The day I was diagnosed with breast cancer was the most stressful day of my life, as I’m sure you can imagine. I was 28, alone at the appointment, and felt completely sideswiped. I was shocked. I was scared. My brain went into autopilot. Thinking back on it now, I am simultaneously aware of every second of that afternoon in excruciating detail but also feel like it’s a blur. That is what stress and fear does to your brain; it kicks it up so you observe everything while also trying to protect you by fuzzing out the unpleasant parts. It’s a strange combination.

And of course the stress only amplified from there. It wasn’t always acute stress, but often it was medium to high-grade background stress, the kind that bubbles away behind every thought you have and action that you take. And that kind of stress, if left unaddressed or when it is too much to deal with quickly, has unavoidable effects on our physical health.

One of those effects is weight loss. I was playing around with my diet a lot after diagnosis, trying vegan and keto, cutting out carbs and sugar and dairy, so that definitely contributed. But, I went from 140 lbs to 112 lbs in the space of about 2 and a half months with zero increase in my exercise (probably a decrease actually). For someone who is 5’7” who was already within her healthy weight range, this was a massive and unhealthy drop that was about more than my diet changes.

My body, mind, and soul were under attack, and I don’t mean from the cancer itself. The stress and anxiety it caused were wreaking havoc on my body. I couldn’t sleep properly, I couldn’t eat properly, and my mind was constantly running on overdrive, going round and round in circles looking for solutions to this problem. It was exhausting, and the scale showed the effects.

How Does Stress Affect Us On A Physiological Level?

When we are in this stress state constantly, it is like our brains are essentially telling our bodies that there is a tiger chasing us 24/7. This fight-or-flight response was only ever meant to last a few seconds to a few minutes, tops; just enough time to either fight our way past that tiger or run fast enough to get away from it. We were never meant to feel as though we are being stalked every minute of the day, and yet that’s what a lot of people are experiencing right now.

When your brain detects danger, it sets off a survival alarm, increasing the production of stress hormones such as cortisol and adrenaline. Among other things, adrenaline increases your heart rate and elevates your blood pressure, while cortisol increases glucose in the bloodstream, alters your immune response, suppresses your digestive and reproductive systems, and affects the part of your brain that controls mood, motivation and fear [1].

So, how are these hormones related to weight loss? A common side effect of stress is that we experience a decrease in appetite, because as adrenaline prepares your body for a fight or for flight, it can also reduce your desire to eat. In fact, one study with animals found that adrenaline produced a prolonged anorexia of 45 minutes to over 2 hours [2]. The fight or flight response can also increase your metabolism to ensure that there is ample glucose for your body to burn for the extra energy needed to get away from the perceived threat, leading to more calories burned and further loss of body weight. 

Meanwhile, cortisol is signaling your body to shut down non-essential functions that will get in the way of fighting or fleeing, which as I mentioned above includes your digestive system. This can result in all sorts of problems that contribute to weight loss including a decrease in nutrient absorption [3]. 

Furthermore, stress has been shown to increase levels of a peptide called leptin that is produced by your fat cells [4]. When leptin binds to neurons in the hypothalamus (the area of our brain that plays a major role in appetite regulation), it decreases our appetite and lowers food intake and body weight [5].

Chronic stress of course leads to sustained increased levels of cortisol in our bloodstream. There is much disagreement and controversy over a condition that many attribute to chronic stress called adrenal fatigue. The idea behind adrenal fatigue is that prolonged exposure to stress drains your adrenals, leading to low cortisol levels. Low cortisol levels in turn can lead to low blood sugar and weight loss [7]. While some doctors maintain that adrenal fatigue isn’t a confirmed illness, there is a huge body of anecdotal evidence from patients who, once they have addressed their adrenal issues, solve a whole host of health problems including fatigue, brain fog, and unexplained weight loss. In a study that examined the body of research on adrenal fatigue, they found that 61% of studies found no difference between the levels of cortisol for those patients that were in the fatigued group when compared to the control group [6], but that suggests that 39% of the studies did find such evidence, and to me that is worth looking at further. Not every instance of symptoms that match adrenal fatigue are going to be because of issues with adrenals, just like not all breast lumps are cancer; but adrenal insufficiencies could be the cause of the results found in other 39% of studies, so it worth mentioning in connection to stress and weight loss.

Finally, this one might be just me, but when I am stressed about a problem, I become extremely focused on it. For the first 6-8 months after diagnosis, I did little else but read, research, watch, and learn everything I could about breast cancer and integrative oncology. I wanted to learn as much as I could about both my conventional and alternative treatment options to ensure I was doing absolutely everything I could and making the best treatment choices for me. When this tunnel vision happens to me, it is quite common that I both forget to eat and also subconsciously decrease the importance of eating; nothing is more important while I’m uber focused in this way than what it is I am focused on, and eating less as a result obviously contributes to weight loss.

So, What Do I Do About Stress-induced Weight Loss?

When I lost all of that weight, I hadn’t even started chemo yet, and although I wasn’t sure whether I would be doing chemo in full or not, I knew that I needed to at least stabilize this decline before that point in my treatment came. Everyone right now, whether a cancer patient or not, is going through heightened levels of stress thanks to COVID-19 and maintaining this quarantine. It has been months since we’ve seen loved ones, we are separated from friends and colleagues, and our regular, comforting routines have been completely upended. Frontline and essential workers must feel as though the weight of the world is on their shoulders, and it is in a way. So, It is not surprising that people are noticing effects such as weight loss associated with this stress, but what can you do about it?

The best thing that you can do is learn to react to stress in a healthy way. It can be really easy when we are under stress to let our thoughts spiral into the negative, only serving to make our stress and anxiety worse. One of the most helpful things you can do is figure out how to stop this spin. It may look a little different for everyone, but you can slow those negative circles of thought through mindfulness with just two basic steps:

1. Learn to become aware of when you are feeling heightened levels of stress – chronic stress can become such a normal part of our everyday life that we stop noticing it; it fades into the background and just becomes our regular soundtrack, our “normal” way of feeling. Learn to recognize your symptoms of stress such as shallow and quickened breathing, sweaty palms, racing thoughts, agitation, a loss of patience, or an inability to focus. You can even try keeping a journal to track these symptoms and make it easier to notice your stress patterns. Once you know how to recognize when you are stressed, you will be able to actually address it.
2. Pause and breathe – When you notice that you are feeling stressed, either chronic or acute, the simplest thing you can do is pause and just breath. When we are in a fight-or-flight response, our body quickens our breathing to ensure more oxygen is reaching our brain (to increase alertness) and to our muscles (to better prepare them for the physical exertion of fighting or fleeing). When we take a deep, diaphragmatic breath, it breaks that breathing response, telling our brains that there is no threat and helping our bodies to relax, because our brains recognize that we wouldn’t be breathing in this way if there actually was a threat.  

Some other great ways to reduce your stress and to react to it in a healthy way include:

• Taking time for self-care practices when you feel stressed, like devoting some time to your favourite hobbies
• Spending quality time with your quarantine buddies doing fun activities like games, arts and crafts, or having a living room dance party!
• If you have a pet, log some serious cuddle time with your furry friend
• Brew a cup of relaxing herbal tea like camomile, lavender, or peppermint
• Incorporating into your daily routine one of many ways to relax and reduce stress including meditation, yoga, exercise, or using the Emotional Freedom Technique (more commonly referred to as tapping)
• Keeping your hands busy by preparing healthy meals, taking on an art project, or building something
• And of course there is absolutely nothing wrong with getting some professional help; everyone can benefit from therapy and there are some great online options right now while we are locked down

Finally, you want to address your stress-related weight loss by preparing healthy, nourishing meals that maximize your caloric intake while staying away from the unhealthies like sugar, processed grains, and bad oils like canola. Aim to include:

• Healthy carbs like whole grains (for those watching their blood sugar because of cancer or anything else, choose grains like sorghum or millet that have a low glycemic index)
• Healthy fats through foods such as nuts and nut butters, salmon (make it wild and pacific to avoid farmed fish and higher toxin levels), and avocado and by adding oils such as olive, coconut or avocado to your salads and meals
• Clean protein such as grass-fed, free-range, and organic eggs and poultry
• Dark chocolate (yes, you read that right!), which has a high calorie density and contains a ton of micronutrients and health-promoting compounds, including fiber, magnesium and antioxidants (I recommend getting dark chocolate with a cocoa content of at least 70%, which means there will be less sugar, or getting a bar like Lily’s Chocolate that is sweetened with stevia or Zazubean that is sweetened with coconut sugar, both of which have low glycemic indexes, important for those healing cancer)

…

Whether the cause of your stress is cancer, COVID-19, or anything else, understanding how stress affects weight loss and what you can do to counteract it are key to finding a solution that works for you. Everyone is a little different, but reducing stress, improving your response to it, and increasing your consumption of the foods listed above should help to bring your body back into balance and a healthy weight range. I gained some pounds back when my naturopath adjusted my diet to include some healthy carbs, but the real gains came with time as I worked on my mental and emotional health and got further out from my diagnosis, easing my stress and anxiety surrounding cancer. I sincerely hope that my suggestions help you to do the same. 

Happy Healing ❤️

References:

1. Chronic stress puts your health at risk – https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
2. Hypothetical liver receptors and the anorexia caused by adrenaline and glucose – https://www.sciencedirect.com/science/article/abs/pii/0031938468900942
3. Stress Effects on the Body – https://www.apa.org/helpcenter/stress/effects-gastrointestinal
4. Leptin concentrations in response to acute stress predict subsequent intake of comfort foods – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3409346/
5. Leptin sensitive neurons in the hypothalamus. – https://www.ncbi.nlm.nih.gov/pubmed/10422733
6. Is adrenal fatigue “real”? – https://www.health.harvard.edu/blog/is-adrenal-fatigue-real-2018022813344
7. Cortisol – https://www.yourhormones.info/hormones/cortisol/