One of the most common ways people cope with stress is by overeating. Stress is a major weight-gain trigger. The simple act of eating temporarily helps relieve stress for many people. Stress can rapidly deplete the body's vital nutrients and glycogen stores, causing low blood sugars and cravings for sweets and carbohydrates. Stress lowers serotonin levels in the brain, which will also cause people to overeat sweets and high glycemic-index carbohydrates in an effort to produce more of this important neurotransmitter hormone. Stress also increases cortisol levels, a stress hormone in our bodies. Elevated levels of cortisol promote the deposition of intraabdominal fat deep in our bellies by increasing levels of insulin. This kind of fat (visceral fat) is the most dangerous to our health and can affect both men and women by causing metabolic syndrome (also called Syndrome X) characterized by high blood pressure, elevated cholesterol, insulin resistance, diabetes, stroke, heart disease, and cancer. Stress can also affect the thyroid gland and thyroid hormones, making it much harder to control body weight. 

Clearly, if we want lean healthy bodies we must learn to minimize and control the stress in our lives. The key, then, is to develop strategies to manage stress and lower our cortisol levels. Learning to control stress is a life-long process. It begins by systematically eliminating or decreasing as much stress in our lives as we can. Many times stress and stress-provoking situations are unavoidable, however, and techniques must be developed and utilized to successfully reduce and manage this stress. 

Cognitive-behavioral methods are believed to be some of the most effective ways we can reduce and manage stress in our lives. They include (1) identifying the sources of stress, (2) restructuring our priorities to deal with stress in our life, and (3) finding methods to reduce or totally eliminate stress.

1. Identifying Sources of Stress. The best way to get a handle on specific stressors in your life is by keeping a daily journal or diary of the events or activities that you find provoke anxiety, anger, loss of energy, frustration, etc in your life. Also, include anything that typically precipitates physical responses like indigestion, headache, or muscle tightness. And while you're at it, include things that make you feel calm, relaxed, uplifted, energized, etc. After one or two weeks, analyze your notes and try to identify specific situations or events that you find especially upsetting or overwhelming. Ask yourself if these stressors are a part of your own doing or are they because of someone else? Have you taken on more than you can reasonably accomplish? Which of these stressors do you have control over and which do you not? The answers to these questions will help you figure out how to manage each stressor more effectively.

2. Restructuring Priorities To Deal with Stress in Our Life. The next step is to develop strategies to deal with the stressful activities or situations in your life. One of the best ways to do this is by adding a pleasant event to your daily routine. Studies indicate that this has a more positive effect on your overall psyche than reducing or eliminating a stressful event. Some ideas might be going to the gym, attending an adult education class, doing volunteer work at the hospital or homeless shelter, reading a book, and the list can go on and on. Other strategies that I have found very helpful in my medical practice and my own life include:

• Write it out. For a lot of people, writing about stressful and traumatic events in a journal is an effective coping strategy that can improve your immune system and help make you more optimistic.
• Discuss Your Feelings. Feelings of anger and frustration that are kept inside lead to more hostility, depression, and a sense of hopelessness. Talk or write to someone that is a good listener and you will be amazed at how this will help you defuse your anger and gain control of your feelings. 
• Look for the Positives. Try to turn your negative ideas into positive thoughts and this will help you reduce stress and tension and better achieve your goals.
• Use Humor. Stress management experts recommend keeping a sense of humor during stressful times. Laughter is great for releasing pent-up emotions and very effective in helping people cope with acute stress and endure emotional pain.

3. Develop Methods to Reduce or Eliminate Stress.

• Nutrition. One of the best protections from stress is a nutritious diet. A diet with adequate calories and the right balance of essential fats, high-quality protein, low-glycemic index carbohydrates, and antioxidant vitamins and minerals goes a long way in helping you deal with life's stresses.
• Exercise. Exercise can play a major role in helping you manage the stress in your life. It increases endogenous opiates (endorphins) which are hormones produced in the brain that act like analgesics, reducing pain and making stress more tolerable. Also, the more fit we are the better able we are at dealing with stress. The stressors in our life just don't seem to be such a big deal when we are lean, fit and strong. Exercise should ideally involve both aerobic training and resistance training to get the most stress-reducing benefit. If you can do your exercise with another person or other people you will also get the added benefit of social interaction and this will add considerably to your ability to cope with stress.
• Organization. A very common source of stress in people's lives comes from the feeling that they cannot get everything done-ie. feelings of being overwhelmed. Developing good organizational skills really helps you get on top of all of this. Start out by using a calendar to organize your daily, weekly, and monthly schedules. Make a list of all your tasks, goals, important deadlines, and the dates you want to start working on these and when you hope to have them done. Get your desk, office, and home in good order. You will be amazed at how much stress in your life can be eliminated if you just get organized! A great book on improving your organizational skills is Organizing from the Inside Out by Julie Morgenstern (published by Henry Holt/Owl Books).
• Prioritize. Prioritize all of your responsibilities and obligations and attack them in their order of importance. Eliminate those that are not all that important and focus on those that are most important.
• Relaxation. Stress in our lives is inescapable. It has been with us since the beginning of time and will continue to be an integral part of each and every day for everybody. We cannot and should not live a stress-free life. Stress, if handled properly, can have a very positive effect on our lives. It can drive us to maximize our potentials and attain goals we never dreamed possible. On the other hand, it can literally make us sick and destroy us if we don't manage it properly. One of the most well documented techniques for reducing stress is through the "relaxation response," a term coined by Harvard Medical School's Herbert Benson, M.D., to describe a state of deep, mindful rest that offsets the physical effects of stress. We all need to develop the ability to invoke this response and get into the relaxation state located deep in our brains. This response can be elicited at any time and at any place and is scientifically proven to lower blood pressure and slow respiration and pulse rates. It also releases muscle tension, eases emotional stress, and decreases cortisol levels. And these responses are not just temporary, they can last up to 24 hours after just two to six weeks of daily practice. You will need a quiet place in your home to elicit the relaxation response. Sit comfortably in a chair or on the floor, whichever works best for you and make sure no one and nothing will bother you. Pick a time in your day that works well for you and keep this as your regularly scheduled relaxation time. Most people find that early morning works very well and can set the tone for the rest of the day. A single session for eliciting the relaxation response usually lasts between fifteen and twenty-five minutes. The following are a few of the tried-and-true ways to invoke the relaxation response and become much calmer in your mind and body. Try them out and pick the one that works best for you.
  • Breath Focus-Most people really don't breathe properly. When we are stressed out we hold our breath. If we are chronically stressed, we become shallow "chest breathers," rather than deep "abdominal breathers." Breath focus involves shifting from shallow chest breathing to deep abdominal breathing for an uninterrupted period of time lasting at least fifteen minutes. Breath focus is probably the easiest approach to relaxation. Begin by taking a deep, slow breath through your nose deep into your lungs as you observe how your abdomen expands. Do not limit this expansion. Then breath out through your mouth. Follow this deep breath with a normal breath then repeat the slow deep abdominal breath again. Alternate normal and deep breaths and notice how you feel on each inhalation and exhalation. You will begin to notice how each normal breath is restricted and how each deep breath is relaxing. During the last ten minutes think about the air traveling through your nose and how it brings with it a sense of calmness and peace as it moves deep into your lungs. Then, as the air moves out of your lungs, imagine that it is removing tension, stress, anxiety, and impurities from your body. Continue to focus on your deep breathing, letting in peace and calm and letting go of stress and tension, for about ten to twenty more minutes. Breath focus is thought to be the most universally applicable way to induce the relaxation response. After a few sessions you will say, "I finally learned how to breathe." This technique works especially well for people with eating disorders like binge eating, cravings, and it also helps control food addictions.
  • Body Scan-Every muscle in our body holds stress and tension. The body scan relaxation technique enables you to scan your body to become aware of bodily tension. You then use your breath to focus on the tension and gradually eliminate it. Start at your forehead. Concentrate on the muscles of your forehead and notice any muscle tension in them. As you exhale, release this tension and when you inhale, become aware of any residual tension. Continue this for several slow, deep breaths then move to the muscles around your eyes. As you exhale, release the tension around your eyes. Slowly work your way down to your mouth and jaw, then your neck. After the tension is out of your neck, move to your back and then your shoulders. Continue this process slowly working your way down your body. When you get to your waist, pause for a minute and do a check of your entire upper body for any left over muscle tension. If you notice any, concentrate on that area as you breath in and release it as you exhale. Then move on to your lower body starting with your pelvis and buttocks and working on down to your legs, ankles, and feet. Once you have finished all body areas, do another check for any muscle tension that may remain and work on getting rid of it. You will find that the body scan relaxation technique works really well if your daily life leaves you physically tense and mentally agitated.
  • Progressive Muscle Relaxation-This technique incorporates the same technique as the Body Scan, but takes it to another level by allowing you to voluntarily increase the amount of tension in an already tense muscle group before you release it from your body. This exercise will greatly enhance your awareness of the tension in each muscle group as well as enhance your sensation of release. This works well because the typical "stressed out" person doesn't really know what muscles are tense or how to relax according to Edmund Jacobson, a University of Chicago researcher and author of You Must Relax (New York: McGraw-Hill, 1962). This technique works great for people with overly active minds as well as those with eating disorders.
  • Guided Imagery-The relaxation response can be elicited by imagining mental pictures of places or experiences that evoke a sense of inner calm. Guided imagery is a proven approach to stress management, relaxation, psychological well-being, and improving your quality of life. It has been described as the "language of the unconscious." It can enable us to discover lost parts of ourselves including the part responsible for deep tranquility. The easiest way to introduce yourself to guided imagery is to use an audiotape (you can order guided imagery tapes as well as other relaxation tapes from: Mind/Body Medical Institute, Deaconess hospital, Attention Tapes, 1 Deaconess Road, Boston, MA 02215).
  • Meditation-Meditation has been used for centuries in Eastern cultures and is now becoming widely accepted in this country as a good relaxation technique. The goal of all meditative procedures is to quiet the mind and relax thought. With some practice, meditation can reduce stress hormone levels, elevate mood, and lower heart rate, blood pressure and body temperature. For more on meditation read L. LeShan's How to Meditate. Boston: Little, Brown and Co., 1974.

Stress is unavoidable in today's world and the better we are at managing and controlling its impact on us, the more successful we will be at controlling our eating behavior, minimizing disease, and experiencing a happier life. If stress is so unmanageable in your life that it is causing you severe anxiety or depression, you should consult a mental health professional. Usually, short-term therapy will resolve even the most severe stress-related emotional problems.

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