The cortisol cocktail
...pass me a chamomile tea
I had some crazy idea that I might write two posts per week for this Substack, but then I went back to work and…here we are, on Saturday afternoon.
Before I fired up the office laptop this Monday, I promised myself that I would definitely be controlling my stress this year. The few weeks leading up to Christmas had been - special. It was relentless. After a bit of down time over late December and January, I was feeling great. I’d been to the gym loads, spent time with friends and family, read, watched rubbish on TV and slept in once or twice. Bliss. I wanted to hold onto the peaceful serenity of my time off.
Reader, it lasted until Wednesday. Two days in Cambridge on the bounce, more meetings than I could actually get to, an email backlog and an awkward conversation -and the effects of my EFT tapping, EMDR meditations and early nights were beginning to dissolve into a fond memory. I was in denial that I was getting stressed until after a particularly energetic gym routine this morning, when I noticed tell-tale stained glass vision and developed an ocular migraine at the Aldi self-checkouts. Oh, the glamour. I’m fine after a nap and some lunch, but it was a warning.
Viscerally stressed
I’ve been doing some research into stress, cortisol and weight loss. It seems that even with Mounjaro on my side, stress can cause weight gain - or at the very least, a stall in weight loss. Although there are a lot of ticks on my side - eating well, GLP-1 and the gym, at the same time, perimenopause, HRT, and work stress are the most likely working against me.
According to experts, stress is very likely the main factor if you’re holding onto visceral fat, the fat that’s stored deep inside the abdomen. While the fat under the skin is relatively harmless in itself, too much visceral fat adds to the risk of type 2 diabetes, heart disease, high blood pressure, and some cancers, all things I’d rather avoid.
I’ve been a bit obsessed with visceral fat since I started this ‘journey’ (I hate that I can’t think of another word for it, as it’s such 2020 influencer speak). It was the first thing that I noticed, on the whizzy bathroom scales that measure everything, and I get a little bit excited when I see a drop in that particular metric.
One of the biggest studies into Mounjaro, the SURMOUNT study from 2025, found that Mounjaro was associated with ‘significantly reduced waist circumference and visceral fat mass compared with placebo.’ So, another thumbs down to the ‘it’s just an appetite suppressant’ naysayers.
Where the cortisol comes in…
Stress - and cortisol - can put a spanner in the works though and unhelpfully derail weight loss, whether you’re using a GLP1 or doing it the old-fashioned way. Put simply, when people experience ongoing psychosocial stress , the body goes into fight or flight mode, trying to protect them. It repeatedly activates hormones, nervous system…and metabolism.
Long term stress - the type that builds and builds, seems to make some people really store visceral fat. How good you are at ‘habituating’ (meaning that your stress systems calm down even when the same stress keeps happening) influences whether you cling onto your visceral fat or gain harmless, under-the-skin fat instead. Here’s a study that explains it all in longer words.
Cortisol, the stress hormone, is the culprit.
Key general effects (not Mounjaro-specific):
Cortisol increases fat storage, especially visceral fat.
It changes appetite and increases hunger and cravings for high-calorie foods.
High cortisol can influence insulin resistance and how the body uses glucose and fat for energy.
So, what am I going to do about it?
My options are limited, given that I don’t have a secret stash of cash that means I can give up the day job and write story books all day.
What I do have is ChatGPT and despite my raging about it stealing creative jobs. I did ask it how to target visceral fat on Mounjaro, and it told me “The key is to support the medication with the right habits so the fat loss comes from the abdomen and not muscle.”
That’s a good start. Apparently, I’m doing a lot of things right. I’ve upped my protein, I eat enough calories and keep myself properly fuelled, especially on gym days when I also try and boost my protein intake like a good girl. I’m already strength training (don’t I know it, the new routine is going to hurt tomorrow).
What I need to add in is a bit more walking, and more sleep.
I also need to drop some of my at-home fitness sessions as they are putting too much stress on my body when it’s already stressed. Less intensity and more recovery days. Lifting kettlebells and doing ab crunches on top of the walking, swimming and gym workouts could actually be making my body hold on to its fat stores - which ties in with the findings from the research.
To calm the stress responses, I’ve got to:
Do breathing exercises (especially on travel to Cambridge by train days)
Keep my meals regular and absolutely-don’t-skip-them (whoops).
Chill out after work
Put my phone down 10-15 minutes at least at lunchtimes (lunch break? What is this thing of which you speak?)
Go to bed at around the same time every night
So. That’s me told. I did manage to do this for the first two days of last week. I’ve also been listening to EMDR meditations on the Calm app at night, and they make me go to sleep, so I’m not complaining. Apparently they are ‘a massage for your brain’.
I do have a nifty plan that ChatGPT generated for me, which I’m happy to share with any other stressed out Mounjaro users of a certain age. It might be helpful? I’ll keep you up to date with how well it works.