I Gained a Devastating 30 lbs on Prednisone

Insomnia, headaches, dizziness and nausea are a few of the undesirable side effects of prednisone. But none of those are as loathed as bloating and weight gain. Since y’all have heard me grip about my weight for some time now I figured I’d do a deeper dive into how and why prednisone causes weight gain.

Prednisone Pros and Cons

Cortisol is the hormone within the body that regulates stress and inflammation in the body. Prednisone is a corticosteroid, which are synthetic versions of cortisol. It’s often a first line defense in many illnesses like myasthenia gravis, asthma, arthritis, sarcoidosis, lupus and everyday rashes. Yes it is a super drug indeed however, it comes at a cost.  

All of the side effects from prednisone, weight gain is the most common. How much and even if you will gain weight (it’s not a definite) depends a lot of factors, including dose and duration.

Generally, the higher the dose of the steroid and the longer you’re on it, the more likely you are to encounter weight gain. Will you get fat from taking a week of steroids for an infection. Most people with chronic illnesses are on steroids so the treatment dosage is high and long.

Some people also experience body fat redistribution, a symptom that is characterized by fat deposits collecting in unusual areas like the base of the neck or back. So even if you manage to slow the prednisone weight gain, you’ll still look like Mrs. Puff from Spongebob as if us spoonies didn’t have enough to worry about. 

Why Prednisone Weight Gain Happens

Weight gain from prednisone is usually caused by the combination of water retention, increased appetite and decreased physical activity. Steroids cause weight gain by altering the body’s electrolyte and water balances, as well as its metabolism. Your metabolism is simply the way your body uses and stores lipids, amino acids, protein, carbohydrates, and glucose, and all those fun things. 

Prednisone causes the body to retain sodium (salt)  and lose potassium. This combination can result in fluid retention, weight gain, and bloating. Prednisone also causes an increase in appetite, which means that eating more and taking in more calories. Let’s be honest, food can be comforting. IDK about you but in the thick of my diagnosis depression I wasn’t reaching for the carrot sticks and hummus. I wanted all the carbs all the cheese all the sweets. With MG, my activity was limited to try to preserve strength and limit weakness. So in a simple math equation: alotta foods – no activity = all the pounds.

Can you prevent prednisone weight gain?

Eh no! Well in my experience I don’t think so but anything is possible. If you’re going to be on a high dose of prednisone for a long time then brace yourself for a few extra LBS. If you don’t gain any weight then lucky you! However I do think there are few things you can do to try to limit the amount of gain:

1. Prednisone Friendly Diet (tons of fruits and veggies, low sodium, high protein)
2. Water (flush toxins and helps you feel full)
3. Eat 6 small meals a day vs 3 large meals
4. Move your body (low impact things like yoga or walking)

The takeaway

So that’s my spiel on why prednisone causes weight gain. Prednisone isn’t a supervillain, it’s a super drug. It does a lot of good. I don’t know where I would be in my healing journey if I didn’t take prednisone. However, I wish it didn’t come with all this extra baggage. I would never advise someone to skip out on prednisone. But I do believe I would have been more vocal with my specialist about finding a different treatment plan. I was on prednisone for 2 years and gained over 30 lbs. It’s caused a lot of mental and emotional anguish during this journey. I’m still dealing with it.

If you want to hear more about this weight gain thing, check out this video: