Does Prednisone Cause Weight Gain?

Prednisone can cause weight gain because it increases fluid retention and appetite. It can also redistribute fat to areas like your face and midsection, increasing their size.

Weight gain is a common side effect of this corticosteroid, which is used to treat inflammatory bowel disease (IBD), autoimmune disorders, and other inflammatory conditions. However, there are ways you can limit the amount you gain and potentially lose it once you stop prednisone or take a lower dosage.

Why Prednisone Causes Weight Gain

The higher the dose of prednisone and the longer you take it, the more weight you're likely to put on. Causes for weight gain include:

• Fluid retention (water weight gain): Prednisone makes your body hold on to sodium (salt) and lose potassium. This combination can result in fluid retention and bloating.
• Increased appetite: You'll feel hungrier and, therefore, may eat more.
  
• Fat redistribution: Prednisone can cause fat to be stored in places like the face, back of the neck, and abdomen. The facial weight gain is sometimes referred to as "moon face."

Some weight gain attributed to prednisone use may be due to reduced physical activity. This isn't because of the prednisone itself, but because of the symptoms of many of the conditions it's used to treat. Symptoms such as pain and fatigue can lead people to be less active.

How Can I Prevent Prednisone Weight Gain?

Understanding why prednisone weight gain happens means you can take steps to avoid it. You may be able to prevent prednisone weight gain by:

• Eating less sodium and more potassium
• Eating fewer calories
• Choosing lean protein
• Getting regular exercise

Low-Sodium/High-Potassium Diet

Eating a reduced-sodium diet and increasing potassium intake can help you avoid or lose extra water weight. You can meet these nutrition goals by:

• Eating foods that are high in potassium, like bananas, cantaloupe, spinach, tomatoes, broccoli, acorn squash, kidney beans, and lentils
• Reducing your sodium intake to less than 2,000 milligrams (mg) a day
• Avoiding highly processed foods

Reduce Calories

It can be tricky to avoid gaining weight when prednisone gives you a bigger appetite. To help your efforts:

• Choose more low-calorie foods, like fruits and vegetables.
• Eat several small meals a day instead of three large ones.
• Eat more fiber-rich foods like fruits, vegetables, and beans to suppress appetite and help you feel full longer.
• Eliminate or reduce empty calories and calorie-dense foods, such as sweet drinks, snack foods, candy, and baked goods (cookies, cake, pastries, muffins, doughnuts, etc.)
• Make sure that most of your calories come from nutrient-rich foods.
• Limit or avoid alcohol.
• Drink plenty of water. Substituting water for sweet drinks and drinking a glass of water before each meal may help lower total daily calories.

Choose Lean Protein

Research has shown including a source of protein with each meal can help curb appetite and control weight. Research has shown that meals containing 25 to 30 grams of protein are most effective at curbing appetite and controlling weight.

Sources of lean protein include:

• Fish and shellfish
• Skinless chicken breast
• Pork tenderloin
• 93% lean ground turkey or beef
• Beans, peas, and lentils
• Soy foods, such as tofu, edamame, and tempeh
• Cottage cheese
• Greek yogurt

Exercise

Regular exercise can help prevent or lessen weight gain from prednisone by increasing the calories you burn each day. Talk to your healthcare provider about starting a physical activity routine.

Your activities may need to be tailored to your symptoms and condition(s). Try to find something that can help you lose weight now and is sustainable for the long term. A referral to a physical therapist or certified trainer may be helpful.

How Can I Lose the Weight?

The fluid retention and increased appetite from prednisone often go away once the medication is stopped or reduced to less than 10 mg/day. However, you should never lower your dose or stop taking prednisone without your healthcare provider's okay.

Any body fat you gain on prednisone won't automatically go away once you reduce your dose or stop taking the drug. As with any weight loss, it may help to have a healthful eating plan and get regular exercise.

If prednisone is effective and your health condition is under control, it'll be easier to eat well and be active again. Check with your healthcare provider about what eating and exercise plans are appropriate for you.

If you have trouble taking off the weight, you may want to see a registered dietitian for help with a healthy eating plan.

Other Side Effects of Prednisone

In addition to weight gain, prednisone can cause other side effects such as:

• Headache
• Dizziness
• Trouble sleeping
• Mood and personality changes
• Skin problems
• Slowed healing
• Heartburn
• Fatigue
• Irregular menstrual periods
• Increased hair growth

Some side effects can be severe and require medical attention. These include:

• Vision problems and/or eye pain and swelling
• Flu-like symptoms including sore throat, fever, and chills
• Seizures
• Confusion
• Depression
• Rash or hives
• Problems breathing
• Nausea and vomiting
• Irregular heartbeat
• Stomach pain or swelling
• Swelling of the eyes, face, throat, or limbs
  

Summary

Prednisone can cause weight gain by increasing water retention and appetite. You may also notice more fat in certain areas due to redistribution.

Not everyone gains a lot of weight while taking prednisone, but most people gain some. Weight gain should stop once you're on a lower dosage or off the drug. Focusing on a healthy lifestyle can help lessen weight gain and help you shed the extra pounds gradually.