[subcosmos]

I don't focus on the whole HPA axis much, and in general the "adrenal fatigue" phrase doesn't have a great reputation among most of my colleagues. I hesitate to write it all off though.

From my diabetes work, its clear that corticosteroids definitely have a strong role in the development of metabolic syndrome, but I'm not sure about its ties to hypothalamic functioning. In the hypothalamus, the effects can be a lot more direct. Eventually its decision-making feed into the sympathetic/parasympathetic nervous systems which directly regulate metabolism and fat release in peripheral tissues. IE, your fat and muscle cells take direct neural firings from the autonomic nervous system as marching orders of whether or not its time to store energy or burn it.

So if the central neurons in the hypothalamus adjust to promote a higher setpoint body weight, that central point in control will direct weight gain via many downstream factors, some of which may be hormonal. Right now a central focus in research is figuring out why the hell the hypothalamus is driving the setpoint higher and higher. It seems like inflammation there might be a strong culprit.

Hopefully someday we will figure out what about our mass produced consumables are gumming up the works there.