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Job Stress and Obesity

Dr. Cederquist gives concrete numbers on how stress at your job or at work relates to the development of obesity

Recent studies have found a link between work stress and the risk of developing obesity.  Researchers in England followed more than 10,000 men and women aged 35-55 for 19 years.  They administered a Job Strain Questionnaire on four occasions and found a relationship between increases in weight and abdominal weight gain in subjects who reported more instances of work stress. 

Subjects who reported two episodes of work related stress had a 24% increased likelihood of becoming obese compared to the subjects who reported no episodes of work stress. 

Subjects who reported three or more episodes of work stress had a 70% increased likelihood of developing obesity compared to the subjects who reported no episodes of work stress.

Findings also reveal that baseline blood pressure is positively associated with waist/hip ratio in men, and blood pressure and heart rate recorded during the work day and evening were elevated in men with a higher waist/hip ratio who experience low job control.

It is not entirely clear how stress affects weight gain, but studies have also shown that stress at work is an important risk factor for the metabolic syndrome.  Metabolic syndrome is a collection of conditions that begins with abdominal weight gain and leads to an increased risk of cardiovascular disease. A patient will meet criteria for metabolic syndrome if they have three of the following five findings:

1) Blood pressure                 greater than 130/85  mmHg  

2) HDL                                  less than 45 (men)  less than 55 (women)

3) Triglycerides                      above 150

4) Fasting glucose                 above 110

5) Waist circumference       greater than 40 inches (men) or greater than 35 inches (women)

Once the metabolic syndrome cascade is established, it affects carbohydrate metabolism and makes further weight gain easier and weight loss difficult because of resultant insulin resistance.  Behavioral factors may also contribute to the work stress/weight gain effort in that patients may increase comfort eating or drinking to deal with the stress.

When patients realize the toll their work environment is having on their health, the motivation to make changes can be strong.  Since the perception of “low job control” is the most significant stressor, having patients evaluate their work situation is important.  It may potentially benefit patients to seek alternative positions, or a different supervisor.  Exercise remains one of the best ways to burn stress produced catecholamines, but when patients are overstressed and overtired it is often the last thing they feel like doing.  It is important for patients to understand that the benefits the effort they make will pay off.  In addition, if metabolic syndrome or insulin resistance has developed, it will respond to a lower calorie, controlled carbohydrate diet—so that the cycle of ongoing and increasing weight gain can be halted.

British Medical Journal 2206;332:521-525.

American Journal Of Epidemiology 2007 165(7):828-837.

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