Stress, the under recognized influencer of weight gain.  Check out our audio transcript to learn more. 

Introduction of stress leads to weight gain

Dawn (00:01):

Hello and welcome to the Gastric Health Show. My name is Dawn Boxell and this week’s topic is digging into stress the seven ways stress leads to weight gain. And I want to show you how really underrated and under-recognized stress is when it comes to weight gain. And this what I want you to really start considering when you are experiencing weight gain. I want you to start thinking about stress being a piece of this puzzle.

Dawn (01:01):

And I know I’ve said this many times that there’s never just one thing that is probably the only thing contributing to your weight gain. I would say that would be unlikely in many cases. Now, in some, I guess we could probably say that is the only thing driving it. But I will say that it’s usually a combination of things when you’re having weight gain issues. That just don’t seem to be resolved you got to start looking at multiple areas that drive it.

Dawn (01:36):

And stress is one of these areas that I feel like is forgotten and not really questioned. So if you show up at your bariatric center and say, I’m gaining weight I would venture to guess very few of the practitioners are asking you, have you had any stressful events in the last three months, the last six months this last year life changing events have you lost a job? Have you gotten married have ?

Stress increases hunger & appetite and leads to weight gain

Dawn (02:21):

you had a baby? Have you had a death in the family? Think of those big major life events. But then also think about the little things. Do you have some relationship issues? Are you struggling emotionally or mentally with just some decisions you have to make? Are you struggling financially? And all of these things are just continually rising that cortisol level or that stress hormone that can really throw us off. Now I know that there is not a person on this earth who hasn’t felt extended stress

Dawn (03:00):

And unfortunately we’ve got to find ways that we can do a better job at managing these stressful events when they arise. Cuz unfortunately stress can drive cravings, inflammation, blood sugar, belly fat can alter your gut bacteria and make you weight loss resistant. So I mean that’s a big deal. And not paying attention to the stress that’s happening in your life is something that is going to make it difficult for you to stop the weight gain and get it back in control.

Dawn (03:41):

So I want to connect these dots for you. I want you to see that stress can lead to weight gain. And when you start kind of peeling back the layers of the onion, if you wanna think of it that way stress is going to be more than likely a piece of everyone’s story. That is why they have experienced weight gain. So I know that I say this many times, but we can’t control the stress we are given, but we can control how we react to it.

Stress leads to hormonal imbalance and leads to weight gain

Dawn (04:35):

And that’s what I think we have to keep reminding ourselves when stressful events occur you can’t change that it is here. And how are you going to react? How are you going to respond to this stressful event that is occurring? And if we think of the big picture, stress is not bad and appropriate doses stress is a normal response that occurs and a normal human thing. And it’s something that our bodies are designed to handle. It’s just our bodies have never been designed to handle it chronically. It gets confused. When it’s chronically having to release that cortisol and it never gets to lower it.

Dawn (05:21):

So stress hormones rise when you. You’re feel threatened either it’s perceived or real. So it doesn’t matter if it’s all made up in your head and you’ve created this because you’ve just kind of ruminated on some thoughts. Oh, I’m going to lose my job. There’s some red flags. So now I have this little voice in my head saying that I’m going to lose my job or my position’s going to be eliminated. And that just perpetuates this chronic cortisol level that cannot get to normal.

Dawn (06:16):

You no longer have a normal response and you don’t get out of that fight or flight mode. And I’ll get into that actually so that you can understand that. But our body, when the threats continue day after day, that natural rhythm of your cortisol gets altered and it causes problems. I want to explain this so you understand how the cortisol really is intended to be helpful and when it goes from helpful to harmful.

Different types of stresses and weight gain

Dawn (07:11):

Cortisol, and I’m really keeping this super simple cause I’m not going into depth on all of these, but your cortisol is one of the stress hormones that gets secreted when a real or believed threat occurs. So this is considered the fight or flight response and this is your sympathetic nervous system. So when your fight or flight is kicked on, then cortisol is secreted because it’s preparing your body to have enough energy to run to jump, to get away from this stressful event that’s occurring.

Dawn (07:46):

And you know, go back centuries and it was different types of stress. They had real stress in the aspect of being killed and being chased and wars and different things they were experiencing compared to the stressors that we experience in the us. Maybe not, we don’t have to worry about somebody coming into our house and dealing our children, but we might have to deal with the stress that we may not be able to meet our bills every month or we may not be able to sign our kids up for things or our work is just I’m having to put in overtime.

Dawn (08:21):

So different stressors that we experience now, but our body doesn’t know the difference. So our body gets turned on this fight or flight mode or this sympathetic nervous system. And if it’s not turned off, then that’s when problems become an issue. So let’s do an example.

Stress leads to digestive issues and chances for regain of weight

Dawn (09:06):

So let’s say you just found out you lost your job. This is what your body would do, your blood pressure would increase, the blood flow decreases from your digestive tract and your reproductive organs because if you are in stressful events, you are not digesting food. Your body is intuitive to know that hey, we don’t need to digest food because you know what? We might need this fuel right now and we need to be able to utilize all of our, cuz it takes I don’t want to get too deep, but when you digest food that takes calories, it takes energy to digest just the foods you eat.

Dawn (09:41):

So you burn calories by digesting food but your body is intuitive to know that hey, I don’t need to be burning these calories to digest this food that you just ate. I need to be redirecting these sugar molecules to my muscles so that I have the energy to run and climb and jump and get away and do those things that our body intuitively knows that it can utilize your muscles for.

Dawn (10:28):

And of course reproductive organs, you don’t need those if you are in a stressful event. And then additionally, your epinephrine and cortisol increases and then also your blood sugar increases. So your body’s going to take it out of your liver it’s going to put it in your bloodstream. So again, you can see how this cascade of events create this problem in our body that now we have our blood sugars elevated, our blood pressure’s elevated and we aren’t digesting foods.

Stress and indigestion problems leads to weight gain

Dawn (11:01):

And then your cortisone, your epinephrine and all of that is elevated. So you can see that if you have digestive issues that maybe it’s more stress related than a problem with other areas, maybe you’re not having difficulties in other ways, but it’s more of the stress and that’s why you don’t feel good when you eat. Has nothing to do with the food per se.

Dawn (11:32):

It has more to do with you what’s happening in your brain and what’s happening in your mind or what’s leading up to a meal. And if you’re ruminating on stressful events or things that have occurred that morning maybe at your job or your house what food may not feel very good when you go to have lunch because now you don’t have anything you need to digest that food.

Dawn (12:01):

So now it makes your stomach hurt, makes your belly hurt, makes have heartburn, makes you have indigestion and bloating and gas because you don’t have anything to digest the foods because all of that is shut off. You don’t have that rest and digest nervous system stimulated. And that’s where we’ll go next is the parasympathetic nervous system. So the sympathetic nervous system is fight or flight and the parasympathetic is rest and digest. So this is activated.

Stress and our digestive state

Dawn (12:35):

So your parasympathetic nervous system is activated once the stress is gone. So you know, get through the stressful event and now your body can kind of calm down and it can digest the foods that you have recently eaten and go back to work. And taking care of that energy that you have nourished your body with other things that can additionally stimulate that parasympathetic nervous system food, eating food can actually increase that parasympathetic or that rest and digest state.

Dawn (13:01):

And then whenever you feel pleasure. Those are areas that it can increase the stimulation of your parasympathetic or rest and digest nervous system. Let’s kind of go back to that example of you just found out you lost your job. So your body’s responses, your blood pressure increases, your blood sugar, increases the blood flow decreases to your digestive tract and your reproductive or organs, and then your cortisol and epinephrine increase.

Dawn (13:51):

So now what could happen if say your boss says, okay, yes, you’ve lost your job, but I’m giving you a one year severance package. So then what’s going to happen? Maybe at that point your parasympathetic will kick in and your heart rate and respirations will slow down so you won’t be breathing as rapidly and your heart won’t be beating as hard your blood pressure will drop. Your blood flow is diverted back to your digestive tract and your reproductive organs and then your cortisol and epinephrine also lower and then your blood sugar will eventually go back down.

practice parasympathetic nervous system to get away from stress

Dawn (14:21):

As long as your cortisol and epinephrine go down, then your body will naturally bring that back down too. So that’s where having multiple stressors and threats on your nervous system daily that the parasympathetic nervous system is never activated, that’s where the problems come. So we want the parasympathetic nervous system to be activated multiple times throughout the day.

Dawn (15:07):

And this is where it’s be. You need it to be a practice where you are practicing parasympathetic nervous system stimulators you. Are engaging in that. You are learning to turn those on so that you have the ability to lower that sympathetic or that fight or flight mode that kind of gets turned on easily throughout the day. So the natural rhythm of your parasympathetic and sympathetic hormones are so naturally your cortisol is high in the morning and then it just kind of tapers as it goes throughout the day and into the evening.

Dawn (15:51):

Your cortisol should be the lowest in the evening because then that’s when melatonin kicks in so that you can naturally be more calm and be ready to rest and sleep. When this rhythm is broken you are going to find that it’s very difficult to manage sometimes your cravings and just your ability to control that or power will not save you when this rhythm is broken with your sympathetic and parasympathetic nervous system, willpower is not going to help you.

Stress reacts to salt intake

Dawn (16:39):

And that’s where you find yourself grazing in the evening when you know what, you may not even be hungry and maybe more that you are just stressed. And there are some studies, I’m not even going into this, but I have talked about this before in some other podcasts and videos on cravings you know can find that when that stress hormone is elevated, the cravings kind of just go up and you have to be diligent at turning it off and not kind of evaluating, saying, oh my gosh, I want to snack on salty things.

Dawn (17:21):

For me personally, I can tell you when my stress is elevated I gravitate towards those saltier snacks. And some of that is because our adrenals, which is where the epinephrine and or epinephrine and cortisol are all released from, they’re two little small bean shaped things sitting on our kidneys and they release these stress hormones and they require sodium to produce all of these hormones.

Dawn (18:06):

And I’ve personally, I find that when I am stressed, I will gravitate more towards those crunchier saltier snacks that I don’t normally find are an issue for me. I can usually take or leave those saltier crunchier snacks but when I am stressed, that is where my body is going, that is where my brain is going and that is where it helps kind of stabilize that for me. So I automatically know that, okay, if I’m wanting to have a bag of potato chips.

Stress hormones and human body leads to weight gain

Dawn (18:41):

I know that my cortisol is elevated and I need to do something for myself to stop it and I need to shut off those stress hormones. And you know, may not always be you’re human, I’m human. We do things out of response sometimes and you long term you have to get to where you are not being reactive, but you’re being more proactive and identifying and recognizing, saying, you know what?

Dawn (19:21):

This is stress. I know why I’m wanting to go get a bag of chips is because I’m stressed, so I have a choice. What am I going to do right now? Am I gonna go get a bag of chips or am I going to go do a meditation or am I gonna go sit outside? Am I gonna go get my pet am ?  I going to hum a song or turn on some music and dance? What am I going to do to help myself and be a human? Sometimes you’re going to go grab that potato chip and there’s nothing wrong with that, but over time you have to get to where you’re like.

Dawn (20:01):

I know what this is and I really don’t need those chips. I need to go serve my body in a different way that can really help lower that cortisol level. So it’s all about protecting that natural rhythm so that the morning cortisol can be elevated, just not too elevated, and the evening cortisol can be lower so that your melatonin can be kicked on and you can rest and sleep well.

How does your sympathetic nervous system or flight lead to weight gain?

Dawn (20:28):

How does your sympathetic nervous system or fight or flight lead to weight gain? The first one is it can increase. Stress can increase hunger and appetite. When we’re thinking about stress and weight gain stress can kind of increase that need for food or really stimulate your appetite in a way that willpower is not going to work. So once your cortisol is kind of in a steady flow of an imbalance, your desire to eat goes up. And one study found that there was a direct correlation between an elevated cortisol level and cravings for high calorie foods especially sugar and carbs for were found to be an issue.

Dawn (21:24):

So those car snacky foods, and it could be any of them and it could even be salty car things as well. So there’s actually quite a bit of evidence connected with stress and your cravings and hunger and appetite can really stimulate these and cause a lot of mind battle because it’s easy to blame yourself and get yourself in this a spiral where you are saying better, you know, don’t need these and there’s no reason for you to not be able to make a different choice.

Stress reduction practices

 Dawn (22:27):

And when your stress hormones are just off the charts, you are just putting yourself in a place that you’re making it hard to make a different choice. So that’s where you might find it better serve you where when you are constantly, and again like we’re saying, you can’t control the stress you’re given but you can control how you react to it. 

Dawn (23:24):

And that’s where building a practice of stress reduction practices or things that you can do on a daily basis to make you more resilient to the stress and make you more capable of handling a higher amount of stress. So if you feel like I respond poorly to stress and I quickly go to food as my way to cope, then I would challenge you to reflect and understand that it really has nothing to do with your willpower, but more to do with these hormones driving it.

Dawn (23:43):

And if you intercede by building this practice of keeping your body in a less stressed state or in that parasympathetic state where your response is more balanced and not so up and down throughout the day because you’ve become more resilient and you’re like, okay, I know what I need to do to help myself that makes a huge difference. So it’s definitely about the regular practice that you do on stress reduction strategies that really can make a big difference.

stress increases the rate that you store fat

Dawn (24:34):

The second one, stress increases the rate that you store fat. Not only will you crave more sugar in carbs you may be more efficient at storing fat. Your body whenever your cortisol is elevated, then fat stores begin producing cortisol two. It’s kind of like this double whammy. So now that your cortisol is elevated, your fat stores start producing more. You can kind of see how this gets you in this vicious cycle of it’s hard to help yourself without stopping the stress.

Dawn (25:11):

So once you can stop the stress, then you remove that second production of cortisol with your fat stores. So if you can one, start lowering that cortisol response, then your fat stores are not going to be additionally adding to that. Most typically we find that when cortisol levels are elevated for long periods of time, usually what we find is that your midsection or your waist is where your weight will go. And that goes into number three, stress increases belly fat. So cortisol affects the way that your body distributes fat and it makes it easier.

Dawn (25:44):

You become more efficient at storing fat around your midsection. So sometimes when I work with patients and they’re saying I’m gaining weight, one question I typically ask is, where are you gaining the weight? Because sometimes that gives me enough information to know that hey, we’re dealing with maybe some cortisol issues, but insulin is another one that can drive that belly fat or that midsection fat estrogen can drive hips and thighs and around that bit and then also in your midsection as well.

Stress reduces your ability to burn fat

Dawn (26:44):

That’s where that information matters. So whenever your cortisol is elevated, you are more than likely to have more fat around your midsection. So again, which is frustrating because then guess what? The more fat you accumulate, you become more efficient at storing fat in your midsection. Then again, those cortisol levels, those fat stores are going to start producing cortisol two, but they also produce estrogen. And estrogen can make you gain weight and win at elevated levels.

Dawn (27:24):

Again, it’s kind of this vicious cycle that we have, which makes us become very efficient at storing fat instead of losing. So it does make you more weight loss resistant and making it more difficult to gain weight. This is how stress leads to weight gain and specifically weight in your midsection. So here the fourth one is it reduces your ability to burn fat. This is again, we’re leading into yes, it starts in the midsection but then it kind of just increases to all over the body.

Dawn (28:13):

So stress reduces your ability to burn fat. So it kind of shuts that off. It tells your body that we don’t need to burn fat, let’s lock those, those fat stores up and we’re not using those and we’ll just add to it. We don’t need to burn those. So you’re craving and storing fat more efficiently and it also leads to more fat all over the body. So you start off it, you gain more around your midsection and then it might continue to get deposited throughout your entire body.

Stress makes Inflammation rises

Dawn (28:54):

And then that’s where you know can recognize that your whole body is being impacted by this stress or these high cortisol levels. So higher levels of body fat then lead to more inflammation and making you more weight loss resistant. So again, here we go, we’re one, it’s like the snowball effect. You have high stress, your cortisol levels make you gain around the midsection.

Dawn (29:33):

Your fat cells actually start producing more cortisol, your fat cells start producing more estrogen. And now we have this increased inflammation throughout your whole body and now making you more weight loss resistant. So this goes right into our fifth reason of inflammation rises with high stress. So inflammation has been associated with chronic disease for a long time and it has been poorly understood on how psychological stress drives physical inflammation in your body.

Dawn (30:14):

But there is a study published in 2021 that found that psychological stress priming alters your inflammatory response. And they found that to be true in mice and in humans. So this is, it’s again, our body is so intuitive to know that long periods of your sympathetic or fight or flight this sympathetic nervous system is very in tune with what’s happening in your brain and mentally and emotionally. So it goes back to how can we help ourselves?

How can we stop this stress response and shut it off?

Dawn (31:05):

How can we stop this stress response and shut it off? Because if not, it’s again, this cascade of events that continue if we don’t shut it off. And this is where I do wish that practitioners would get more questions, they would ask more questions about this because it’s such an important piece and quit focusing on, okay, yes, they’re stressed and they’re eating crap food but it’s because the stress, it’s not because they have no willpower, has nothing to do with your abilities. It has more to do with we aren’t focusing on the real problem. And the real problem is your stress level.

Dawn (31:44):

We fix your stress level and we get you into a stress management practice where you are incorporating stress management skills and you are doing meditations or you are journaling, or you are doing things that shut off that sympathetic nervous system at least once a day, twice a day, whatever your body needs to prevent this cascade of events from occurring, stopping your fat cells from producing more cortisol and more inflammation and more estrogen making you weight loss resistant.

Dawn (32:36):

So again, it’s all woven together and you can’t fix these other areas without fixing the stress. And then the sixth one is gut bacteria are altered. So we know that stress works bidirectionally when it comes to gut bacteria and stress can alter your gut bacteria and gut bacteria can influence your stress levels. So again, it’s one of those things that is it the chicken or the egg? And you have to start with something, you can do both.

Stress Gut bacteria are altered leads weight gain

Dawn (33:24):

You could tackle both ends by addressing your gut bacteria and really ramping up your short chain fatty acids and your fibers and really growing your beneficial gut bacteria, correcting any gut dysbiosis, but then also working on the stress end. So yeah, sure you can do the diet changes, but then you’ve gotta do the lifestyle changes so that highway from our gut to our brain are working together and you’re not correcting one but not focusing on the other at all because you’re only gonna get so far with just doing one.

Dawn (34:00):

You don’t need to take a bunch of supplements and pills or even medications or probiotics or those types of things if we’re not working on your stress level two, cause they work together. There’s a study published in 2020, found that stress can reshape the gut bacterias composition through stress hormones, inflammation and autonomic alterations. In turn your gut bacteria release metabolites, toxins and neuro hormones that can alter eating behavior and your mood. In fact, some bacterial species may encourage dysregulated eating.

Dawn (34:44):

So again, it goes back to all of these areas are interconnected and when stress is out of balance and you have that rhythm off and your cortisol is not rising throughout in the morning and then slowly throughout the day getting lower so that your melatonin can kick in at night and have you rest in the evening and sleep well, that’s when all havoc gets when things get outta balance.

Stress raises your blood sugar and leads to weight gain

Dawn (35:12):

And then the seventh one is it stress raises your blood sugar and naturally cortisol increases your blood sugar when you’re in fight or flight. So that’s a natural response. I kind of talked about this at the beginning that this is your body’s way of saying, oh, we need energy, we need fuel to in our bloodstream so that we can run, we can jump, we can climb and get away from a bear or whatever is chasing us.

Dawn (35:44):

So our body is intuitive like that, but it’s not intuitive to know the difference between I’m being chased by a bear or I’m just really stressed about work. It cannot tell the difference. And in these days and times, those are the stressors that we’re under. We’re not under being chased by a bear in most cases. So this is where it’s important to. Yes, take a look at the big picture.

Dawn (36:17):

What are your blood sugar numbers? Why is your blood sugar elevated at a fasting level? Or why is your hemoglobin A1C slowly inclining? And it could be your stress hormones. Now, something that I did talk about recently on another post in regards to estrogen. As your estrogen lowers in menopause, this is something that we see increase is our cortisol levels increase, your inflammation increases and your blood sugars increase during this season of life.

Stress increases insulin levels leads to weight gain

Dawn (36:44):

So for females who are in that pyramid menopause to menopause season, you may find that it’s the drop in your estrogen that is driving this. So you might have to do things a little bit differently to support your body in a different way so that it can compensate for this lowered estrogen level and maybe working with a practitioner to get a sorted on some bioidentical estrogen so that you can stabilize that more readily with just hormones being added.

Dawn (37:35):

When you’re stressed, your body just prepares itself making sure that it has adequate sugar readily available. So insulin levels fall glucagon and epinephrine levels rise and more glucose is released from the liver. All of these things work together to prepare your body to manage this stressful event for this fight or flight. So as you are reflecting on, okay, so as I think through why am I gaining weight or why am I experiencing weight gain right now, why is this an issue?

Dawn (38:04):

And if you think about, okay, is my blood sugar elevated? Am I having issues with blood sugar regulation? That could be one thing to consider. Do I have inflammation like joint pain and other aches and pains that don’t make sense? It’s not like you just had an injury or a fall or something to that degree. And then where am I gaining weight?

Stress produces more estrogen and inflammation in cortisol

Dawn (38:46):

Is the weight gain in the midsection is ? it around my hips? Is it all all over my body? Is my appetite and my cravings, have those been altered? Do I feel like I find myself craving more carby sweet things or sugary things? I have to have those? Am I seeking that out in the afternoon? Am I having an afternoon crash and I need sugar or carbs or caffeine to perk me up? These are the things you’ve got to start asking and reflecting on so that you can put the whole big picture together to say, okay, how is my stress level? And many people, it’s interesting and I would say this is something that I had to learn.

Dawn (39:24):

I had to put that awareness around that, hey, my stress levels are elevated. I am having issues with my stress, so what can I do to help myself so that I can shut those stress hormones off quicker so they don’t have the ability to have my fat cell to get into where I’m stocking away all of this energy, all these calories are getting stored away in my fat and now my fat stores are producing more estrogen and inflammation in cortisol, which is making it even harder for me to lose weight and making it easier to gain weight.

Dawn (40:19):

So as you are reflecting on why am I having weight gain, go through these and just kind of timeline it and write it down on a piece of paper and say, when did this start? Then reflect back what happened three months, six months prior and what occurred, did anything change and ? what is going on that could maybe have set me up for this?

Realizing that your stress response is dysregulated and leads to weight gain

Dawn (41:24):

And then that’s where working with a practitioner like myself who can help really hone in on the right areas so that one than stress wont leads to weight gain. You’re not feeling overwhelmed, like, oh my gosh, I have to attack all of these. And that’s not true. We have to attack the right one that can kind of do this cascade of correction and lots of areas. So it’s not that you have to do everything all at once. It’s that you’ve gotta pick the right ones to focus on and then continue down that path.

Dawn (41:24):

And some of them correct themselves once you get the root cause of what’s driving it. If it’s truly stress that’s driving it, we’ve gotta fix the stress. There’s no sense in evaluating why you’re having issues with cravings all the time. If we’re not looking at stress as a driver. There’s no reason to just focus on your blood sugar only without bringing in the stress and. That realizing that your stress response is dysregulated and it needs corrected.

Dawn (42:04):

And if you’re having joint pain and other aches and pain issues just focusing on inflammation. And really helping calm that down may be the wrong place to start. It may be that we need to focus on the stress only and then it corrects all of those. So I hope you find that that makes sense because again. The big picture is these are kind of bidirectional things. They, it’s the chicken or the egg, which happened first and.

When you are in stress, experiment with what is going to work best

Dawn (42:40):

 I want you as a patient to feel empowered and to have those conversations with your doctor and saying.  Okay If I am experiencing high blood sugars, inflammation. I’m gaining weight around my midsection and I’m just really struggling with cravings. What can I do to help stabilize myself better until I can get through this and get out? And that’s what I would say I work with patients and on a lot is really just one. Acknowledging stress as a piece of the puzzle to one.  Why you’re gaining weight or why weight gain is such an issue and the connection with stress.

Dawn (43:05):

And we pull all these together by maybe not even focusing on anything on your diet. That may be the last thing that I do. I might really just focus on. How can I help you with your stress management and give you lots of tools to. Experiment with because there’s not one strategy that works for every person.

Dawn (43:57):

We all have to experiment with what is going to work best. When you’re deep in a stressful event. You are not gonna whip out your phone and plus press play on a meditation. You’re likely going to need to do some deep breathing. You might need to turn on some music and just kind of shake and dance it out. You might need to put your face in cold water you . Might need to do some other things that can really flip that dial quick for you. So that you don’t get yourself in a spiral.

Conclusion

Dawn (45:05):

And that’s what I work with my patients on really understanding all the tools that are available. And even just recognizing that. hey, my nervous system is dysregulated. My sympathetic nervous system is on high alert all the time and . My parasympathetic nervous system is shut off. And sometimes just acknowledging that and identifying that I am in fight or flight, this is what I’m feeling.

Dawn (45:05):

I am in fight or flight. And then what do you do to help yourself? So those are the things that I help patients work through because again. Having bariatric surgery is not something that is one and done. This is a lifelong thing. And you have to learn new coping mechanisms because sometimes in the past.  A lot of bariatric patients have relied on food as a way to soothe and comfort themselves in stressful events. And that is never going to be a great long term strategy for coping and

Dawn (45:45):

 It’s finding new ways that you can get the same calm and nervous system response by implementing. More healthy ways to get away from stress that can set you up for long-term success. So I really do hope this has helped you guys and giving you an insight to . How bad stress really can contribute to weight gain. So you guys have a great week and we will see you next time. Bye-bye.
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