Prednisone and weight gain: What you need to know

Prednisone is a generic prescription drug that helps treat a range of conditions related to inflammation, such as severe allergies, allergic reactions, asthma, arthritis, and autoimmune diseases.

It’s available in different forms, including:

• oral tablets
• oral liquid solutions
• injectable forms (given by a healthcare professional)

Prednisone is also available under several brand names, such as Deltasone and Rayos.

Prednisone is a type of steroid called a corticosteroid. Corticosteroids have certain side effects, including weight gain, that you may want to know about.

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Why does prednisone make you gain weight?

Weight gain is a common side effect of prednisone. There are three main reasons that prednisone causes weight gain:

• Fluid retention: With fluid retention, your body holds onto more fluid than usual as your kidneys hold onto more sodium (salt), which brings water along with it. By holding onto more sodium, your body may lose more potassium. This combination typically results in bloating and swelling in the hands, legs, feet, and face.
• Increased appetite: Prednisone can increase your appetite. Prednisone mimics the stress hormone cortisol, which causes you to feel more hungry than usual. This not only increases your appetite but may also interrupt your sleep cycles. Changes in your sleep cycle may further disrupt the hormones that regulate your appetite.
• Fat redistribution: Prednisone can change where your body stores fat. It may cause fat to be stored in places like your face, the back of your neck, your upper back, or your abdomen.

Prednisone is a synthetic version of cortisol. And just like cortisol, prednisone may cause your metabolism to slow down, your body to store more fat, your appetite to increase, and you may crave more high calorie, high-carbohydrate foods. 

You may also experience weight gain while taking prednisone, not due to the drug itself but because the conditions that prednisone treats often have symptoms that lead to reduced physical activity. Symptoms such as pain, fatigue, and difficulty breathing may make it harder to stay active.

The majority of people who take prednisone long term do experience weight gain. Long term would be defined as taking prednisone for 3 months or longer.

How long does prednisone weight gain last?

How long weight gain from prednisone lasts may depend on factors like the amount of time you’ve taken prednisone, whether you are still taking it, and your personal health history.

Typically, side effects that may cause weight gain like fluid retention and increased appetite go away once you stop taking prednisone, or once your dose is reduced to less than 10 milligrams (mg) per day.

The body fat you have gained while taking prednisone won’t go away on its own once you stop taking the drug or reduce your dosage. Like most forms of weight loss, you will need to ensure you are eating balanced, nutritious food and getting regular physical activity. Your doctor or a dietitian can help figure out suitable eating and exercise plans for you.

How can I avoid weight gain on prednisone?

Here are several different strategies you can follow to help you avoid gaining weight while taking prednisone.

• Manage increased appetite by consuming less calories:
  • Eat fiber-rich foods like fruits, vegetables, and complex carbohydrates.
  • Include proteins in each meal, such as fish, chicken, or soy products. Meals containing 25 to 30 grams of protein tend to be more effective at curbing your appetite to help manage weight.
  • Opt for small, frequent meals on a schedule to help manage hunger.
  • Drink water to curb appetite.
  • Engage in regular physical activity to help burn off calories.
• Manage fluid retention:
  • Aim for a low sodium diet of no more than 2,000 mg of sodium per day.
  • Try to consume more potassium-rich foods like oranges, bananas, spinach, tomatoes, cantaloupe, broccoli, acorn squash, kidney beans, and lentils.
  • Avoid high sodium foods like canned goods, processed foods, soy sauce, cold cuts, and chips.

If you are concerned about the weight you may gain while taking prednisone, talk with your doctor. They may ask you to skip your dosing schedule every other day or start you on a higher dose and then taper it down. Your doctor will prescribe the lowest dose that will be effective for you for the shortest possible time.

It’s important that you don’t adjust your dosing schedule or stop taking prednisone on your own. You will need to stop steroids by tapering slowly as per your doctor’s directions. Stopping prednisone suddenly may cause serious side effects.

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Summary

Prednisone may cause weight gain because it increases your appetite and the amount of fluids your body retains. It also causes fat storage in your face and midsection, causing a rounder appearance. This is more likely in people taking prednisone at a higher dosage or for a longer amount of time.

Prednisone weight gain will likely last until you stop taking prednisone or taper down to a lower dose. You can avoid some of the weight gain with prednisone by taking actions to help manage increased appetite and fluid retention. These include following a low sodium diet, eating foods rich in fiber and protein, drinking lots of water, and engaging in regular physical activity.