Prednisolone and Weight gain

Hello, I have been prescribed a reducing dose of prednisolone starting at 30mg and reducing to 5mg over 3 months. I’m already taking Sulfa and Leflu but inflammation and pain remain constant, despite steroid injections (4 over the past 2 months).

It might sound silly to be asking about weight gain as the pain is awful however I’ve just started a diet and don’t know if I’m wasting my time. I’m already overweight and could probably do with losing around 3 stone so the thought of gaining more is really upsetting.

Ideas, advice etc is very welcome. Thank you.

[helixhelix]

I think it’s a good idea to be extra strict about what you eat when taking pred. I was only on it for a few months and was careful, and didn’t gain weight (didn’t lose any either tho!)

[Hidden in reply to helixhelix]

Thank you. It seems silly to worry about something which is purely vanity when the positive aspects of taking in will, hopefully, be immense 😕

[helixhelix in reply to Hidden]

It’s not vanity at all! With RA it’s hugely important to try to keep within guideline weight... It’s been clearly shown that people with a BMI above 25 with RA have worse outcomes, reporting more pain and higher levels of disability...and drugs don't work as well either.

So even if you're well within the range it’s sensible to try not to gain any.

[Mmrr]

Hello, I also gained several stones in weight having been previously very fit and active. I've managed to take off around 18 lbs but it is very slow going as I'm not very mobile.

I think it wise to be careful with what you eat, as it is difficult to take the weight off. Prednisilone does not necessarily mean weight gain, but you do need to take care. It's good you are thinking about your weight though.

[Hidden in reply to Mmrr]

Thank you Mmrr. It’s good to know it’s not inevitable.

[Jesnaskah]

Hi!

Some tips:

Don't eat salt! Or anything salty while on pred and for a few months after you are off of it. It will cause water retention!

Don't eat junk food like: chips, fried, sweets, and be really careful with carbs.

Initially, I was doing really well, not even eating butter or oils on anything and I was able to not gain any weight, even lost a couple pounds. But the moment I slacked, I put on a lot of weight and it has been insanely hard trying to lose the weight I gained! It also caused me to have weird fat pockets on my body and I do have the fat hump on the back of my neck. The moon face will eventually go away on its own. I stopped pred in Nov 2018 and still struggling.

It's hard but TRUST me, it worth it! I wish I had stuck to being strict.

[Hidden]

Thank you for the advice, support and positivity jesnaskah 😊

[Seaberry]

It is so much easier said than done not to gain weight even though you have a lot of great tips. Steroids cause me to have terrible pangs of hunger. It is hard to go to sleep at night feeling hungry. Try not to gain but certainly do not beat yourself up over it. When I am in pain I have a serious desire to indulge myself. And my greatest sin is chocolate. But the hardest thing For me is I am a type 1 diabetic on an insulin pump and steroids cause my blood sugars to spike. (Yes another autoimmune blessing on me). And extra insulin can cause more weight gain. I have to admit to watching what I eat all day and rewarding myself with 15 m and m’s or 1/2 c chocolate milk behind bed. Find a way to reward yourself fir your cautiousness and indulge yourself at the same time. Total denial will only make you resentful. I always find that having ways to forgive myself when I do not make my own expectations and to be good to myself emotionally as well as physically gets me over the tough times. Best wishes.

[Hidden]

Thank you so much for the kind words Seaberry 🙂

[Jaxine]

Hi there,

I've been on Pred sporadically for 9 months ( low dosage) I watched my diet very carefully, however, I look like a greedy hamster! I've defo got the moon face and hump neck. I thought exackly like you, I should not be so vain as keeping the joint pain to a minimum is the most important thing, but let's face it of course we dont want to be gaining weight and especially on the face! But neither did I want to be waking up every morning feeling wretched! Your health is more important so take the Pred you will lose the excess weight when you come off it. I can't wait to get definition in my face again though!

[Hidden in reply to Jaxine]

Hi Jaxine, you’re absolutely right. Although we do everything we can to reduce the impact of this terrible disease it’s only human to worry about the winder effects.

I have just finished my reducing dose...started at 30mg and tapered down to 5mg although to be honest as soon as it dropped to 20mg the benefits were negligible but the moon face, hump etc were there as a constant reminder.

Saw rheumy team earlier this week and I’m starting on biosimilar so hopefully mobility and pain levels will improve and I can get back to feeling like me.

Wishing you the very best x