DEAR DOCTOR K:

Why do I eat when I'm stressed out? Can you suggest ways to help me overcome this impulse?

DEAR READER:

Worry and pressure can cause a person to seek comfort, and one of the most immediate forms of comfort is "comfort food." It's good, and it's also a temporary distraction from what you're worrying about. But this is not the whole story.

The effect of stress on appetite is a bit complicated. An acute stressor can actually shut down appetite. For our ancestors in prehistoric times, an acute stressor might have been an approaching lion. For us it might be an approaching automobile, a fire, or a medical emergency involving a family member.

During such acute stress, the brain sends messages to the adrenal glands atop the kidneys to pump out the hormone epinephrine (also known as adrenaline). Epinephrine helps trigger the body's fight-or-flight response. That's a revved-up physiological state that temporarily puts appetite on hold.

But the drip-drip-drip of chronic stress, day in and day out, is a different story. The adrenal glands release another hormone called cortisol, which increases appetite and may also ramp up the motivation to eat. Once a stressful episode is over, cortisol levels should fall. But if the stress doesn't go away -- or if your stress response gets stuck in the "on" position -- cortisol may stay elevated.

Stress also seems to affect food preferences. Stress hormones increase a craving for high-fat, sugary foods. Once ingested, these foods may inhibit activity in the parts of the brain that control stress and related emotions. In other words, these foods really are "comfort" foods in that they seem to counteract stress. This may contribute to your stress-induced craving for them.

The best way to counter chronic stress-induced eating may be to deal with your underlying stress. You'll be killing two birds with one stone. Here are some suggestions for countering stress:

-- Meditation reduces stress and may help you become more mindful of your food choices. My friend Dr. Herbert Benson, a meditation researcher here at Harvard Medical School, described the following exercises to elicit the relaxation response:

Select a word, mantra, prayer or thought. Focus your attention on it in a relaxed manner.

When other, everyday thoughts intrude, let them go. Refocus your attention on step one in a relaxed and patient manner without frustration or judgment.

Start by doing this for five minutes. Gradually increase the amount of time you spend on the exercises.

-- Low-intensity exercise may reduce cortisol levels. Some activities, such as yoga and tai chi, have elements of both exercise and meditation.

-- Friends, family and other social supports can ease the effect of stress. Reach out to friends and family for help from time to time.

While you're working on lowering your stress, rid your refrigerator and cupboards of high-fat, sugary foods. Keeping those "comfort foods" handy is just inviting trouble.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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