The Hypothalamic-Pituitary-Adrenal Axis, Obesity, and Chronic Stress Exposure: Foods and HPA Axis

The prevalence of overweight and obesity has increased worldwide to epidemic proportions. Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis and chronic stress exposure are hypothesized to contribute to obesity development. In this review, we discuss the potential role of the HPA axis for energy balance regulation, with particular attention to energy intake. We present evidence from human and animal studies that highlight the bidirectional relationship between HPA axis functioning and energy intake. Of particular interest is the association between dysregulation of the HPA axis and altered homeostatic and non-homeostatic food intake regulation. Lastly, we discuss a model depicting a role for a hyperactive HPA axis in overeating and the development of obesity, suggesting chronic stress as a major risk factor for excessive weight gain and (visceral) obesity.