Chronic stress, combined with positive energy balance, may be a contributor to the increased risk for obesity, especially upper body obesity, and other metabolic diseases. This association may be mediated by alterations in the hypothalamic–pituitary–adrenal (HPA) axis. In this review, we summarize the major research that has been conducted on the role of the HPA axis in obesity and metabolic disease.

Stress is thought to influence human eating behavior and has been examined in animal and human studies. Our understanding of the stress-eating relation is confounded by limitations inherent in the study designs; however, we can make some tentative conclusions that support the notion that stress can influence eating patterns in humans. Stress appears to alter overall food intake in two ways, resulting in under- or overeating, which may be influenced by stressor severity. Chronic life stress seems to be associated with a greater preference for energy- and nutrient-dense foods, namely those that are high in sugar and fat. Evidence from longitudinal studies suggests that chronic life stress may be causally linked to weight gain, with a greater effect seen in men. Stress-induced eating may be one factor contributing to the development of obesity. Future studies that measure biological markers of stress will assist our understanding of the physiologic mechanism underlying the stress-eating relation and how stress might be linked to neurotransmitters and hormones that control appetite.

Stress at work is an important risk factor for the metabolic syndrome. The study provides evidence for the biological plausibility of the link between psychosocial stressors from everyday life and heart disease.

The latest estimates from the Labour Force Survey show:

The total number of cases of work-related stress, depression or anxiety in 2013/14 was 487 000 cases (39%) out of a total of 1 241 000 cases for all work-related illnesses.

The number of new cases of work-related stress, depression or anxiety in 2013/14 was 244 000.

The rates of work-related stress, depression or anxiety, for both total and new cases, have remained broadly flat for more than a decade.

The total number of working days lost due to work-related stress, depression or anxiety was 11.3 million in 2013/14, an average of 23 days per case of stress, depression or anxiety.

The industries that reported the highest prevalence rates of work-related stress, depression or anxiety (three-year average) were human health and social work, education and public administration and defence.

The occupations that reported the highest prevalence rates of work-related stress, depression or anxiety (three-year average) were health professionals (in particular nurses), teaching and educational professionals, and health and social care associate professionals (in particular welfare and housing associate professionals).