Chronic Stress and Comfort Eating: Why Stress Alters Food Choices

Stress is a familiar part of everyday life and not only affects our mental and psychological state, but also our appetite and, in the long term, may influence the food choices we make. While some experience loss of appetite during stressful times, particularly when the stress is acute, chronic exposure to stress can also have the opposite effect. (1) Oftentimes, this adversely leads to stronger cravings, particularly for sugary, salty, or highly palatable comfort foods. During periods when the body may benefit most from nourishing foods and valuable nutrients, many people instead experience cravings for energy-dense convenience foods such as chocolate, crisps, pastries, or fast food. This response is by no means unusual and is influenced by several biological and psychological mechanisms.

How does stress affect appetite regulation?

Through a complex mechanism, the stress hormone cortisol is released by the adrenal glands upon a perceived stressor, and subsequently, through a negative feedback loop, is suppressed again once the threat has passed. However, if the exposure to stressors becomes chronic, this feedback loop may become impaired, leading to consistently elevated cortisol levels. (2) Chronically elevated cortisol may impair normal satiety signals, making it easier to eat beyond physiological hunger. In addition, food intake may temporarily reduce stress-related discomfort and improve mood, which can reinforce comfort eating behaviours over time. (1)

What does the evidence say?

• A systematic review and meta-analysis from 2022 included 54 studies that looked at healthy adults experiencing some type of perceived stress and their eating habits. The authors explored the relationship between stress and unhealthy foods, healthy foods and other foods, with these categories being based on energy density and nutrient profile. Results showed an association between higher perceived stress and higher intake of unhealthy food choices, and likewise, lower stress was linked to healthier choices, although the effect size was small. (3)

• A cross-sectional study from 2015 assessed the relationship between chronic stress, food cravings and BMI from an available data set of 619 subjects and findings showed a positive correlation between chronic stress and total food cravings. These included foods such as high-fat foods, complex carbohydrates/starches, sweets, and fast-food fats. The data set also included subjects with nicotine and alcohol intake, and this has to be considered as a potential confounding factor. (4)

• Another systematic review and meta-analysis from 2020 included 24 studies that explored diet quality and perceived stress in women and confirmed previous findings that increased perceived stress led to poorer, less nutritious food choices, such as high in fat, sweets, salt, and fast food and low in fruits, vegetables, fish, and unsaturated fats. (5)

What does that mean in practice?

• Acute stress is more likely to suppress appetite, whereas chronic stress may increase food cravings, in particular for high-palatable foods.

• Consistently elevated cortisol levels due to chronic stress may alter appetite and lead to impaired satiety cues as well as reinforce reward-driven eating of comfort foods in an emotion-driven response to stress.

• Evidence shows that higher chronic stress has been associated with poorer food choices in some individuals, but the overall consensus is that the response to chronic stress varies significantly depending on the individual, and more high-quality studies are needed to determine clearer findings.

  
  

Key takeaway

Chronic stress can influence both appetite and food preferences, often increasing cravings for highly palatable foods in some individuals. Understanding that comfort eating can have biological as well as psychological drivers may help create a more compassionate and practical approach to better food choices and eating behaviours.

References:

1. Ans AH, Anjum I, Satija V, Inayat A, Asghar Z, Akram I, et al. Neurohormonal regulation of appetite and its relationship with stress: a mini literature review. Cureus. 2018;10(7):e3032. doi:10.7759/cureus.3032.

2. O'Connor DB, Thayer JF, Vedhara K. Stress and health: a review of psychobiological processes. Annu Rev Psychol. 2021;72:663-688. doi:10.1146/annurev-psych-062520-122331.

3. Hill D, Conner M, Clancy F, Moss R, Wilding S, Bristow M, et al. Stress and eating behaviours in healthy adults: a systematic review and meta-analysis. Health Psychol Rev. 2022;16(2):280-304. doi:10.1080/17437199.2021.1923406.

4. Chao A, Grilo CM, White MA, Sinha R. Food cravings mediate the relationship between chronic stress and body mass index. J Health Psychol. 2015;20(6):721-729. doi:10.1177/1359105315573448.

5. Khaled K, Tsofliou F, Hundley V, Helmreich R, Almilaji O. Perceived stress and diet quality in women of reproductive age: a systematic review and meta-analysis. Nutr J. 2020;19(1):92. doi:10.1186/s12937-020-00609-w.

   
   

Disclaimer: This article is for educational purposes only and does not replace medical advice. Individual needs vary, and personalised guidance from a qualified healthcare professional is recommended for tailored support.