Patient-Friendly Explanation

Your body copes with stress by adjusting hormones, heart rate and blood sugar. When stress never switches off, those adjustments stay switched on and slowly wear the body down, and that cumulative wear and tear is called allostatic load. A high allostatic load is linked to weight gain, especially around the waist.

Clinical Definition

Allostatic load is the cumulative physiological cost of chronic or repeated activation of the stress-response systems, chiefly the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. Allostatic load indices combine primary mediators (cortisol, catecholamines, DHEA-S) with secondary outcomes (blood pressure, HbA1c, waist circumference, lipid profile) and tertiary markers such as IL-6 and CRP. Persistently elevated cortisol and catecholamines promote visceral adiposity, hepatic insulin resistance and heightened appetite drive.

Why It Matters

Patients with a high allostatic load often gain weight even when their diet has not changed, because stress hormones preferentially store fat in the abdomen. Assessing stress physiology alongside weight helps target the driver instead of only the symptom.