Corticosteroids, commonly referred to as “steroids,” belong to a drug class known for their potent anti-inflammatory properties. Corticosteroids exert their anti-inflammatory effects by decreasing the activity of the immune system. That’s why steroids are used to treat various conditions such as arthritis, asthma, allergies, eczema, inflammatory bowel diseases like ulcerative colitis, and autoimmune diseases such as lupus and rheumatoid arthritis. There is no doubt about the usefulness of this drug class; however, steroids can cause various adverse events, such as weight gain. Weight gain is more likely with systemic corticosteroid therapy, in which steroids are given orally or into the vein and travel throughout the entire body. However, the good news is that once you stop taking steroid therapy, you can usually lose weight in 6-12 months.

Please continue reading to learn more about what types of steroids can cause weight gain, how much weight you may gain while being on steroid therapy, and how you can prevent or, at least, lessen the severity of this steroid-induced weight gain.

Can steroid medicines cause weight gain?

Steroid medications affect metabolism, the way the body stores fat, and the distribution of fat in the body. Taking steroid medications can therefore lead to an increased appetite and consequently an increase in calorie intake, leading to weight gain.

In particular, taking steroids long-term can lead to deposits of fat in the abdominal area. Steroids can also cause fat redistribution leading to fat accumulation in the face, neck, and back. Facial weight gain caused by steroids is commonly known as “moon face,” where the face appears wider and rounder. This type of fat redistribution can make a person look heavier even though they haven’t actually gained any weight. However, just like other adverse effects from other medications, remember that the severity and duration of weight gain and fat redistribution due to steroid therapy varies from person to person.

Steroids also play a role in the body’s water and electrolyte balance. Steroids make your body retain more salt (sodium); therefore, taking steroid medications can lead to fluid retention (water weight gain) with symptoms like swelling of the ankles and feet.

What are the 3 types of steroids?

Glucocorticoids

The adrenal glands make glucocorticoid hormones such as cortisol. Cortisol is responsible for the body’s “fight or flight” response to stress. This hormone also helps to reduce inflammation in the body. Synthetic forms of cortisol are called corticosteroids and are used to treat inflammatory conditions like arthritis, asthma, allergies, eczema, lupus, and Crohn’s disease.

Mineralocorticoids

The adrenal glands also make another type of steroid hormones called mineralocorticoids. The main mineralocorticoid is aldosterone, which controls the body's salt and water balance.

Anabolic Steroids

The third type of naturally occurring steroids in the body are androgens, such as the male hormone testosterone. Synthetic versions of these steroids are called anabolic steroids, and they help to build muscle. Healthcare providers may prescribe anabolic steroids to treat problems like delayed puberty in boys or muscle loss due to certain health conditions such as severe illness or surgery. However, anabolic steroids are frequently misused by bodybuilders and athletes to build muscle, decrease body fat, and enhance performance.

What type of steroids causes weight gain?

Glucocorticoids are most commonly implicated in causing weight gain as an adverse effect. Examples of glucocorticoids include prednisone, dexamethasone, prednisolone, methylprednisolone, betamethasone, beclomethasone, hydrocortisone, cortisone, budesonide, and triamcinolone.

Other side effects of steroid use include bone loss, high blood pressure, and high blood sugar.

How much weight do you gain on steroids?

How much weight you might gain on steroids depends on a number of factors, including the dose of your steroid medicine and the duration of treatment. However, studies have shown that 70% of people report weight gain with steroid use.

Generally speaking, a high dose of steroid medication taken for a longer duration will more than likely increase the chances of weight gain from increased appetite along with water weight gain.

Keep in mind that weight gain is not a common side effect of short-term steroid treatment. Studies show that taking prednisone at 7.5 mg a day for 60 days or more is associated with a significantly higher risk of adverse effects like weight gain compared to lower doses taken for shorter periods of time, such as 2 to 3 weeks.

Does steroid weight gain go away?

Steroid weight gain typically goes away in 6-12 months. Most people start losing weight gradually once they stop taking the steroid medicine. However, steroid medications are usually tapered slowly, and coming off them can take several weeks. Rapid withdrawal from steroids can cause side effects like fatigue, body aches, joint pain, muscle stiffness, weakness, and mood swings.

How to prevent weight gain on steroids?

You can do several things to reduce the effects of steroids on your body weight. To achieve or maintain a healthy weight, it is important that you eat a low-calorie diet with plenty of fiber-rich foods like fresh fruits and vegetables. Eating less sodium (salt) and more potassium-rich foods can help to prevent weight gain due to water retention. Besides avoiding high sodium foods, you should aim to eat a diet low in fried foods, saturated fat, and complex carbohydrates. Wellness professionals also advise eating small, frequent meals and drinking water instead of high-calorie drinks such as sodas.

It is also important to participate in regular exercise and physical activity to burn calories. The goal is to regulate appetite and energy expenditure in order to reduce corticosteroid-related weight gain.

If you are struggling with weight gain due to steroids, your healthcare provider may be able to offer some suggestions and a practical guide to healthy weight loss. They may also refer you for a clinical nutrition consultation.

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