Steroids, MTX & Weight

[hope-always316]

I’ve struggled with my weight most of my life but since having a steroid injection in January (and one in spring last year) I cannot for the life of me shift any weight. I’ve changed my diet so much (no junk, rare treats, little sugar, lots of veg, fruit and fresh meat..) but I’m still stuck at the same weight! My exercise is sporadic because of an office based job but usually hit 7-8k steps a day. I’ve started WW to make sure I’m not just eating far too many calories albeit it good food but it’s nkt budging and I’m getting really disheartened. I’m 42 and 16stone. I need the weight off my joints... but I also need to stave off the feelings of helplessness that this disease brings.

Is it the steroid shot in January hats causing this? My thyroid has been checked and is normal. In fact, all my results are totally normal other than some stiffness overall, a couple of sore small joints and a stabbing pain in my hip if I sit too long.

I’m on 20mg MTX, folic acid and vitamin D.

My GP suggested trying Whole 30 but with a family and a fulltime job and a husband who hates vegetables and does most of the cooking - that could be very hard!

I’m just totally stuck and need some help Has anyone been in this silo?

[nomoreheels]

I may be wrong here but I'm not sure one steroid injection would cause you so much trouble with weight. Regular (more than one) steroid injections may, more so if you're on oral steroids, that's usually when people notice problems with weight gain. As you say you struggle with it anyway you may be more susceptible, with the addition your metabolism may have changed with having RD, that makes a big difference in how much weight we can carry. It changes our body in more ways than we might think. I don't know if this will help, please don't shoot me down in flames if it doesn't nras.org.uk/weight-diet-and...

I'm also on 20mg MTX, folic acid plus Adcal-D3 & 8 other prescribed meds.

[Laura_dilcock]

Hi. I too have had steroid injections and take a small dose daily. So far I've put on 2 stone and feel like I'm holding a lot of weight around my face. I hate it. My consultant explained to me that the steroids affect your appetite and the feeling of fullness (I rarely feel full unless I've eaten so much I can feel my stomach stretching) but they also affect your digestion and metabolism so it's a double battle. I found slimming world worked well for me in the beginning (stopped the gain but rarely lost) but I am a comfort eater and eventually quit. Like you say, this disease makes you miserable enough without cutting out some of your favourite foods as well.

Now I just buy as many fat free or low fat alternatives for the house as possible (mayo/cheese/milk/crisps etc) and try maintain light exercise.

Sorry I couldn't help, just wanted to let you know you aren't alone.

[helixhelix in reply to Laura_dilcock]

You may be wasting your money with low fat alternatives! Look at the packets and you might find that the calories you 'save' is minmal as the fats are replaced by sugars! I think the difference in a plain yoghurt is about 10 calories....

[nomoreheels in reply to Laura_dilcock]

Yes do take a look at the ingredients list/nutrition labels on anything low fat. It's a habit I got into when my h became diabetic & as important since being diagnosed lactose intolerant. With most things the flavour lost to being made low fat are made up for with sugars, some not listed as such so be aware of such terms as barley malt, dextrose, molasses, maltose, as well as those with the obvious sugar, syrup labels etc. Also be aware of invert sugar, this is made by splitting sucrose into it's two components, glucose & fructose. You've to have a blinkin degree in food & nutrition nowadays to figure out where sugars are hidden!

[Laura_dilcock in reply to nomoreheels]

Thanks for the tips, will keep a look out 🙂

[Juliachoo]

Im in the same boat, I used to be really slim until I developed RA 3 years ago & yes, steroids do make a difference ..I too am 2 stone overweight & what with the lack of same energy & mobility I can’t shift it....

[Thingybob]

I posted a similar question last week . Got lots of responses. Then I spoke to my rheumatologist about the weight gain, not shifting it despite cutting back, being more active etc etc . She said its due to the steroids and that the weight wont shift unti i come off them (currently on 5mg daily so not high dose). She also said its important to eat well to combat the effects of ra and the drugs.

[oldtimer]

I have had problems with weight gain on high dose steroids in the past. The steroids seem to remove my sense of when I've had enough food and make me jittery and anxious and wanting to nibble. But it is possible to control this, at least partially, with strict control of calorie intake. I managed to lose 10K after coming down to a maintenance dose of steroids. But it's hard work. I don't think that the exercise that I'm able to take would make me lose weight, but it certainly makes me feel better!

[Mmrr]

Steroids increased my appetite, but it was MTX that caused the huge weight gain for me. I could do nothing to shuft the weight.

I've started biologics and my apetite has been curbed thankfully. I lost 4 lbs last week.

Any supermarket food labelled healthy generally isn't. You are better using 'normal' foods and using portion control.

So a couple of spoonfuls of full fat natural yoghurt and a handful of raspberries/blueberries or whatever is less calories and healthier than a diet fruit youghurt.

[Hidden in reply to Mmrr]

Interesting Mmr, I’ve noticed a decrease in appetite too since being on biologics. I drive my husband mad because I never fancy eating anything,and I have no enthusiasm for cooking a meal. I have to make myself eat whereas before I was a real pig 😁

[helixhelix in reply to Hidden]

I wish! My appetite has been huge since starting on Enbrel...a real struggle not to gain pounds.

[Jaxine]

Ive been on steroids for 6 weeks now and have def put on weight, especially around my ankles, calves, knees and face, actually everywhere! can't wait to come off them! I just feel like a swollen ball😤

[helixhelix]

It is a bitch trying to shift pounds/kilos (I prefer pounds as loosing 2 pounds sounds so much better than 1 kilo). I was overweight at diagnosis and had a battle. The only thing that worked for me was to keep a food diary and be totally and completely honest about what I ate, down to a stick of gum, a single peanut - everything. And somehow when I knew I had to write it down it helped me reduce what I ate, so 1 potato instead of two, no second piece of toast, that sort of thing. I lost a fair bit.

[Leics]

I’m on steroids and baricitinib currently. I have to say although I’m overweight by about 1.5 stone I am losing inches although not adding anymore whilst being on steroids. I’ve tried w/w in the past and never lost a pound until I got so fed up with disapproving looks from the lady who ran the class that I went out and had the biggest pizza available all washed down by a couple of strawberry daiquiri’s I lost 7 lbs that week so figured I wasn’t eating enough and quit the class. Sometimes it’s not good to restrict yourself with diets because you don’t help yourself at all. I think the extra weight I’m carrying is down to massively reduced mobility which I can’t do much about but new treatment is staring to help so watch this space.

[Nanna71]

I lost about 25 pounds before RA diagnosis. Pain was too great to feel like eating. I now take 20 mgs prednisone, 15 mgs MTX, and sulfasalazine, 2000. Somehow the increased appetite with the pred. is countered by the lack of appetite with the MTX and so I seem to be okay as no real weight gain except for getting my atrophied muscle mass back.

I have never been a light weight but the advantage of less pressure on my poor feet is worth the struggle to keep the calories down.

By the way, sugar has less than half the calories of oils and fats in the same measure. But nobody sits down to a bowl of sugar, right? Usually the thing you eat that has sugar in it is loaded with fat too, like cake, cookies. Hence the big calorie intake.

[Cheylann]

I doubt 2 steroid injections can make you gain/hold onto weight. I've had 5 and no problems with weight. If you don't have any thyroid or hormone problems then no matter how healthily you eat it mus be due to the quantities of food you consume. Try cutting back the amount you eat, go for a half an hour walk daily and drink plenty of water. My advice to you. Steroids don't make you fat they make you hungry.