Tips for Reducing Prednisone Weight Gain

ePrednisone is a type of corticosteroid, a drug that reduces inflammation. Healthcare providers use steroids to treat many inflammatory conditions, including inflammatory bowel disease (IBD) and autoimmune disorders.

Weight gain is a common side effect of prednisone. That may be welcome if you're underweight because of your medical condition. But if you're at a healthy weight or you're already overweight, it's likely unwelcome.

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

Prednisone Weight Gain Causes

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.

In a study of people on low doses of prednisone—from 5 milligrams (mg) to 10 mg per day—for two years, the typical weight gain was between 4% and 8% of their pre-prednisone body weight. For most people, that was less than 10 pounds.

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 due to prednisone itself—it's due to 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 milligrams (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 avoid gaining weight, try the following:

• 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.

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.

How Can I Lose Prednisone 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. That makes it easier to approach weight loss.

Any body fat you gained on prednisone won't automatically go away. As with any weight loss, it may help to have a healthful eating plan and get regular exercise.

If prednisone was 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.

Summary

Water retention, increased appetite, and decreased physical activity contribute to weight gain while taking prednisone.

You may be able to prevent weight gain by eating a low-sodium, low-calorie diet and being physically active every day. Talk to your doctor about your fitness plan and ask them if a physical therapist may be right for you.

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.

A Word From Verywell

The best way to proceed when you're on prednisone is to focus first and foremost on getting better. A healthy lifestyle is likely beneficial for that, too.

If prednisone does lead to added body fat, it'll be easier to tackle losing it when your symptoms are less of a burden.