the start of actual diabetes, but is not as severe as diabetes, where the cells cannot secrete enough insulin to maintain safe blood sugar levels. Instead, insulin levels may actually be high, and the pancreas continues to pump out, even more, insulin in an attempt to store the glucose left in the blood. But the cells cannot react to the insulin that is released, and the glucose continues to circulate in the bloodstream. Then, when you eat, glucose levels rise even higher.

After a period of time, the overworked pancreas begins to tire and may lose its ability to produce enough insulin, leading to Type 2 diabetes. Insulin resistance is, in fact, sometimes called pre-diabetes, because it often leads to Type 2 diabetes.

The high levels of insulin circulating through the bloodstream also stimulate the storage of fat and amino acids and prevent the breakdown of fat and protein. It also prevents the release of glucagon.

The fat cells in your abdomen are particularly sensitive to high insulin and are very effective at storing energy—far more so that fat cells you’d find in other areas such as the lower body (i.e. hips, rear end, thighs).

Because abdominal fat cells are so close to your digestive organs, and there is an extensive network of blood vessels circulating in the abdominal area, it’s even easier for fat cells to store excess glucose there.

Insulin Resistance Is Reversible

Insulin resistance—and Type 2 diabetes—is a reversible condition. Exercise, a reduction in simple carbohydrates, and a reduction in calories can all help to reduce insulin levels.

Exercise helps cells respond more effectively to insulin—which then helps reduce the excess glucose in the bloodstream before it is stored as fat.

Fewer simple carbohydrates reduce the overall circulating blood glucose levels. And avoiding overeating prevents excess calories from all sources from being released into the bloodstream as glucose.

The less glucose, the less insulin, and when insulin levels are low, the body turns to fat reserves for energy and starts to break down large fat molecules into fatty acids for easy energy production. Some supplements, including cinnamon and Glucosol, may also help reduce insulin levels. And prescription drugs such as Glucophage (metformin) can help insulin sensitivity.

Metabolic Syndrome

When insulin resistance is left unchecked, it can progress to a condition known as metabolic syndrome (formerly known as “Syndrome X”). Metabolic syndrome is usually characterized by insulin resistance, plus elevated levels of cholesterol and triglycerides, as well as obesity. Metabolic syndrome puts you at far greater risk of heart disease and stroke.

The official diagnostic criteria for metabolic syndrome include:

  • Abdominal obesity (waist circumference > 40 inches in men, and more than 35 inches in women)
  • Triglyceride levels above 150 mg/dL
  • Low HDL cholesterol levels, of less than 40 mg/dL in men and < 50 mg/dL in women
  • High blood pressure, greater than or equal to 130/85 mm Hg
  • High fasting glucose level, with fasting blood sugar more than 110 mg/dL
  • High blood pressure, greater than or equal to 130/85 mm Hg

Some experts estimate that as many as one in four—or 47 million—adults in the U.S. have metabolic syndrome. These numbers are expected to rise as the population ages.

The CortiSlim Controversy

According to Shawn Talbott, Ph.D. and William Kraemer—the authors of a book "The Cortisol Connection"—stress, and the resulting chronic overload of cortisol make you feel tired and listless. So you overeat to renew your energy and comfort yourself. The result? Accumulated extra inches around the middle.

Based on this theory, Talbott has formulated a costly supplement that is heavily advertised online, in magazines and on cable and network TV. According to the commercials, taking a daily dose of the product—CortiSlim—is supposed to help suppress cortisol levels.

With cortisol under control, you’re supposed to be able to decrease your tendency to store fat and lose unwanted weight. (Another heavily advertised product named Relacore claims to perform much the same magic.) Both CortiSlim and Relacore are classified as dietary supplements, which means they are not required to undergo testing or research to back up these claims.

CortiSlim, which typically costs as much as $50 for a one-month 60-capsule supply, contains common ingredients, including Vitamin C, calcium, chromium, along with what they claim is a proprietary blend of magnolia bark extract, l-theanine, green tea leaf extract, bitter orange peel extract, banaba leaf extract, and vanadium. Relacore, at $50 for 90 capsules, also includes Vitamin C, calcium, B vitamins, magnesium, magnolia bark, plus a variety of flowers and roots, as well as the amino acid phosphatidylserine.

At the same time, green tea leaf extract contains high amounts of caffeine, and bitter orange, also known as synephrine, is a stimulant, much like the now-banned ephedra. While stimulants can sometimes artificially raise metabolism, they can have adverse, sometimes even deadly, effects on dieters, because they can raise the heart rate and blood pressure.

High Cortisol Symptoms May Point to Metabolic Syndrome

Dr. Pamela Peeke, author of "Fight Fat After Forty," is also concerned about taking supplements for high cortisol. Peeke is concerned because the supposed high cortisol symptom of abdominal obesity may actually point to metabolic syndrome—including associated heart problems or high blood pressure—which could go undiagnosed and untreated.

In general, several of the ingredients — such as calcium and phosphatidylserine—have in some studies been shown to have some mild effect on weight, but typically in amounts higher than are contained in these products.

Overall, there is little evidence, except in studies produced by the product’s own makers for use in their advertising, that the CortiSlim formulation can deliver any unique impact on cortisol levels.

In late October of 2004, the Federal Trade Commission also found fault with some of the claims promoted by CortiSlim. It charged the makers, including Shawn Talbott, with false advertising. The FTC told them they must cease and desist advertising that CortiSlim causes weight loss of 10 to 50 pounds or more for virtually all users, that it causes users to lose as much as 4 to 10 pounds per week over multiple weeks, and that it was backed by 15 years of scientific research.

To address the Federal Trade Commission’s concerns, CortiSlim has produced some new television ads. But the truth remains that the supplement likely does little to affect weight loss, and may even pose a health threat if people taking it to overlook and ignore potential signs of heart disease or high blood pressure.

According to an article printed in 2007 ub the Salt Lake City Tribune, Talbott and his associates have made more than $50 million dollars from desperate dieters who bought their product. Some critics have accused Talbott of serious consumer fraud, and of being willing to take a slap on the wrist by the FTC in exchange for a quick buck earned at the expense of unsuspecting customers. So what can you do if you want to reduce cortisol?

Reducing Cortisol

If we accept that chronic stress and elevated cortisol may be factors in weight problems, what can we do, besides plunking down $50 a month for supplements that are questionably effective?

First, focus on becoming stress-resistant. One of the best things to reduce stress and improve insulin sensitivity, for example, is getting regular exercise, even a daily brisk walk.

Second, practice stress-reduction techniques—such as yoga, tai chi, meditation, breathing exercises, anger management therapy, therapeutic massage, listening to calming music, or other similar techniques. These sorts of approaches can help reduce your body’s physiological response to daily stressors.

Third, get enough sleep. In November of 2004, we saw research showing the link between insufficient sleep and weight problems. Chronic sleep deprivation increases stress, reduces the immune system, and make it more likely that you’ll be overweight.

In fact, researchers found that those between the 32 and 59 who slept four hours or less per night were 73 percent more likely to be obese than those who slept between seven and nine hours each night. So snuggle up and get those zzz’s.

And, if you’re determined to at least try the particular mix of supplements you’ll find in CortiSlim or Relacore, keep in mind that you can at least save money. There are other brands that offer the same combination of ingredients in similar quantities, at far less cost. For example, CortiSol Balance is similar to CortiSlim but costs about half the price, and Relora by Source Naturals is similar to Relacore).

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