Cortisol belly and the TikTok detox trend

Philip Pape 0:00

Today we're talking about belly fat again. If you're over 40, your belly fat just won't budge. One of the theories you've heard all over social media is it's got to be related to cortisol, that you need a cortisol cocktail or an adaptogen like ashwagandha. Maybe drink less coffee, maybe work out less. Today I'm evaluating the cortisol claims. You'll learn how much cortisol really does have to do with belly fat, why lowering cortisol with a supplement probably doesn't do what you think, and what does shrink the deep fat, that visceral fat around your organs, once and for all. You've seen the cortisol stuff. The cortisol detox trend alone has hundreds of millions of views on TikTok. You've seen cortisol belly, cortisol face, the cortisol detox, and the adrenal cocktail with orange juice and coconut water and a pinch of salt. Please don't go off and make this thinking that that is the answer. The story goes like this: you're stressed. Stress raises cortisol. Cortisol stores fat in your belly. So lower the cortisol and the belly goes away. And if you're over 40, and especially if you're in perimenopause or menopause or gentlemen, you know, with lower testosterone, that probably feels true, right? Your life is stressful, your midsection has changed. There are real physiological things happening. And there aren't always great explanations online for why or what to do about it. Now, I want to be fair because stress does matter a ton for fat loss. I totally believe that. That is part and parcel of the things that we try to control with our habits and our behaviors to improve our ability to lose fat and improve our metabolism. But stress makes fat loss harder and cortisol puts fat on your belly, are two completely different claims. It's like a leap of logic. So today we're gonna separate them out for you. This also builds on a few recent episodes: episode 501 on what perimenopause does and doesn't do to weight, 506 on sleep, and then 507, where we looked at carbs and menopause. So we've been hitting a lot of these topics lately. If you want to go back in the feed or hit follow, make sure you get new episodes going forward. And then I wanted you to stick around to the end because I'm gonna give you the weekly dose of step count, the weekly walking dose that can potentially help with cutting that deep belly fat based on actual trials of postmenopausal women, could affect men and women. They didn't change what they ate. So we're gonna talk about that. So first I'm gonna explain why belly fat is really a whole body fat problem. Then we'll look at what the research says about cortisol, including studies that support the cortisol side, because there are a few of them. Then we'll talk about what's really changing with your body after 40 and then what to do about it. What is the fix, which is a lot cheaper and easier than a supplement, even if it does require effort, as any good solution does. So if fat loss, especially if you're older, if you're over 40 like me, if it's felt like it stalls right in the midsection, this episode is for

Belly fat and total body fat

Philip Pape 3:19

you. Okay, let's start with the belly itself, because I think this is where the cortisol story gets its firm foothold, because we just want to lose that belly fat. And, you know, a lot of us have something we're not happy with with our body, and it often goes right to that midsection, right? When you say belly fat, you're talking about two kinds of fat. There's subcutaneous fat, which is under the skin. That's the fat you can pinch, right? You can measure with calipers. Then there's visceral fat, which sits deeper around your organs. That is the fat tied to heart disease and diabetes risk. And when people post about cortisol belly online, they usually mean both, and they mean the fat that seems to stay there no matter what you do. You just can't get rid of it. So, can you target that fat? Can you do something that takes belly fat off your stomach specifically? The research says pretty consistently, no. I'm very sorry to say. In a small 2011 trial, people did ab exercises for six weeks on top of a diet. And compared with diet alone, the ab work didn't reduce belly fat. A meta-analysis of 13 studies with more than a thousand people found that training a body part did not reduce the fat on that body part, no matter who they studied or what program they used. And we can go on and on with countless studies that have tried to look at this and find things. And you've probably heard, you know, you can't spot reduce a hundred times by now. Well, the same logic applies to the hormone, cortisol, that supposedly targets your belly, and a supplement that supposedly untargets that thing to help with your belly. So we're gonna get into those things. Belly fat, however, does come off when your total body fat drops. And your body's gonna decide in what order you lose fat. Unfortunately, a lot of that is genetic. For a lot of people that are older, the belly is the last in line to go. I know it's frustrating. It is frustrating. It's also very normal. I mean, I've gotten fairly lean. I try not to get too lean because honestly, I'm not happy when I'm extremely lean and trying to maintain that. Well, even when I get fairly lean, that belly is just pudging out there, you know. And I'm sure a lot of you have that same frustration. And, you know, I know there's a double standard sometimes between men and women where men can kind of get away with it, let's say, or often walk around with pride, you know, even the big beer guts and stuff. And for women, it's a very different situation. So uh it's a big thing for a lot of you, but it's also a health concern. So if you've lost some weight and your belly looks about the same, that doesn't usually mean something's preventing you from losing belly fat. It just means you haven't lost enough total body fat. Or, and this is this is the part a lot of you are ignoring, the scale did go down, but you've lost some muscle. So it's not really targeting fat. And that's another important piece. Especially if you go back and listen two episodes ago, we talked about what to track for fat loss. When you diet without lifting weights and without enough protein, a meaningful part of what you lose can be muscle. It gets accelerated when you go to more extreme diets. It gets accelerated like if you're on a GLP-1 because it tends to help you lose weight faster. It's not because of the GLP-1, but because of the rate of fat loss of weight loss. And less muscle means you look softer at the same weight. Sometimes we call that skinny fat, depending on how light you are on the scale. So your belly looks just as big even when the scale goes down. And then you think, okay, I lost 10 pounds and my stomach didn't change. So then it must be hormonal. Like I just can't lose the belly fat, right? And then, of course, you go into your feed, and hey, there's a video about cortisol, and it's got like a really simple thing I can try, this detox, for example. Okay. And I'm simplifying, it could be one of a number of solutions. It could be some legitimate, you know, coach trying to sell you a training program that targets, you know, belly fat. I put it this way belly fat, especially with age, is a total fat problem and a muscle problem. If you can solve those two, you're giving yourself the best chance where the belly fat will follow slowly and probably slower than you'd like. Now, there are other factors like alcohol and things like that, assuming we've addressed those as well. Okay.

Protein to keep muscle while you lose fat

Philip Pape 7:27

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What cortisol does (plus Cushing's syndrome)

Philip Pape 9:03

right, let's get back to cortisol. What is it and why does it get blamed? Well, cortisol is a hormone that your adrenal glands make every single day. It rises in the morning to help you wake up, it helps regulate blood sugar and blood pressure, and it goes up when you're stressed or when you train hard, which is an acute stressor, and then it comes back down. You need it. Like every hormone, it is normal. It is part of your body. It isn't a toxin. There's nothing to flush out, which is why the word detox is a little funny here when I see it used. I would say detox is funny pretty much exclusively in the fitness industry because it almost is tied to some wild claim or product you don't need. Now, there is a condition where cortisol really does put fat on your belly. And that's called Cushing syndrome. That's when your body makes way too much cortisol for a long time, usually from a tumor, not always, or when someone takes high-dose steroid medication for many months. I've seen this in horses as well. A lot of horses will have this. People with cushions get central obesity, they get a rounder face, what you might call a fat pad on the upper back, muscle loss. When it's treated, a lot of that goes away. So the cortisol belly idea, I wouldn't say it just came out of the blue. I think it probably came from Cushien's disease. And a lot of trends start that way from a very narrow scope and application of something, kind of like the keto diet was for epileptics, and then it eventually became a general thing. The flaw is taking what happens in a disease and then applying it to the general population, or in your case, to a normal stressful week. Cushions is abnormally high cortisol all day for months or years, right? But for you, dear listener, if you don't have Cushions, something like deadlines at work, financial pressures, rough night with the parents or the kids might cause a normal rise of stress inside a normal range and then drops. And we're meant to handle those. I was joking with my wife. I was watching some show where half of an airplane got ripped off in midair and people started to fly out, and one person was holding on to the seatbelt. This might have been the new season of American Horror Story, I think, actually. And I was thinking, what would my body be doing if I was holding on to a seatbelt trying to prevent from flying out of the plane? Well, I bet it would be pretty damn stressful, right? And yet the body can handle those things because we evolved that way to handle super high moments of stress, acute stressors, and then it comes back down. Those are very different things, right? The disease-based stressor that we're not talking about here, and then the normal population, you, dear listener,

Cortisol and belly fat research

Philip Pape 11:36

and me. So what about us regular people? Does higher everyday cortisol go along with more belly fat? Well, you thought I was gonna say no, but there is some evidence for that, but you're gonna see in a moment why. Elisa Eppel at UCSF, she's a really well-respected stress researcher. She ran a study back in 2000 with 59 women and put them through some different uh stressful tasks in her lab. And the women who carried more fat around their midsection released more cortisol under stress. And that included some lean women with more fat at the waist. So that's maybe some of the best evidence for the cortisol side. But when you look at what kind of study it is, it's correlational. It's a snapshot. It shows two things together. It can't tell you cause and effect. When you look at bigger studies, the relationship gets a lot smaller. So there was a study of 2,500 adults in England between 54 and 87 years old that measured cortisol in hair. And hair cortisol gives you a picture of cortisol over several months. The correlation between hair cortisol and waist size was 0.08. Now that's statistically significant because of the large sample size, but the actual value explained less than 1% of the difference in people's waistline. So even though it was it was statistically significant, showing that there wasn't a difference. Okay. And then a 2022 meta-analysis of more than 34,000 people found the same pattern, a consistent but small correlations of like 0.1 to 0.2. So there's a very, very, very tiny link, and it's probably correlational. And there is, you know, research that the belly or belly fat can produce cortisol. It's not that the cortisol is calling the belly fat. That's where I think the key here is that the link is the other direction. Your fat tissue has an enzyme. I had to write this down. It's called 11 beta HSD1 that turns inactive cortisone into active cortisol right inside the fat. So people with more fat tend to have more of it. So more belly fat may mean more cortisol instead of the other way around. That's what I'm saying. Now, to be fair to both sides, we we love nuance here. Most of the evidence that this local cortisol causes belly fat comes from mice. Okay. Like much of the research, we have to basically limit our claims here to what we know and what populations we know, especially when it's not in humans. Now, let's look at actual human trials, because this is what matters. If cortisol were driving belly fat, stick with me. If cortisol were driving belly fat, then lowering cortisol should lower belly fat. That's pretty logical statement, I think. The most popular way that people try to lower it, believe it or not, right now, is Ashwagandha. Now, I'm a fan of Oswagandha in some cases. It does seem to lower measured cortisol, but it lowers stress. I've known many, many people, especially women at certain points in their life who've taken it and it's helped, but I've also seen it stop working for some and be more of a crutch or band-aid for others. So it really depends. There was a trial of 52 stress adults over eight weeks, and cortisol dropped more than with a placebo. So this was on Ashrogonda. The Ashrogonda group lost a couple of pounds more when you compare the change scores between the groups, but they didn't measure belly fat or body fat. Also, the product was supplied by the company making it, if that matters to you, when you're thinking of conflict of interest. And then the body weight at the end wasn't different between the groups. And then when a much more recent meta-analysis this year in 2026 pooled together trials that did measure body fat, Aswagonda had no significant effect on body fat percentage. So cortisol went down, but body fat didn't. So isn't that interesting? That's a fairly direct uh evidence from that at least that lowering cortisol and losing belly fat are two separate things, which is something I've been talking about for a long time anyway, but it's good to see studies that, you know, continue to reinforce things that you believe to be the case. And that's how science works, because if it didn't, you'd have to change your mind about it. Now, what about the rest of the toolkit here for cortisol?

Cortisol cocktails, coffee, and hard workouts

Philip Pape 15:43

The crazy social media TikTok toolkit. You've got the adrenal cocktail, the orange juice, coconut water, salt. You know, there are no studies behind this stuff, right? Adrenal fatigue, which is the idea underneath a lot of this, came from a 1998 book by a naturopath who sold supplements for it. And in 2016, there was a systematic review that concluded no evidence that adrenal fatigue is a real medical condition. No endocinology society recognizes adrenal fatigue as a diagnosis, as far as I can find. Cutting coffee. Now that's another interesting one. Caffeine does raise cortisol if you're not adapted to it, if you're not used to it. But in a study where people took caffeine every day for five days, the morning cortisol response basically went away because their body adapted. So your morning coffee is probably not the problem. Although coffee late in the day can definitely affect your sleep. We're going to come back to sleep later in this episode. Now, what about I've I've heard people talk about skipping hard workouts because of the stress. Now, to me, this is ridiculous because that is the stress that you want most of all. Hard training raises cortisol for a few hours. It also raises blood pressure, just in case you didn't realize that. Also raises your heart rate. You know, nobody complains about getting their heart rate raised, you know, which is a sign of stress, but somehow we haven't come around to the fact that hard training and higher blood pressure and higher cortisol from that is also a good stressor. This is a normal signal. This is a normal signal. And we know from studies from meta-analysis that hard training can reduce total fat, belly fat, visceral fat, you know, when combined with proper nutrition and energy intake, of course, but there are forms of training like lifting weights and even sprinting that seem to have a unique benefit for reducing visceral fat. So why would we be reducing our workouts, like those types of workouts? I think it actually is the opposite. Like you should be doing these things, not doing more. I'm not saying go out and do a bunch of cardio, but doing the right types of, you know, lifting things. Don't avoid them just because they quote unquote cause stress or increase your cortisol.

Belly fat after 40 and the menopause transition

Philip Pape 17:53

All right. So if everyday cortisol isn't the main driver of belly fat, then what is? Because something seems to be changing as we get to into our 40s. You know, for many of you probably could have started in your mid to late 30s, in your 40s, 50s, you're not imagining this. For women, the biggest change, of course, is perimenopause and then the menopause transition. The Swan study we talk about all the time that followed thousands of women through menopause. They see that when the transition of menopause begins, the rate of fat gain roughly doubles and lean mass starts to go down. So you start to lose muscle and gain fat more quickly, and that keeps going until about two years after your final period and then levels off. And there doesn't seem to be as much of a change on the scale because they're canceling out, right? The fat you gain, the muscle you lose, is canceling out. Um, I went through this on a few recent episodes. Now, where does that fat go? Well, Lovejoy and colleagues, I mentioned this on episode 507, the carb cycling episode. They followed 156 women for four years and they used CT scans. The women who went through menopause gained visceral fat, the deep belly fat we're talking about today, and it tracked with their estrogen falling. But they also burned less energy while they slept, they burned less fat, and they moved a lot less. So, what about cortisol during menopause? The Seattle Midlife Women's Health Study looked at exactly that. Sometimes we actually do have studies on this stuff. Some women's cortisol did rise late in the transition, but once they accounted for the other hormones changing at the same time, stress and symptoms had very little to do with it. And then the best evidence for a hormone uh lever or cause related to belly fat in this group is, of course, hormone replacement therapy, HRT. So there was a study of 107 trials that found menopausal hormone therapy reduced abdominal fat by about 7%. Now that's a real change. That's a meaningful change. Meaningful, modest, depending on what you think 7% is. But HRT isn't recommended as a treatment for belly fat, but it's definitely a conversation with your doctor when it comes to symptoms. And of course, if you get a benefit for belly fat, that's great. But right now it isn't like indicated as a treatment to reduce belly fat. Because going back to what I said earlier, it really ultimately comes down to are you lifting? Are you managing your nutrition? Are you managing your body fat? That is what's going to make the biggest difference, as well as things like you know, sleep stress and alcohol. For men, it's a bit simpler. Men already store more fat around the middle. And with age, less activity, you know, the gradual muscle loss only make that worse. And you don't need a story about cortisol there either. It's pretty obvious why it's happening. A lot of men also drink a lot more alcohol and things like that. So now where does stress

Stress, sleep, and eating habits

Philip Pape 20:35

come in? Right? Because I don't want you to think stress doesn't matter. It absolutely matters, but it mostly matters as it ties to your behavior because it can throw off your sleep. It can make you eat more, it can make you drink more. It can make you get, I'll say, more apathetic or lazier and skip your workout. Uh, maybe lazy is a harsh word, but you know, you feel less energetic, so you might skip your workouts. So sleep is a big one as well, tied to stress, as I just mentioned. In a Mayo clinic study, people limited to about four hours of sleep for two weeks, ate 300 more calories a day, and their visceral fat went up 11%. That is crazy for two weeks. All right. Now, that was young, healthy adults, mostly men, but if it can happen in them, it can definitely happen in anyone else. The pathway, as you see here, it's food and sleep. That's how stress gets to your belly. It's food and sleep. It's training, it's lifting, it's movement, it's all the behavioral things we talk about on this show, not some mystery of your body producing more cortisol, if that makes sense. So stress affects fat loss. Yes. Does cortisol cause your belly fat? For most people, no. That's the distinction I want to make. All right, so what do you do?

4 basics for losing belly fat

Philip Pape 21:41

This is the deceptively simple part. Okay. And I'll keep it to four things. Number one, get into a calorie deficit that is reasonable for you if you're trying to lose belly fat at a decent clip. Belly fat comes off when total fat comes off. So you need to lose total overall body fat. I'd rather see you run a moderate calorie. Calorie deficit for a little bit longer than an aggressive one that you can't sustain. But I'm all for aggressive deficits for people who are really good at tracking and I'll say are somewhat disciplined. I mean, I hate to use that word, but it's true. Something like a rapid fat loss, right? You're gonna you're gonna track the right things, like your trend weight and your waist measurement. And for many of you, your belly is gonna be the last thing to go. So you might have to get fairly lean. I'm just telling you the reality of it. Number two is I want you to keep lifting weights with progressive overload, with the compound lifts, with the main, you know, prime movers of your movement patterns. Now, lifting on its own isn't, I'll say, the strongest tool for visceral fat. We know this from studies. We actually see that aerobic exercise sometimes has a bigger impact on visceral fat, but lifting is what keeps your muscle, makes you stronger, improves so many other things, and you don't want to lose muscle mass. But then combined with some appropriate cardiovascular exercise, including my one of my favorites, which is sprintine, you can really then jack up the ability to lose that belly fat. Number three is, of course, protein. I mean, we have to think of the nutrition side, always eating more protein. Many of the studies that look at more versus less protein for keeping lean mass, you've got to have a certain minimum. And there, the numbers are kind of all over the place, but they narrow in on a pretty reliable window, which is around 1.6 kilograms or grams per kilogram or 0.7 grams per pound, which I've said for probably years at this point, right? So about 0.7 grams per pound of protein spread across your meals in whatever way worked practically for you. A lot of you who live or listen to the show already eat more than that. That's fine. But if you're not even there yet, that is a very, very important metric for holding on to that muscle mass so that you can lose your belly fat and your body fat. And then number four is add in walking or other cardio. If you're not even walking, like at least say 7,000 steps, getting to that point is a big lever. Like going from 3,000 to 7,000, huge. But other forms of cardio as well. We're not going to make this a cardio episode. We don't want to overdo it with cardio where it's too stressful, right? That's a whole different issue. But definitely walking, definitely doing those fun, active things you like to do with your family, with yourself, with your dog, playing pickleball, going hiking, walking your dog, whatever. And then other forms of cardio like sprinting. Please, please, please protect those hours of sleep and your consistent sleep uh wake times. Just do what you need to do with your schedule, with your loved ones in your house to make it work so that you can get the solid amount of sleep that you need. Sleep is the stress management with the best evidence behind it for body composition. So we can talk about mindfulness and stress and breathing and all that, but if you can fix your sleep, that's gonna be a big part of it. And that's it. You don't need a cocktail, you don't need an adaptogen, you don't need a cortisol test, you need the basics of behavior change, a calorie deficit, if indicated, lifting weights, enough protein, some cardio. I know it sounds boring, but it's also the evidence-based combo that's gonna work for

Bonus: weekly habit for deep belly fat

Philip Pape 24:58

you. All right, before we wrap up, I promised you how a weekly walking dose from a menopause trial. I'm gonna give you that in just a second. But if you know someone who's been drinking cortisol cocktails or spending money on adrenal supplements to get rid of belly fat, send them this episode, please. Just text it to them. It's one of the best ways you can support the show. You'll save them some money and some frustration. They'll thank you for setting them on the right path, I hope. It helps the show reach more people needed. Just text it to them. Share this episode with a friend. All right, if you want to lose belly fat after menopause, there is a study, a year-long trial in Seattle, looking at 173 sedentary postmenopausal women. None of them were on HRT, and they were split into an exercise group and a stretching group. Now, the exercise was mostly brisk walking. Remember, they're sedentary, they don't lift weights or anything else. They didn't change what they ate. The exercisers lost between 3 and 7% of their deep belly fat. And the women who did the most, which is a little over three hours a week, lost the most. So, what does that tell you? Perhaps look at a target of three hours of brisk walking a week, which is like 30 to 45 minutes most days. And again, you don't judge it. We're not gonna judge how much weight you lose on this. This is interesting. In the study, the difference was only three pounds of weight loss, but the walking group lost three to seven percent of deep belly fat. That is really powerful. So, brisk walking for me, that's like four miles an hour. It's pretty fast. For you, it might be three and a half, might be three. All right. An incline, things like that to make it harder probably help a little bit more, but definitely aim for whatever makes sense from where you are today. All right, until next time, keep using your wits, lifting those weights. And remember, cortisol isn't a toxin that you need to flush. Your belly fat comes off the same way the rest of the fat does by doing the boring basics. I'm Philip Hape, and I'll talk to you next time here on the Wits and Weights podcast.