Stress and Pediatric Obesity: Neurobiology and Behavior

Abstract Pediatric and adolescent obesity commonly coexist with stress‐related symptoms and disorders. Stress, the state of threatened homeostasis, is associated with the acute activation of the hypothalamic–pituitary–adrenal axis and the sympathetic nervous system. However, the chronic activation of hypothalamic–pituitary–adrenal and sympathetic nervous system axes during chronic or intense stress can lead to a variety of psychopathological and physical conditions. Behavioral and neurobiological mechanisms link chronic stress with pediatric obesity, in a bidirectional relation. Chronically stressed individuals are characterized by low adherence to a healthy lifestyle and by disturbed eating behaviors, whereas alterations in the secretion of stress hormones might also contribute to obesity and obesity‐related complications. Obesity could lead to increased social distress, low self‐esteem, and anxiety, thereby contributing to a vicious cycle between distress and obesity and increasing further the risk of cardiometabolic morbidity. This review article summarizes recent research findings and discusses mechanisms linking stress with pediatric obesity.