When someone has too much cortisol (the stress hormone) in their body, like in Cushing syndrome, the fat builds up in the belly area but disappears from arms and legs, giving them a distinctive body shape with a big belly and skinny limbs.

Chronic elevation of cortisol preferentially promotes central adiposity due to the higher density of glucocorticoid receptors in visceral adipose tissue compared to subcutaneous depots.

A specific protein called glucocorticoid receptor helps the stress hormone cortisol control how fat is stored and broken down in body fat. This receptor is more abundant in the deep belly fat than in the fat under the skin.