title: Stress and obesity: the role of the hypothalamic-pituitary-adrenal axis in metabolic disease.
abstract: OBJECTIVE
  Chronic stress, combined with positive energy balance, may be a contributor to the increased risk for obesity, especially upper body obesity, and other metabolic diseases. This association may be mediated by alterations in the hypothalamic-pituitary-adrenal (HPA) axis. In this review, we summarize the major research that has been conducted on the role of the HPA axis in obesity and metabolic disease.
  
  
  RESULTS
  Dysregulation in the HPA axis has been associated with upper body obesity, but data are inconsistent, possibly due to methodological differences across studies. In addition to systemic effects, changes in local cortisol metabolism in adipose tissue may also influence the risk for obesity. HPA axis dysregulation may be the causal link between conditions such as maternal malnutrition and sleep deprivation with metabolic disease.
  
  
  CONCLUSIONS
  The present review provides evidence for the relationship between chronic stress, alterations in HPA activity, and obesity. Understanding these associations and its interactions with other factors will be important in developing effective treatments for obesity and related metabolic diseases.
authors: New York Obesity Research Center, St Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York, USA. mb3103@columbia.edu
authors: Mousumi
authors: M
authors: Bose
authors: Blanca
authors: B
authors: Oliván
authors: Blandine
authors: B
authors: Laferrère
mesh_terms: D000818:Animals; D047109:Fetal Development / Q000235:genetics / Q000502:physiology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008659:Metabolic Diseases / Q000209:etiology / Q000235:genetics / Q000503:physiopathology; D009765:Obesity / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011110:Polymorphism, Genetic / Q000502:physiology; D012892:Sleep Deprivation / Q000150:complications / Q000378:metabolism; D013315:Stress, Psychological / Q000150:complications*