Weight gain: Pred or extra food?

On Pred 15mg for 2 weeks - early days but need to know about putting on weight. I just lost 2 stone with healthy eating and exercise over the past 2 years and now PMR arrives!

Please can you tell me - is there evidence to suggest that Pred causes weight gain or is it the Pred making me feel so hungry that I eat loads and the extra foods causes weight gain?

If I continued to eat sensibly would I necessarily gain weight due to PMR or Pred?

Is i possible to control weight?

Thank you


21 Replies

  • Hi cassie,

    Bit of everything really!

    The Pred can make you put weight on- especially around the face, it can make you feel hungrier, so you eat more, and you feel better in yourself, so your appetite improves (most people in continuous pain lose their appetite). So a triple whammy!

    However, it you continue to eat sensibly (as you have been to lose weight previously), and continue to take gentle exercise you should be able to keep on top of things - you'll probably get the inevitable hamster face I'm afraid, but that does go as you reduce the Pred.

    Sure you will get more advice re what particular foods people suggest you avoid, or eat more of.

  • Hi Dorset lady

    Thanks for explaining and I hope I can keep weight off with so many factors involved. Oh well it's the time of year to make homemage veg soup!


  • Cassie I cut out gluten and simple carbs as I had heard that it stopped the moon face. Pred does cause fat to move about to face, back of shoulders and waist area. I was absolutely ravenous when I started pred, while before I was eating virtually nothing.

  • Piglette

    I will try to reduce carbs and make sure I have nutritious snacks in the cupboard!

    I read that Pred gets rid if wrinkles too - but I would rather have the wrinkles anytime!

    Back of neck hurting lots today so will have to get moving to ease it.

    I read that it's better to take paracetemol when needed than to increase Pred from 15mg which I started taking 2 weeks ago after diagnosis of PMR. Back to GP in 2 weeks to assess effectiveness of Pred. It's just the neck causing me to feel drained.


  • I don't think I have met anyone who has found that taking paracetamol makes the slightest difference to PMR pain. It never helped me - and theoretically it won't as it isn't an anti-inflammatory. And NSAIDs (non-steroidal antiinflammatory drugs) should not be taken alongside pred.

    Some people, especially if they are heavy/overweight/big built (choose the word you find most acceptable), may need 20mg to get the initial inflammation well under control. But if you have had a good response to 15mg then staying on it for at least 6 weeks until your discomfort levels are stable is a good idea. It is unusual for pred to get rid of all the pain but there should be something like a 70% improvement overall after a couple of weeks. Some pain, especially tendonitis/synovitis/bursitis, all of which can occur in PMR if it is left long enough, may take months to fade because the blood supply to those areas isn't as good as to muscles.

    I found sitting on a footstool with my back against a radiator did marvels for that pain at the bottom of your neck! Getting up again was occasionally a problem though!!

    I lost a lot of pred weight (which was due to pred, nothing to do with eating more) by cutting carbs drastically. If I eat many carbs I don't lose weight, it's a simple as that.

  • I found the hunger did not start til I'd been on pred about a month. I like you had previously worked hard to lose weight but unfortunately I just haven't been able to control myself. My only hope is that the weight I've recently put back on will come off as I reduce the pred dose. I wish you luck and hope you're not affected by this side effect.

  • Thanks for sharing your experiences - weight gain has always been a problem for me so I hope I can keep it off. Someone here suggested that eating a slice of cucumber makes hunger go away in between meals but I havent tried it yet!

  • I initially put on about 8 lbs, I've always had a weight problem, but this frightened me as I thought putting this weight would have an adverse effect on my health! This probably happened about 6 weeks after starting 50 mg Pred. I have now lost this weight (8lbs) also another 8lbs by following an anti-inflamatory diet and cutting out as many/much sugar as possible (no processed foods) only whole foods and cooking from scratch. I haven't gone Organic for cost reasons, although if I see any reduced, I do buy if it is something that I would use!

    I have gained the Hampster face and weight around my midriff so hopefully that will reduce again as I reduce the Pred, however this is proving quite hard to achieve!

  • Hi Cassie,

    I developed PMR in July, 8 months after the symptoms started. Like others on this site, I am relatively young to have the disorder - 57.i was in acute pain and getting up in the morning frequently made me cry, I was on the point of not being able to drive because I could not turn my head ...to reverse etc...

    I started at 15mg and am now on the dead slow, nearly stop reduction approach and am alternating between 9 - 10mg. I have some residual pain in my neck, back and shoulders but the prednisolone works. I have found taking it at night means I am pain free in the morning, but ache a bit late in the evening. It also means that the predict does not cause sleeplessness, somehow.

    I am managing my weight with lots of walking and a low calorie, low carb diet and have lost nearly a stone. I realise that I am lucky not to feel fatigue or intense pain as others on e site do. I have not developed a hamster face which was a fear of mine.

    I continue to work full time, I travel for work, and life is pretty much back to normal for me. My hope s that the PMR will burn itself out in a year or two. And I can finish with prednisolone for good.

    I realise that my experience if the disease is different to others but I thought I would share it with you. PMR is not necessarily a permanent condition and it responds to steroids.

    Wishing you good luck,

  • Hi Cassie. Don't despair! I too was concerned about possible weight gain on Pred. Steroids changes the way your body deals with simple carbs, converting them straight into fat, so as soon as I read this I was determined to take control. I've been on Pred (originally Medrol, as I was in Greece when diagnosed) for 16 months, and while I haven't lost weight, I haven't gained any either, although I did have moonface last year. People are inclined to comment on how well you look, with your rosy apple cheeks; grrrrr!

    So, no potatoes, white rice, most grains - corn is ok, thank goodness - and use general common sense. It can be tough. We spent four weeks in Italy in September, and what's the most common food available? Yeah, pasta and pizza - both no-nos! Also I cook wonderful triple-cooked chips for my partner, but can't eat them and I do so miss hot, buttered toast...

    However, as I said, I haven't put on weight, although I wasn't particularly slim (size 14 UK) to start with. I'm happy with how I am but didn't want to expand further!

    Be good to yourself, make sure key people know about your PMR as you may need help occasionally. I often forgot I have it and did too much. Also I'm stubborn and was determined not to 'give in' to it, but that can be counter-productive in the early stages. Allow yourself to be looked after sometimes and don't feel guilty because you have an illness. I'm guessing it wasn't on your Christmas wish-list!

    Cheers and enjoy the popcorn.

  • Hi Marila

    Thank you for your encouraging words - I didn't know about the carbs been converted to fat - very useful info as I feel I must be realisict that right now. I have always eaten healthy diet but now it is more important than ever. I think you have done really well not gaining weight - but I do love the Med diet so continuuing with that is great for me. You do well resisting chips and toast - I don't think I could do that if I had to cook them so you have good willpower!

    Yes I will try to delegate doesn't come easy at times but why not!

    Popcorn yumee!!!!!

  • Hi... been reading through the thread and weight gain sure can be a problem when on steroids. Initially, I was fine but as the year's have progressed so has the weight (in the wrong direction). When first diagnosed over 5 years ago I didn't know much about PMR and was still active. Now with GCA as well, things got worse and Type II diabetes (steroid induced) my weight increased far too much. There were times a few years ago when I just had to have something sweet and I would make a cake at night just to stave off my cravings. I'm now on a mission not to have any cakes or trying to avoid carbs as much as possible. I now have the "steroid tummy" and as exercising is difficult when you're having a bad patch it will be sometime before I see any weight loss. If you can avoid carbs and be sensible with your diet, I hope you don't put any weight on... the moonface, well nothing much can be done as far as I know, but when you reduce so does the face. Wish you good luck and stay happy.

  • Hi Cassie, I've been on 40mgs of Preds for the last month for temporal arteritis kept to my healthy eating plan, making everything from scratch, walk as much as I can and I have continued to loose weight. Not sure how long it takes on the medication before people say they gain weight as this is my first time on steroids.

  • Hi Sue

    Thanks for your info it all helps to build a picture


  • Cassie,

    I'll add my two tips here in case they help anyone. I was on high doses of pred ( 60 mg. for GCA) twice due to a relapse. I tried to cope with the ravenous appetite by having the same daily amount of calories as always (I already was a eat-healthy low-carb kind of person) over 6 "meals" instead of 3. That meant a small meal each time: breakfast, mid-morning, lunch, mid-afternoon, supper, evening snack. It was a bit like caring for a baby, but It worked for me and I didn't gain weight or feel overly hungry all the time. My other tip is to drink some high-potassium drink like orange juice, carrott juice or tomato juice (make sure it's low sodium) about an hour after taking the prednisone. I read that our serum sodium elevates an hour after taking the drug and our bodies seek potassium to balance it. It always made me feel more comfortable and less speedy. Good luck to you experimenting and finding what is best for you.

  • cdenoncourt

    Thanks for your advice - I may try to eat 6 meals a day - at the moment I feel that would suit me as I do feel very low sometimes=it is so good that you didn't gain weight. I like you am a healthy eater anyway but my husband is always munching biscuits but I am not tempted now,

    I take Pred around 8am but maybe this is a bit late as I ache all over at this time.

    I know I have to take Pred with food but is just a banana or a peice of toast enough food to take it with?

    Interesting about the potassium.


  • I usually take it with a small breakfast, but I have taken it with just a banana (good potassium) and had no problems.

  • I was told that you don't have to necessarily eat breakfast with pred just something to line your stomach. I like to go to the gym early before work a few days a week and have never eaten before going and enjoy breakfast later. To get around this I bought some yoghurt and just take my pred with a spoonful and some water. I was having my calcium tablets then too but after advice on this site, now take them with breakfast later. I have not gained weight or noticed an increase in my appetite but it's early days. Like you have battled with weight in the past and dread it becoming an issue again.

  • Yes, it is the dread of putting on so much weight that gets me but you are inspiring going to the gym before work too. I went swimming yesterday and felt better for it nut instead of being more tired at night I was lively at 1am - but I did have a nap in the afternoon! 3 weeks ago on diagnosis I was feeling sorry for myself and this feeling had continued for that time but now I am more positive regarding exercise.

    Can Pred make you feel less tired than before at certain times then get exhausted? Perhaps it is the reduction of the PMR pain that is such a relief.I think I have had PMR since April but only diagnosed 3 weeks ago.

    I am increasingly thinking after reading posts here that my frozen shoulder and other issues in shoulder were PMR and I am thinking why didn't the professionals identify it before - the steroid injections in my shoulder had no effect and the pain was terrible but the pain has gone with Pred.

    After 3 weeks the brain fog is still there but has lessened and I am starting to feel more human again. Thanks for advice re taking Pred.

  • I was only diagnosed 2 weeks before you....probably had it since May time but only really bad since August. Glad you enjoyed your swim. I'm so fortunate to have private medical insurance as my GP kept fobbing me off....and this website is brilliant as like you, my mum and friends all suggested that I just listen to the doctor. Slept 12 hours last night and pain in neck has returned slightly ...day 4 of 10mg but despite the rain off to have a gentle jog in the park with my run club which I have not managed on a Saturday morning for ages. Hope brain fog lifts soon ....it did for me on about week 4 ... started to feel almost normal again...hope that soon happens for you x

  • So you are just a bit ahead of me. Maybe I will start to sleep better soon but my neck is a dull ache, It is encouraging to know you are doing well on 10mg and that you are being positive. I do feel better after exercise but its just thinking about it.

    Needs must today as I am looking after an elderly lurcher girl aged 16 and a cat for family over the weekend so I will be walking in the rain too later am I am looking forward to that. Have a good weekend.

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