Humira and weight gain

[Hallwood]

A couple of years ago there were posts regarding the experience of some users of Humira (and other biologics) - namely gaining weight. Suggestions to deal with this included the Mitochondria diet. I'm convinced my depressing weight gain is Humira, which I take for RA, related. So the choice is come off it or find a solution, I am naturally cynical about mention of 'keto' or 'paleo' diets, mainly because of who peddles them. So my question is, has anyone found a solution they can recommend?

[Lolabridge]

I gained weight from several years of taking Prednisolone and my biologic. I started the Second Nature programme, which includes a low carbohydrate eating plan, and am losing weight slowly so I stand a good chance of not putting all back on again. The plan is a resetting of eating habits and is working well for me as I’ve already lost a stone and intend to continue.

secondnature.io/

[Hallwood in reply to Lolabridge]

Hi, thank you for posting so quickly! Yes, it seems from what I've been reading, tho anecdotal not scientific, that the meds cause carbohydrates to add more weight than previously. I clicked on the link, pleased to see it's NHS endorsed, so I'll take a longer read.

[Neonkittie17]

I think it’s been the oral steroids for me as I inflated taking Pred for ten months in 2015/16 and IV steroids before my infusion causing my gain and lack of mobility during lockdowns/shielding, but I’d never rule out the actual meds.

[medway-lady]

My Renal Dietician said that steroids alter the way food is metabolised and I took high dose for a good while so am still trying to get rid of a few excess pounds. Its slow though. The moon face has gone and thats good but I think its keep on going for another few months. I'm going to look at the Second Nature one too now.

[Hallwood]

Replying to myself.... Found this study

frontiersin.org/articles/10...

Impact of TNF-α Inhibitors on Body Weight and BMI: A Systematic Review and Meta-Analysis

Extract below, suggests tnf inhibitors could be acting on brain controls for how food is digested/stored. Which could explain why dieting/exercise is a v slow process.

Mechanisms How TNF-α Inhibitors Might Lead to Weight Gain

TNF-α can lead to weight loss through two distinct mechanisms, namely by influencing the central weight regulation in the brain (Bernstein, 1996; Plata-Salamán, 1998b; Laviano et al., 2003; Bach et al., 2013), and by leading to catabolic processes in the body periphery (Layne and Farmer, 1999; Guttridge et al., 2000). Therefore, TNF-α inhibition might affect both the central as well as the peripheral mechanisms regulating body weight.

[bienassis in reply to Hallwood]

That's news to me - that TNFa inhibitors can lead to weight loss. Interesting because I find it difficult to put on weight since starting Infliximab. I had already lost weight while in hospital which is not unusual, and after discharge I was started - a few months later- on infliximab, and have been unable to gain the 7lbs lost in hospital.

Not bad news if you are overweight, but I have always been on the thin side and 7lbs is a lot for me to lose.

Food for thought there (excuse the pun!).

bienassis

[Hallwood in reply to bienassis]

Hi, sorry to be a pedant, but the extract I posted (as I read it ) says tnf-a ( if produced by an over active immune system) can lead to weight loss and then the authors deduce that tnf-a inhibitors could have the opposite effect. I think I'm in the unlucky group of users who have this side effect. I didn't mind at first because I was under weight but it's all round my middle and accelerating. I don't feel like me anymore.

I wonder if infliximab is worth checking out based on your experience.

Thank you for responding!

[bienassis in reply to Hallwood]

Yes, on rereading the extract I can see that tnf-a if inhibited by an anti-tnf medication could lead to weight gain. Thank you for pointing that out. I should read these scientific extracts more carefully.

Perhaps I haven't taken the drug long enough to get such an effect. I started the infliximab in March 2020 and my weight is much the same now as when I was discharged from hospital after an operation for a fractured femur in August 2019. I was told then that I was underweight for my height. I've always found it difficult to gain weight as I'm not a big eater, and I tend not to like the kind of food that adds weight.

It may be that the difference between the two anti-tnf drugs, infliximab and humira, although perhaps slight, has something to do with it. It might be worth checking that out. Patients often change medications - even within the same group -because of unwanted side effects with sometimes dramatic results. We are all individuals and don't have identical systems.

I've never really understood all these diets that have been bouncing around for many years - low carbs, high carbs, low protein, high protein - they all seem to contradict each other. It may be because of my age - 86 in a couple of weeks - that I belong to a generation that, when young, and healthy, had never heard of diets. I nearly mentioned "lifestyle" there but, of course, that word too is modern - we didn't have lifestyles!

Anyway, I do hope you sort things out with humira. It's always worth having a chat with your rheumatologist - providing he/she is sympathetic and anxious to help.

Best wishes,

bienassis