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Lori is a Nurse Practitioner, Board Certified Health Coach & Creation Coach who specializes in getting to the root cause of your symptoms

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Hormone Health

Heart Health


Cortisol, often dubbed as the stress hormone, plays a vital role in the body’s response to stress. Cortisol is not all bad. In an acute situation, it’s actually quite helpful.

However, when cortisol levels become chronically elevated, it can lead to a myriad of health issues, including, as I mentioned in last week’s blog, the dreaded and notorious “cortisol belly.” With summer and swimsuits around the corner, I thought it’s time that we delve into the causes, effects, and remedies for cortisol belly.

What Causes Cortisol Belly?

Cortisol belly, also known as stress belly or visceral fat, typically develops due to prolonged exposure to high levels of cortisol. Several factors can contribute to the accumulation of visceral fat and the development of cortisol belly:

Chronic Stress: While we are not threatened by Saber Tooth tigers today, we are subjected to a lot of other stressors. Your stress may be work stress, relationship stress, exercise stress (yes, too much can be very stressful to the body), blood sugar imbalances, and poor sleep. In today’s fast-paced world, our brain interprets various events as stress and sends a signal to the Hypothalamus, which then sends a message to the Pituitary. From there, ACTH stimulates the Adrenal glands to produce cortisol. This pathway is called the HPA axis.

Now, one of the reasons that I am such an advocate of meditation and mindfulness practices is that it can transform our interpretation of what is stressful, and we also learn tools to immediately calm our nervous systems down and blunt the release of cortisol. In our modern world, these skills are invaluable for long-term health, not to mention happiness.

Poor Diet: Consuming a diet high in refined carbohydrates, sugars, and processed foods can contribute to weight gain, particularly around the abdominal area known as visceral fat. Unfortunately, when people are stressed, they often reach for comfort foods, which exacerbate the problem. A diet high in refined carbs is closely associated with insulin resistance and elevated blood sugars, which cause Diabetes. These dietary choices coupled with stress, can exacerbate cortisol belly.

Lack of Physical Activity: Sedentary lifestyles and lack of exercise can lead to weight gain and contribute to the accumulation of visceral fat. Visceral fat, or fat around the internal organs is metabolically active and triggers significant health issues, such as insulin resistance (again leading to Diabetes), and increased inflammatory markers.

Sleep Deprivation: When sleep is disturbed, so are all of the hormones involved in in metabolism – Cortisol, Growth Hormone, Leptin, Ghrelin, and even insulin. A disruption in all of these can lead to weight gain and visceral fat accumulation, in particular White adipose tissue (WAT or white fat – which is more likely to cause inflammation and disease).

Hormonal Imbalance: I write often about hormonal imbalance and the long-term effects of imbalance on cortisol. If you are under stress and producing a lot of cortisol, then progesterone declines, causing a disruption or imbalance in the Progesterone: Estrogen balance (P:E ratio). The resultant estrogen dominance is like a magnet to fat. And fat is a magnet to excess estrogens. Unfortunately, it’s a vicious cycle. 

Other hormonal imbalances, like Cushing’s Syndrome, where the body produces too much cortisol, can also lead to a cortisol belly.

The Side Effects and Morbidity Associated with Cortisol Belly:`

Cortisol belly not only affects one’s physical appearance but also poses serious health risks. The excess visceral fat surrounding vital organs can increase the risk of various health conditions, including:

Cardiovascular Disease: Visceral fat is metabolically active and releases inflammatory substances that can contribute to the development of heart disease, including hypertension, atherosclerosis, and heart attacks.

Type 2 Diabetes: Cortisol belly is strongly associated with insulin resistance and impaired glucose metabolism, increasing the risk of developing type 2 diabetes.

Metabolic Syndrome: Cortisol belly is a hallmark of metabolic syndrome, a cluster of conditions that includes high blood pressure, high blood sugar, abnormal cholesterol levels, and excess abdominal fat, significantly raising the risk of heart disease, stroke, and diabetes.

Mental Health Disorders: Chronic stress and cortisol dysregulation can also impact mental health, increasing the risk of anxiety, depression, and mood disorders. Again, there is a significant link to hormonal imbalance and imbalance in P:E which is another link to significant mood disorders like anxiety, depression, and even rage.

Healing Cortisol Belly: Remedies and Lifestyle Changes

While cortisol belly can be challenging to address, adopting a holistic approach focusing on lifestyle modifications can help reduce cortisol levels and visceral fat accumulation:

Stress Management Techniques: Incorporate stress-reducing activities such as mindfulness meditation, yoga, deep breathing exercises, or engaging in hobbies to lower cortisol levels and promote relaxation. I like to track my HRV (Heart Rate Variability) which is a measure of Sympathetic (Stressed or Survival Nervous System) and Parasympathetic (rest and digest of Pretty Safe Nervous System). The ole’ adage of “you can’t manage what you don’t measure” comes into play here and has certainly reinforced my stress reduction efforts. 

Balanced Diet: These tips may seem obvious, but let me repeat them, as sometimes we take the obvious for granted. Be sure to consume a whole foods diet rich in fruits, vegetables, lean proteins, and healthy fats while minimizing processed foods, sugars, and refined carbohydrates. Consuming foods rich in antioxidants and omega-3 fatty acids can help combat inflammation and support metabolic health.

Now, what about Intermittent Fasting (IF)? I love intermittent fasting. I have studied it, practice diet, recommend it to clients for quite some time. Yet, there is a time when it is NOT appropriate. If you are under a lot of stress, intermittent fasting can exacerbate your stress and cortisol belly. Again, it’s another reason why I love to get tests, not guesses. But, if IF is good for you, you will probably feel great about it. If you are feeling horrible, and I don’t just mean hungry, then listen to your body. You may be pushing yourself too hard. You may instead need to eat smaller meals every 2-4 hours to keep your blood sugar stable and get things under control.

Regular Exercise: Engage in regular physical activity, including aerobic exercise, strength training, and flexibility exercises, to promote weight loss, reduce visceral fat, and improve overall health. Now, let me share a little caveat for peri-menopausal and post-menopausal women, from both my education and personal experience.

As our hormones decrease, we are more susceptible to the imbalance of the rise in cortisol. If we do not have enough progesterone, any increase in cortisol can throw things out of whack, thereby putting you are risk for “cortisol belly” and all the health risks associated with it. If you are dealing with a higher stress load, you may need to calm down some of the HIIT workouts and try something calming like longer walks, yoga, and soothing workouts.

Yes, strength or resistance training is still very important, yet keep even these workouts to 30 minutes.  A trainer may encourage you to work harder, to burn more calories, but you may be making matters worse. That is why I love the DUTCH test – you can see clearly what is going on with your hormones and cortisol levels. You may just be pushing too hard?

This is exactly what I found for myself this year- although I can compete with 30-year-olds on my Peloton and love to work out, love HIIT workouts etc. I have toned down my workouts a bit, to just one HIIT a week, do more yoga, more exercise on my mini-tramp, more time in my infrared sauna, and more walking to bring my cortisol levels back down.

Prioritize Rest: Aim for 7-9 hours of quality sleep per night to support optimal cortisol regulation, metabolism, and weight management.  Now, getting 7-9 is awesome, yet I love the insights from the amazing book “Sacred Rest” by Dr. Sandra Dalton-Smith. This book explores the concept of rest beyond mere physical relaxation or sleep. Dr. Dalton-Smith introduces seven different types of rest: physical, mental, emotional, spiritual, social, sensory, and creative. She argues that proper rest in each of these areas is essential for overall well-being and productivity. Personally, although I do get 7-9 hours of sleep every night, I began focusing on the other areas of rest. It’s been fascinating to watch my HRV (Heart Rate Variability) increase – which is an amazing indicator of Parasympathetic tone (our rest and digest nervous system). If you’re interested in taking her Sacred Rest quiz, to see what areas you might need to improve, to achieve more rest and thereby decreasing cortisol, click here.  Consider implementing other rest practices recommended by Dr. Sandra Dalton-Smith

Seek Medical Guidance: If cortisol belly is due to an underlying medical condition such as Cushing’s syndrome or adrenal disorders, consult with a healthcare professional for proper diagnosis and treatment. Again, I highly recommend the DUTCH PLUS test to check your cortisol awakening response (CAR) as well as your cortisone metabolites. This will give clear specific answers that are individualized to what is going on with YOU, right now. No personal trainer can guess this. If you want to use my coupon code to get $100 off the DUTCH test, use LDF100.


Cortisol belly, fueled by chronic stress and unhealthy lifestyle habits, poses significant health risks and can lead to various metabolic and cardiovascular complications. By implementing stress management techniques, adopting a balanced diet, prioritizing physical activity, and prioritizing sleep, individuals can mitigate cortisol belly and promote overall health and well-being. However, for persistent or severe cases, seeking medical guidance is essential to address underlying medical conditions and optimize treatment outcomes. With a holistic approach encompassing both lifestyle modifications and medical interventions when necessary, individuals can take proactive steps towards healing cortisol belly and achieving long-term health goals.

This Free Quiz was created to help you gain clarity about some of your most aggravating symptoms and to help you get on your healthy hormone path.

FREE Hormone Symptom Quiz!