Researchers in 1997 made a groundbreaking discovery. They found that people who had experienced childhood trauma, were 46% more likely to develop obesity, and and those who experienced 4 or more types of abuse were up to twice as likely to develop diabetes. And that got me super curious- what is the connection between trauma, weight gain and diabetes?
Trauma and Stress Trigger Weight Gain and Diabetes
So let me back up a little, in the 1980’s Dr. Vincent Felitti was leading an obesity clinic for Kaiser Permanente in San Diego. He observed a strange phenomenon: many patients who successfully lost weight quickly regained it. Some even dropped out of the program despite their success.
Curious, Dr. Felitti’s team started interviewing patients to understand why they regained the weight, and a pattern arose. Most of their patients who were morbidly obese had been sexually abused in childhood.
Now initially the doctors hypothesized that gaining or regaining weight was a psychological issue, perhaps a subconscious way to avoid unwanted attention, or protect in case of an attack, because carrying around that weight seemed to provide a barrier to future abuse.
But, while some patients said they felt safer with the weight back on, it turned out that childhood trauma turns a biological switch that contributes to weight gain. I’ll get to that in a minute.
The CDC and Dr. Felitti knew they had to explore the impact of trauma on people’s health, so they did another study exploring Adverse Childhood Experiences, ACEs, which include experiencing or witnessing abuse, neglect or family dysfunction.
And the results were groundbreaking. I’ve got a much longer video on the topic, but basically, childhood trauma drastically increases people’s risk of substance abuse, heart disease, cancer, mental health conditions, and obesity and diabetes.
And while there are clearly psychological and behavioral reasons for overeating, there is actually a fundamental biological reason why trauma and chronic stress lead to weight gain, so today we’re going to explore the stress-cortisol-weight gain triangle, and some strategies to manage it.
Disclaimer
OK, first caveat- I’m not a medical doctor. Always work with your doctor when making changes to your physical health. I’m a therapist. I specialize in anxiety and trauma treatment, and if you’d like to learn more about the psychological approach to managing trauma, I take a holistic approach to that, and I’ve got a trauma recovery playlist that I’ll link below.
Second, weight is not a moral issue. There’s nothing about your weight to be ashamed of. But if you choose to work toward overall health, understanding how chronic stress impacts that can be helpful.
Explanation: The Stress Cycle
OK, so why are people who experienced more trauma in their childhood more likely to develop diabetes and obesity?
One of the lasting impacts of trauma is that it damages our brain’s ability to regulate stress. So let’s talk about the stress cycle, and we’ll come back to how that impacts insulin and weight gain.
Here’s how a healthy nervous system deals with stress. Maybe you’re walking through a campground at night, and suddenly you hear rustling in the bushes and you think “What if it’s a bear?!” Your body releases a huge surge of adrenaline and cortisol, (more on this later) this preps your body to fight it off or run away. So you’re buzzing with stress hormones. But suddenly your best friend jumps out at you, yells “Boo!” you jump about ten feet high, recognize it’s him, realize you’re safe and your body turns on a different response- the parasympathetic or rest and digest response… You feel a surge of relief, you laugh it off, maybe you shake a little, but the stress melts away. This is how your body is supposed to work through stressors. The FFF response primes you to take some big physical action, then you do, and when you’re safe, it removes all those stress hormones from your body and you can relax.
But, when someone experiences repeated trauma or chronic stress, their nervous system’s fight/flight/freeze response gets stuck “on”.
Whether that’s answering work emails 24/7, reading the news day and night, or getting triggered by past trauma, your body perceives those emails as a threat to your employment, the news as an immediate threat to your safety, and those PTSD triggers as a threat to your survival. And those can kick on the stress response, and then your adrenal glands pump out a bunch of cortisol and adrenaline. But then if we don’t develop a way to resolve that stress, those stress hormones keep floating around in our body.
And guess what those stress hormones do over the long run.
- Cortisol increases blood sugar levels by promoting gluconeogenesis (the production of glucose from non-carbohydrate sources) in the liver. This provides immediate energy to handle stress but can lead to high blood sugar levels over time if stress is chronic.
- Because your body needs energy to run away from that bear, Cortisol stimulates appetite, increasing cravings for high-calorie, sugary, and fatty foods.
- Constantly producing blood sugar can cause insulin resistance, meaning cells become less responsive to insulin. This resistance forces the pancreas to produce more insulin to manage blood sugar levels, potentially leading to higher overall insulin levels and an increased risk of type 2 diabetes.
- Chronic elevated cortisol levels can lead to weight gain, particularly around the abdomen. This is because cortisol promotes the storage of fat in the visceral area (around internal organs), which is associated with various health risks such as cardiovascular disease and metabolic syndrome.
So basically, Stress releases Cortisol which increases blood sugar and stimulates appetite. And when that stress response is stuck on, that can lead to weight gain, insulin resistance and diabetes if the stress is chronic.
Now what if that stress response has been stuck in the “on” position since childhood? If we take a look at the trauma side of this, childhood trauma can dysregulate the stress centers in the brain. A child who experiences multiple ACEs will be on constant high alert, making it more likely that the stress response rarely gets turned off. These kids have seen the bear multiple times, and it could be coming for them at any given moment. And this is why the ACEs study showed such drastic impacts on obesity and diabetes for people with repeated childhood trauma.
Therapy
Stress isn’t inherently bad, the stress response can help us take action to avoid danger, fight off threats, and actually be more productive at times. But the problem is when we don’t have the tools to turn off that stress response and return to a state of relaxation, the parasympathetic state. You can learn the skills to regulate your stress response, even in stressful environments or if you have trauma.
So how can we learn to regulate the stress response?
- Identify that you are feeling stress in your body- Many of us are so busy that we aren’t even aware that we’re stressed out until we feel exhausted at the end of the day, so I recommend that you use an app tlo check in with yourself. When you get the reminder alert, check in with yourself. Is your breath shallow? Are you clenching your teeth? Are your shoulders tense?
- Learn to close the stress cycle, Learn to turn on the parasympathetic response– even when you’re busy this is the key to healing the traumatized nervous system. I go into a lot of detail in my 30 Day anxiety course, but here’s some things you can practice now:
- Breathing
- Yawning
- Stretching
- Laughing
3. Develop habitual strategies for relaxation and play
4. Develop intentional strategies to manage stressors
- if you’re drowning in emails, you can learn how to set healthy boundaries- for example, you could communicate to co-workers that you don’t check emails after work or on weekends and that you will check them in two time-windows during the day.
- Learn the skills to relate to your past, to your internal pain, with compassion and flexibility (therapy can be great here)
- Practice accepting what you cannot change- have a practical strategy to do so. I like the locus of control activity.
Summary
You really can learn to regulate your nervous system. You can learn to not just cope with stress or trauma, but actually resolve it.
You’ll see that for each of these skills, I have videos that teach you how to do it. And if you’d like to learn more on how to regulate your nervous system, I’ve got a free online course called ”Grounding skills for stress, anxiety and PTSD” that will walk you through it.
Spend time with Emma in a live webinar every month, as well as get access to all her courses by joining the Therapy in a Nutshell Membership.
Click below.
