The role of socioeconomic stress in the risk for obesity and diabetes: potential new targets of treatment

Our health can be negatively affected by chronic stress. Stress can be normal variable hassles of daily life, life events, or sleep disruption, or it can be the more chronic social stresses related to personal role in community, economic status, or status incongruity. Socioeconomic stress is often overlooked as being a significant contributor to the increased prevalence of many chronic diseases like obesity, diabetes mellitus, cardiovascular disease, and cancer; however the evidence is now compelling. Although correlations between socioeconomic stress and chronic disease have been made, the physiologic mechanisms by which socioeconomic stress results in increased risk remain poorly understood and are only now being explored. For example, chronic stress can lead to a chronic increase in cortisol secretion, leading to accelerated lipolysis, truncal obesity, and insulin resistance, which are risk factors for the development of type 2 diabetes. We will review our current understanding of how socioeconomic stress contributes to the development of obesity, insulin resistance, and type 2 diabetes, and discuss newer targets for therapy based on these observations.