Does Prednisone Make You Gain Weight?

Prednisone can make you gain weight 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 very common side effect of this corticosteroid, which is used to treat inflammatory bowel disease (IBD), autoimmune disorders, and other inflammatory conditions. The risk increases with higher doses and long-term use.

This article looks at why prednisone causes weight gain, how you can limit the amount you gain, and how to lose it once you're off of prednisone or on a lower dosage.

Why Is Prednisone Used?

Prednisone is a synthetic steroid similar to the natural stress hormone cortisol, which plays important roles in your body. Cortisol helps regulate:

• Metabolism
• Immune function
• Inflammation
• Response to stress and injury

Cortisol is produced by your adrenal glands, a pair of triangular glands located above the kidneys.

Like cortisol, prednisone lowers inflammation and suppresses the immune system. It may be prescribed to help manage conditions that involve inflammation and abnormal immune function, such as:

• Some types of asthma
• Severe allergic reactions
• Inflammatory bowel disease (IBD)
• Autoimmune diseases like lupus, multiple sclerosis, and rheumatoid arthritis
• Some diseases of the stomach, kidneys, lungs, and eyes

Prednisone can work fast. It can also cause many side effects aside from weight gain, such as trouble sleeping, acne, mood swings, and headaches. When used long-term, it can cause osteoporosis or cataracts.

Because of that, prednisone is often used to get a condition under control until a more sustainable, long-term treatment plan starts working.

Why Prednisone Makes You Gain Weight

A drawback of prednisone is that it can make you gain a lot of weight. The higher the dose and the longer you take it, the more weight you're likely to put on.

Prednisone causes weight gain for several reasons, including:

• 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, eat more.
  
• Fat redistribution: Prednisone can also 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."
  

Reduced Physical Activity

Weight gain attributed to prednisone use may actually 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
• Getting regular exercise

Low-Sodium/High-Potassium Diet

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

• Eating foods that are high in potassium, like dates, bananas, cantaloupe, grapefruit, and lima beans
• Reducing your sodium to less than 2,000 mg a day
• Avoiding highly processed foods

Reduced-Calorie Diet

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

• Eat fewer calories each day.
• Eat several small meals a day instead of three large ones.
• Eat more fiber-rich foods.
• Eliminate or reduce empty calories, such as simple carbohydrates and processed sugars.
• Make sure that most of your calories come from nourishing foods.
• Don't drink alcohol.

Exercise

Regular exercise can also help prevent or lessen weight gain from prednisone. Talk to your doctor 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 the medication 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 on what types of diet and exercise are appropriate for you.

If you have trouble taking off the weight, you may want to see a nutritionist for help with a healthy diet 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. The increases should stop once you're on a lower dosage or off the drug. Then you can focus on a healthy lifestyle that'll help you shed the extra pounds.