The Role of Stress Reduction in Cardiometabolic Disease Management for Patients with Obesity

Stress, emotional eating, and depression can have a profound impact on managing cardiometabolic diseases, particularly in patients with obesity, according to Monu Khanna, MD, a board-certified obesity medicine expert and current chair of the Obesity Medicine Association’s Diversity, Equity, and Inclusion Committee. In the interview above, Dr Khanna discusses the crucial role of psychological factors in managing cardiometabolic diseases in patients with obesity. She highlights how integrating behavioral strategies such as breathwork, yoga, and even dancing can help reduce stress and improve overall health in patients with obesity. These practices not only address the emotional components of chronic disease but also contribute to physical well-being, offering a holistic approach to treatment, Dr Khanna explained in the video above.

The following transcript has been edited for clarity, flow, and style.

Patient Care: How do psychological factors such as stress, emotional eating, and depression influence the management of cardiometabolic diseases in patients with obesity?

Monu Khanna, MD: Our central nervous system has two main branches: the parasympathetic and the sympathetic nervous systems. The sympathetic system is what keeps us alert, ready for action—think fight or flight mode. It’s essential in short bursts, especially in professions like emergency services or the military, where being in a heightened state of readiness is necessary. However, when this stress mode persists beyond those situations—lasting for months or years—it can lead to significant health problems. The heart stays in overdrive, and it becomes difficult to disconnect from racing thoughts. Over time, this constant state of stress can cause real damage.

That’s why it’s so important to incorporate strategies that help manage and reduce stress. Techniques like breathwork, yoga, tai chi, meditation, and even sound therapy—like chanting or sound bowls—can help calm the sympathetic nervous system and activate the parasympathetic system, which is responsible for relaxation. Creating that balance is essential because prolonged stress, marked by a constantly elevated heart rate and high blood pressure, is a well-known independent risk factor for cardiovascular disease.

By integrating these behavioral strategies, we can address cardiovascular risk beyond just medications. Other activities, like journaling, practicing gratitude, or even singing and dancing, can also play a significant role. Dancing, in particular, is a great way to engage both the body and mind. It’s often done with others, whether in a community setting or at home with loved ones, which adds an emotional connection. Plus, dancing requires coordination—whether it's remembering steps or adjusting to rhythms—which helps keep the brain sharp.

When we talk about reducing cardiovascular risk and aging successfully, dancing is a fun and effective way to incorporate both physical activity and mental engagement into daily life. It’s an enjoyable form of exercise that supports both emotional and physical well-being, making it a great addition to any lifestyle.