Key Takeaways
- A 2026 survey found teacher stress and burnout about 20 points above similar workers.
- Studies of cortisol in burnout disagree, and some find lower cortisol with burnout.
- Stress eating and short sleep are clearer routes to weight gain than cortisol alone.
- Evidence for school-wide changes is low quality, and exercise may ease exhaustion.
- Tirzepatide can reduce weight and visceral fat but doesn't treat stress, burnout, or cortisol.
Teacher stress is measurably high, and it may contribute to weight gain through eating and sleep.
Evidence that everyday cortisol levels add belly fat is weak.
How Common Teacher Burnout Is
In a nationally representative 2026 survey, US public school teachers reported more burnout and frequent stress than similar working adults.
| Survey | Measure | Teachers | Similar Working Adults |
|---|---|---|---|
| 2026, 829 teachers | Often or always stressful work | 55% | 34% |
| 2026, 829 teachers | Met burnout cutoff (two of four items) | 57% | 36% |
| Late 2024, 1,989 teachers | Always or very often burned out | 44% | Not measured |
Similar working adults were college graduates aged 18 to 65 who work at least 35 hours a week. The two surveys asked different burnout questions, so their figures differ. All figures are self-reported.
Teachers in the 2026 survey reported working about 50 hours a week on school work and four hours on outside jobs. Their top stressors:
- managing student behavior, about half
- low salary, 33%
- hours outside contract time and administrative work, 32%
A review of curriculum design models notes that one model involves teachers from start to finish. It also notes that a cyclical model is time-consuming in practice.
The international disease classification lists burnout as an occupational phenomenon from chronic workplace stress, not as a medical condition.
What Cortisol Does Under Chronic Stress
Chronic stress can change the daily pattern of cortisol, a steroid hormone that helps the body respond to stress.
The adrenal glands make cortisol. The hypothalamus and pituitary gland control its release, and the three glands form the HPA axis.
Cortisol is normally highest in the morning and much lower by late afternoon. A meta-analysis found cortisol tends to rise when a stressor begins and fall as time passes. In the same analysis, uncontrollable stress tended to produce a high, flat daily curve.
A systematic review found no cortisol measure that reliably separated people with and without burnout. A meta-analysis found job stress went with a larger cortisol rise after waking, while exhaustion and burnout went with a smaller rise.
In a study of 66 teachers in Germany, those with high burnout scores secreted less cortisol on all three sampling days.
Cortisol, Cravings and Belly Fat
Stress is linked to eating more sweet and fatty food in some people, but cortisol clearly expands belly fat only at very high levels.
In a laboratory study of 59 women, those whose cortisol rose most under stress ate more calories afterward. A review found chronic stress is linked to a preference for foods high in sugar and fat.
Fat deep in the abdomen has more cortisol receptors than fat under the skin. Cushing's syndrome, a disorder of excess cortisol over a long time, can cause weight gain in the face, abdomen, and upper back, with thin arms and legs.
Across 146 observational study groups, long-term cortisol measured in hair tracked with body mass index and waist size, but the links were small. Belly fat itself can make cortisol, so observational links cannot show which came first.
High job strain did not predict weight gain or new obesity in eight pooled cohort studies. Job strain means high demands with low control.
Stress and Sleep
Short sleep is linked to later burnout and to eating more.
Teachers in the 2026 survey reported about six hours of sleep a night, below the seven or more hours adults need.
One short night raised cortisol the next evening by about a third or more in a laboratory study of young men. A meta-analysis of sleep-restriction experiments found people ate about 385 more calories a day after short sleep without burning more. That extra intake may contribute to weight gain.
In a two-year study of 388 working adults in Sweden, sleeping less than six hours was the strongest predictor of later clinical burnout.
What Helps: Workload, Exercise, Sleep, Food
Exercise and a reduced-calorie diet can both reduce visceral fat, while school-wide changes for teacher stress have little testing.
- Workload: The stressors teachers rank highest are organizational. A systematic review rated the evidence low quality, with small benefits.
- Exercise: National guidance calls for 150 to 300 minutes of moderate aerobic activity a week, plus muscle strengthening on at least two days. A systematic review found physical activity may ease exhaustion, though few high-quality studies exist. A meta-analysis linked exercise to about a 6% drop in visceral fat even without weight loss.
- Sleep: Adults need seven or more hours a night.
- Food: The same meta-analysis found a reduced-calorie diet produced more weight loss than exercise and also reduced visceral fat.
When Lifestyle Changes Are Not Enough: Tirzepatide (Mounjaro, Zepbound, and Compounded)
Tirzepatide can reduce weight and visceral fat, but it doesn't treat stress, burnout, or high cortisol.
It is a once-weekly injection that activates GIP and GLP-1 receptors, which are involved in appetite.
| Product | US Status |
|---|---|
| Mounjaro (tirzepatide) | Approved for type 2 diabetes; weight-loss use is off-label |
| Zepbound (tirzepatide) | Approved for weight management and moderate to severe obstructive sleep apnea with obesity |
| Compounded tirzepatide | Pharmacy-made; not FDA approved |
The FDA approved Zepbound for adults with a body mass index of 30 or higher, or 27 or higher with a weight-related condition. It is used with a reduced-calorie diet and more physical activity.
In a 72-week trial of 2,539 adults with obesity or overweight and no diabetes, average weight fell 15% to 21% by dose, versus 3% on placebo. Waist size fell by about 5.5 to 7.3 inches, versus 1.6 inches on placebo. In a body-scan substudy of 160 participants, estimated visceral fat fell about 40% on tirzepatide versus 7% on placebo. That result came from an unplanned (post hoc) analysis.
Common adverse reactions can include nausea, diarrhea, vomiting, and constipation.
Tirzepatide carries a boxed warning because it causes thyroid C-cell tumors in rats. Whether it does so in humans is unknown. People with a personal or family history of medullary thyroid carcinoma (MTC) or with multiple endocrine neoplasia syndrome type 2 (MEN 2) must not use it.
The FDA does not review compounded drugs for safety, effectiveness, or quality. It declared the tirzepatide shortage resolved in December 2024. It had received more than 730 adverse event reports associated with compounded tirzepatide as of May 31, 2026. Starting a prescription drug is the prescribing clinician's decision.
Sources
- Teacher stress and burnout: Steiner et al., RAND (State of the American Teacher), 2026; Walton Family Foundation and Gallup, Teaching Tomorrow, 2025
- Curriculum models: Bhuttah et al., Eur J Soc Sci, 2019
- Burnout definition: WHO, Burn-out an Occupational Phenomenon, 2019
- Cortisol basics: Endocrine Society Adrenal Hormones, 2022; MedlinePlus Cortisol Test, 2024; NIDDK Cushing's Syndrome, 2018
- Chronic stress and cortisol: Miller et al., Psychol Bull, 2007
- Cortisol in burnout: Danhof-Pont et al., J Psychosom Res, 2011; Chida and Steptoe, Biol Psychol, 2009; Pruessner et al., Psychosom Med, 1999
- Stress eating: Epel et al., Psychoneuroendocrinology, 2001; Torres and Nowson, Nutrition, 2007
- Visceral fat and receptors: Rebuffé-Scrive et al., J Clin Endocrinol Metab, 1990; Lee et al., Biochim Biophys Acta, 2014
- Cortisol and body fat: van der Valk et al., Obes Rev, 2022; Incollingo Rodriguez et al., Psychoneuroendocrinology, 2015
- Job strain and weight: Kivimäki et al., Int J Obes, 2015
- Sleep need: CDC About Sleep, 2024
- Sleep and cortisol: Leproult et al., Sleep, 1997
- Sleep and intake: Al Khatib et al., Eur J Clin Nutr, 2017
- Sleep and burnout: Söderström et al., J Occup Health Psychol, 2012
- Organizational interventions: Naghieh et al., Cochrane Database Syst Rev, 2015
- Physical activity guidance: Physical Activity Guidelines for Americans, 2nd Edition, 2018
- Physical activity and burnout: Naczenski et al., J Occup Health, 2017
- Exercise, diet, and visceral fat: Verheggen et al., Obes Rev, 2016
- Tirzepatide labels: Zepbound label, 2026; Mounjaro label, 2026
- Weight management approval: FDA Approves New Medication for Chronic Weight Management, 2023
- Weight and waist trial: Jastreboff et al., N Engl J Med (SURMOUNT-1), 2022
- Visceral fat substudy: Look et al., Diabetes Obes Metab (SURMOUNT-1), 2025
- Compounded GLP-1 supply and safety: FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss, 2026; FDA Clarifies Policies for Compounders as National GLP-1 Supply Begins to Stabilize, 2024 to 2026
This article is for general information and does not provide medical advice.