Dysregulation Of The Hypothalamic-Pituitary-Adrenal (Hpa) Axis And Its Role In Obesity

Abstract

Obesity is a complex condition characterized by metabolic dysfunctions, chronic low-grade inflammation and an increased risk of cardiovascular disease, often associated with hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. This article reviews the role of dysregulation of this axis in the development and maintenance of obesity, with a focus on abdominal obesity. Chronic activation of the HPA axis, common in obese individuals, results in hypercortisolism, promoting increased visceral fat storage, insulin resistance and metabolic dysfunction. Failure in the negative feedback of the HPA axis contributes to sustained high levels of cortisol, intensifying metabolic complications. Phenotypic differences in body fat distribution, as well as external factors such as diet, sleep and psychosocial stress, also influence HPA axis activity, affecting appetite and energy balance. These factors aggravate the hyperactivity of the axis and promote weight gain. Therapeutic strategies that include stress control, regulation of HPA axis activity and lifestyle changes are highlighted as essential for the effective management of obesity and its comorbidities. It is concluded that interventions aimed at normalizing the HPA axis and controlling cortisol can be effective in preventing and treating obesity and its associated risks.