The others have said some very useful things about managing with the weight gain and body shape changes. I have also been doing quite a lot of research into this as I wanted to find a plan that might suit me but also let me not beat myself up if I wasn't able to be really strict with myself. I couldn't find a single source of information so gathered quite a few different details together. So far I've managed to keep the weight gain on high dose steroids for GCA (60mg then 40mg) to 1-2kg (depending on the day), and I'm definitely no saint when it comes to food temptation.
In case this is of help, what I've pulled together is:
1. The weight gain and body shape changes on prednisolone are due to increased appetite that is difficult to resist, water retention and a redistribution of body fat into areas where we notice it (abdomen, back and base of the neck and face), and we know that others might notice it too.
2. Reading about fluid retention and prednisolone, I decided to reduce sodium in my diet and increase the potassium, and make sure I drank a bit more water throughout the day. I have noticed that when I have meals with more potassium the bloating is better the next day. This is my favourite source of information about high-potassium foods:
3. Having frequent small meals has worked well for me. It makes the hunger cravings easier to manage and has let me work out the pattern of cravings in relation to the release of the drug into my system across the day. I've found that adjusting when I eat to my prednisolone-dictated schedule is much easier than feeling the steroids are controlling what I do. I wake up early and have some instant porridge with almond milk (skimmed milk is also good) at about 5am, go back to bed, then I have my medication around 8am with something light so I'm not having the tablets on an empty stomach. I get really hungry about 11.30am so that's when I have the first half of my lunch. I have the second part of my lunch at around 3pm, and a snack at about 5. By the evening the cravings are lessening a bit so my evening meal is almost at a normal time. Someone here recommended a tiny bit of a higher fat ingredient to help with the cravings and that certainly seems to work with me. I think it may trigger the satiety part of the brain that tells the stomach it doesn't need any more food.
4. I have switched from simple carbs (pasta, rice, white bread) to complex wholegrain carbs and reduced them overall. I've substituted lots more protein and vegetables. It's hard when you're feeling ill to cook a lot but I give myself a break and sometimes buy a few of the healthier ready meals to make sure I don't give in to my love of pasta too easily. Dietitians recommend lots of variety in terms of ingredients and flavours to keep people from becoming de-motivated, so I try that too when I'm feeling up to it.
5. This link might be helpful (ignore the references to chemotherapy - the prednisolone/steroid references are probably just as relevant to all its uses in terms of weight gain)
6. Oh, and yes, I have treats. It's hard enough to have everything else going on and manage the mood changes that sometimes come with the pred. A square (or two) of dark chocolate or a couple of crisps now and then help me stay on track, oddly.