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Chronically elevated cortisol: Promotes visceral fat accumulation — specifically, the metabolically dangerous intra-abdominal fat Drives hepatic glucose output, raising fasting blood sugar Suppresses adiponectin, a hormone that improves insulin sensitivity Increases appetite for calorie-dense foods by elevating ghrelin relative to leptin Impairs thyroid hormone conversion from T4 to active T3 This is why metabolic syndrome so frequently co-presents with sleep disorders