Is Obesity Causing Us Stress or Is Stress Causing Obesity?

Sad Young Man on a Train“We have found a way to soothe the pain of living in this society by stimulating the reward pathway with unhealthy foods just as people do with alcohol and drugs.” This blunt obserservation landed in our inbox with a thud from obesity scientist and clinician Caroline Apovian last week. A counterbalance to the optimistic talk about eliminating the health impact of obesity, her words suggest progress might not be possible without addressing the toxic combination of lives filled with stress and a food supply tailored to soothe it.

Stressful, Lonely Lives

Stress has been rising in the U.S. for the last three decades in parallel with obesity. This is a trend that Gallup tells us is prevalent around the world. The organization has been tracking negative emotional experiences since 2006 – stress, worry, pain, anger, and sadness. The composite of these measures has been rising steadily since 2011 and remained at a record high in 2022.

Likewise, loneliness has risen worldwide, especially during the COVID pandemic and especially among younger adults. Though we have seen some relief in the time after COVID vaccination permitted less isolation, loneliness remains relatively high for young persons. Surgeon General Vivek Murthy tells us this remains a serious concern for our health:

“Most of us probably think of loneliness as just a bad feeling. It turns out that loneliness has far greater implications for our health when we struggle with a sense of social disconnection, being lonely or isolated.”

Food to Soothe

One of the unhealthy responses to elevated stress and loneliness is to reach for comfort foods. The definition for these foods is a bit slippery. But they often overlap with another ubiquitous and elusive-to-define category, ultra-processed foods.

Regardless, neuroscience is beginning to help us understand a phenomenon that clinicians have recognized for decades – stress eating of these so-called comfort foods. Taking on the identity of a comfort food is, franky, desirable for the marketing of ultra-processed foods. It’s helpful to a brand if consumers associate it with comfort and good feelings. Mothers produced comfort foods long before ultra-processed food was a hot topic.

Social Determinants, Poorly Understood

At this intersection of stress eating, ultra-processed food, and stressful, lonely lives, we cannot avoid yet another buzz word – social determinants of health. We know that many of these factors correlate and that social and economic factors are also important correlates for these trends in the population.

Clearly, stress can be a trigger for obesity, as much as obesity causes stress. Ubiquitous, pleasing, and comforting ultra-processed foods can contribute. Social and economic factors seem to put a greater burden of stress on some people, putting them at risk for obesity and other health issues.

But the interplay of this complex web of contributors is daunting to untangle. What is not so hard to see is that we need to find a pathway from stressful and lonely lives to lives that are more rewarding.

This is a social challenge with big implications for health. It may be daunting, but taking it on is surely worthwhile.

For further perspective on this challenge, click here, here, and here.

Sad Young Man on a Train, painting by Marcel Duchamp / WikiArt

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December 31, 2023