Stress does not always stay in the mind. When it becomes a constant part of daily life, it can affect sleep, eating habits, blood sugar control and how the body stores fat. This has important implications for South Africans. Chronic stress is increasingly linked to metabolic health problems such as obesity, type 2 diabetes and cardiovascular disease.
The connection is concerning in a country that already faces a significant burden of these conditions.
According to the International Diabetes Federation, an estimated 2.32 million South African adults were living with diabetes in 2024. Workplace stress is also widespread. Gallup’s 2026 State of the Global Workplace report found that 36% of South African employees experienced significant stress the previous day.
Stress is a normal response that helps the body deal with pressure. The problem arises when that response stays switched on for long periods. One of the hormones involved is cortisol. Prolonged changes in cortisol can affect blood sugar regulation, insulin sensitivity and fat metabolism.
Nicole Jennings, spokesperson for Pharma Dynamics, said most people know stress can affect mood and sleep, but fewer realise it can also disrupt the body’s metabolism. Research has linked long-term psychological stress with changes in glucose metabolism, reduced insulin sensitivity and the build-up of visceral fat around the abdominal organs.
Behaviour also plays a role. People under constant pressure may eat differently, exercise less or sleep poorly. Stress-related eating, for example, can lead to weight gain over time, which then raises the risk of high blood pressure and type 2 diabetes.
This creates a difficult cycle. Stress can contribute to behaviours and biological changes that harm metabolic health, while living with a chronic condition can add further physical and emotional stress. Poor sleep often becomes part of the same cycle, reducing energy for exercise and making healthy eating harder.
Metabolic conditions frequently occur alongside cardiovascular risk factors such as high blood pressure, abnormal cholesterol and excess abdominal fat. Together, these increase the risk of heart disease and stroke.
Reducing chronic stress will not remove every health risk. Genetics, diet, physical activity and other factors all play a role. However, managing stress can form part of a broader approach to protecting long-term health. Regular movement, enough sleep, a balanced diet, avoiding smoking and moderating alcohol can all help. Mindfulness practices and strong social support may also make a difference.
Jennings says stress management should not be seen as a luxury, but as part of looking after long-term health. Persistent stress deserves to be taken seriously as one piece of the wider picture of metabolic and heart health.
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