How Anxiety Affects Weight—And How to Manage It

Got a headache or a fever? Over-the-counter meds will usually do the trick. Nursing a running injury? Some combination of rest, ice, compression or elevation (and good old-fashioned patience) will likely have you back on track before too long. Indeed, most physical symptoms, although uncomfortable and inconvenient, are pretty straightforward to spot and treat.

The mental and emotional ones, like anxiety, are a little trickier.

According to the Anxiety and Depression Association of America (ADAA), anxiety affects 40 million adults in the United States, making it the country's most common mental disorder. Cheryl Carmin, Ph.D., professor of clinical psychology at The Ohio State University College of Medicine, describes anxiety as a "fight or flight" response to what a person perceives as a dangerous situation. "This response activates the hypothalamic-pituitary-adrenal (HPA) axis, which causes an adrenaline reaction," she explains.

Depending on the strength of that reaction, symptoms could include an increased heart and respiration rate, upset stomach, shaking, sweating, dizziness, headache or even a panic attack. Others may not have as dramatic of a response, and instead may worry excessively, notes Dr. Carmin. "While worry may not involve panic-like symptoms, its chronic nature can similarly take a physical toll on people, as they are in a state of high alert for long periods," she says.

Common Triggers of Anxiety

There are many different types of anxiety with a myriad of triggers, from genetics to personal trauma to brain chemistry. Although there are effective treatments available, nearly 60 percent of people suffer through anxiety without seeking care.

"The causes or triggers for anxiety are very individualized," Dr. Carmin notes. "Some people focus on physical symptoms as an indication that there is something medically or psychologically amiss. Other people fear what people may think of them, or believe that others will negatively evaluate them. Many people have specific phobias—such as fear of heights, freeway driving, enclosed spaces, certain animals or insects [or] blood—and being in the presence of anything they fear is a trigger."

The Anxiety/Weight Loss Connection

For many people, the struggle or inability to lose weight can be a major source of anxiety. But on the other hand, if someone already has anxiety, that could contribute to behaviors leading to weight gain—sort of the old "chicken or the egg" conundrum. Which comes first?

It depends on the individual, Dr. Carmin says. For some people, feeling anxious may cause them to "stress eat," which will increase calorie intake and could cause weight gain. But for others, anxiety may lead to a loss of appetite. Some studies have found a link between obesity and anxiety.

A person with anxiety may also be more bothered by a less-than-ideal weight than someone without the disorder. "Individuals who tend to be perfectionists may have a greater tendency to focus on appearance-related variables, such as weight," explains Dr. Carmin.

And then there's the hormonal aspect to consider, notes weight loss therapist Dr. Candice Seti, Psy.D., CPT, CNC. "Cortisol is our body's stress hormone, also known as our 'fight or flight' hormone," she explains. "In the short term, a little burst of cortisol can help get us moving and out of danger, so to speak. But long-term exposure to cortisol—through chronic stress or chronic anxiety—can cause all of our body systems to slow down, and ultimately hold onto weight and body fat. So, in that sense, chronic anxiety can lead to weight gain."

On the flip side, Dr. Seti notes that a build-up of anxiety can cause an excess of nervous energy in the body, which increases movement (think fidgetiness) and decreases hunger. In that sense, anxiety could actually lead to weight loss.

Healthy Ways to Handle Anxiety

Just as every individual is different, no two cases of anxiety are the same. The best approach to handling it will depend on the severity of the problem, says Dr. Carmin—both from the standpoint of the anxiety and any weight-related struggles.

The first step, she says, is to determine whether the person has a diagnosable condition: Is the person suffering from an anxiety disorder, an eating disorder or both? "Having a frank discussion with your primary care physician or a mental health professional will help to put this in perspective," she says. "There are effective, cognitive behavior therapy treatments and medications for anxiety and eating disorders."

If the anxiety or eating issues are less severe and aren't interfering with quality of daily life or causing undue distress, these other strategies could help alleviate symptoms.

Stay active. Anxiety and depression can sometimes make the sufferer feel like crawling in a hole and hibernating, but this usually exacerbates the problem. "Remember to find time for activities that are enjoyable or provide a sense of accomplishment," Dr. Carmin recommends. In addition to burning more calories, the activity will also help to redirect your attention away from thoughts and worries that contribute to anxiety. Plus, exercise can serve as a natural mood lifter.

Keep a journal. The ADAA recommends writing in a journal when stress or anxiety hits. Over time, you'll start to see patterns of potential triggers, such as work, relationships, weight or other factors.

Surround yourself with a positive circle. Positivity is a powerful thing. Seek out people who are energizing and encouraging, optimistic and upbeat, and who regard challenges as growth opportunities.

Be mindful of what you eat and drink. The ADAA suggests eating nutritious, well-balanced meals and healthy snacks, and limiting alcohol and caffeine, which can worsen anxiety. If you tend to be a stress eater, Dr. Carmin says to ask yourself if that treat is something you truly want, or if it is just a form of self-soothing that will interfere with a goal. "If it's the latter, what really is the cause for wanting to snack? Can you deal with the underlying concern in a straightforward manner?" she asks.

Consider seeing a therapist. Dr. Seti believes that some of the most effective ways of dealing with anxiety are rooted in cognitive-behavioral therapy, which involves identifying the stimuli that cause the anxiety and then questioning that reaction anxiety. She recommends seeing a cognitive-behavioral therapist, who can help develop a strong anxiety management toolkit.

Try a relaxing activity. This can be anything that calms and centers you, whether that's music, meditation, massage or another form of self-care. Diane Malaspina, Ph.D., a therapeutic specialist with Yoga Medicine, recommends a yoga practice as a means of relieving anxiety. "Learning how to breathe and control the breath can help to calm the nervous system," she explains. "Yoga postures also release tension in the muscles and endorphins in the brain, which help us to feel good. Mindfulness practices have also been found to reduce stress, lower cortisol levels and calm an active mind."

If you're one of the millions of people who experience chronic anxiety, you don't have to let it limit your health or quality of life. If you've tried your own coping strategies but are still struggling, reach out to a doctor or mental health professional for help.