The Impact of Psychological Stress on Obesity Risk in Women: The Roles of Emotional Eating and Sleep Quality

Abstract

Obesity in women is a serious global public health challenge closely linked to chronic psychological stress. The female hypothalamic-pituitary-adrenal (HPA) axis exhibits heightened sensitivity, predisposing women to unhealthy behaviors under stress. However, existing studies have examined individual behavioral pathways in isolation without integrating emotional eating and sleep disturbances into a unified framework. This narrative review searched PubMed, Google Scholar, and other databases for high-quality population-based studies published between 2020 and 2025. It examines gaps in the existing research on the multiple behavioral mechanisms through which stress may contribute to obesity in women, with a focus on the independent and combined mediating effects of three behavioral categories. Research confirms that chronic stress elevates cortisol levels, induces emotional instability and behavioral patterns such as emotional overeating and poor sleep, thereby increasing women's risk of weight gain; this behavioral pathway exhibits significant gender differences. Most existing evidence consists of cross-sectional data, with a lack of studies specific to women across their life stages. This review provides insights into combined behavioral interventions for the prevention and control of obesity in women and suggests directions for future epidemiological research.