What is the connection between food cravings specially carb cravings, weight gain and cortisol?
I see a lot of my patients’ who complaint that they get food cravings on and off when they really feel like they need to eat carbs. They often end up binging during these episodes. These cravings are a major barrier for those who are trying to control their calorie intake and lose weight. I will discuss a case and the underlying causes that lead to these cravings. Below is a common scenario that will help us understand the connection between food cravings, weight gain and cortisol
A 35 year old female experienced food cravings during the evening and night times. She was progressively gaining weight especially around her belly. She was under a lot of stress due to family issues and work. She also had complaints of brain fog and fatigue. It took her more than 30 minutes to fall asleep and often woke up in the middle of the night.
In order to understand the root cause of this patient's problem, we need to understand how the hormone Cortisol works.
Cortisol is an essential hormone that is released by the adrenal glands. It is responsible for helping our bodies deal with stress through its action on multiple systems. It promotes the formation of glucose in the liver as well as break down of protein to release amino acids that can be used for forming glucose. It also impacts the immune system, the sleep-wake cycle, bone formation, electrolyte and water excretion, memory and mood. This hormone has a particular rhythm called the circadian rhythm that it follows to regulate the different functions of the body. The highest level of Cortisol is in the morning and the lowest is at night time.
Individuals who are undergoing a lot of stress or have an inflammatory condition are likely to release a lot of cortisol that can adversely affect the circadian rhythm. Excessive cortisol and abnormal cortisol rhythm is associated with food cravings including cravings for carbs and fatty foods. In addition these individuals have also been found to have symptoms of insomnia, weight gain especially around the belly area and muscle wasting. A prolonged period of cortisol exposure leads to suppression of the immune system with increase in allergies and infections. Cortisol also affects the function of thyroid gland including the conversion of the inactive thyroid hormone T4 to the active thyroid hormone T3. Women can have issues with infertility and men will have decreased libido from excess cortisol due to inability to form progesterone and testosterone respectively. Insulin resistance, Metabolic Syndrome, obesity, polycystic ovary disease, Diabetes and high blood pressure are associated with excess cortisol production.
The cause of our patient's food cravings was found to be an abnormal cortisol rhythm. In addition, her insulin and HBA1C (marker of diabetes) levels were also high possibly from the high cortisol level. The most important part of this case was to determine the root cause of abnormal cortisol. She had a lot of bowel issues including an overgrowth of bacteria in her small intestine which was the main source of inflammation causing the high cortisol. Her insomnia was related to high cortisol at night. Her fatigue was due to the decrease in active T3 from the high cortisol. Her brain fog was due to alteration of cortisol and insulin levels.
The first step in understanding your food craving is to keep a weekly diet diary where you can identify when and how often you get food cravings. The second step is completion of the Medical Symptoms Questionnaire which provides you with an overview of all other symptoms that can be part of the problem too. The third is evaluation of the cortisol rhythm, insulin and blood sugar levels followed by a root cause analysis of the problem.