Just wondered when the weight gain starts and ends while taking Pred? My sed rate was high in December and I was put on 40 gms of Prednisolone, tapered down to 20gms now. I have the puffy face and hump now, but does it increase still further?
Why does the doctor, Rheumatologist and Orthopeadist express ‘you are going to pile on the weight’. especially as I have been told I’m going to be taking the Pred for two years, (I already watch the carbs as I was found to be diabetic 13 years back. All my siblings and my mother had/have diabetes seems it’s hereditary). Wish remarks like this were not so discouraging, got enough health issues and would appreciate a more positive response from the medics.
Written by
Birdboxinthegarden
To view profiles and participate in discussions please or .
Hello. It’s so disappointing when docs don’t empower patients to do the best for themselves to get better. The weight thing and Pred is often presented like you have no choice but to put on weight, which is rubbish. So the moon face and hump etc are par for the course for most because what fat you do have will tend to go there for some reason. I didn’t put on any weight because I was determined but it still went there. At least it goes as the dose reduces, but it is slow and gradual. One day you notice it isn’t as bad, then one day it’s even better, but be patient.
I was determined not to put on weight or get diabetes as a result but I had to cut out any potato, sugar, rice, pasta, flours etc. Pred makes you retain sodium so salt in the diet will tend to make you puffier; I got it around the eyes especially. On the higher doses my salt intake had to be super low.
I was diagnosed wit PMR in October 2018 and started on 25 mg prednisolone. Am on 12.5 mg at present. I have been doing more or less the same as Snazzy D and have managed to keep my weight. I have a little bit of puffiness in the face but how much varies. It's often worst in the evenings. Watching what and how much you eat, including the amount of salt, really does help. Good luck.
I can't answer your questions because my experience was different - I was fortunate in that I didn't gain weight on pred (in fact, I lost some). I cut carbs drastically, and ate virtually no sugar or salt (but I didn't eat much sugar & salt before PMR, so that was no loss!). I agree with you - health professionals should be offering advice about how not to gain weight when on pred, rather than assuming you will gain weight. But I don't think nutrition plays a big part in medical training, unfortunately!
I'd guess that as you get to below 20mg, the "puffy face & hump" certainly won't increase, and may start to reduce. There are many people on here with more experience of pred than me - I'm sure they'll be along soon.
I didn’t gain weight (started at 20mg pred, now down to 9mg over 10 month period). I already had high blood pressure and knew my poor knees were in bad shape (I have to get a total knee replacement), so losing weight was my focus. I’ve lost 30lbs, but would like to drop 15 more.
Both my GP and Ortho surgeon were surprised at my weight loss while on pred, and praised me for my efforts. I’ve also cut my bp medication in half.
Medical professionals should not make assumptions or scare their patients...indeed they don’t know your abilities and we are all different.
Unless I am in denial, the moon face, the fatty back, the rounded belly, all kind of normalise. The voracious appetite dies down and the odd fatty deposits put themselves back. All you are left with are the results of giving in to yourself and cutting back and comfort eating control becomes easier. Like a beachside village after a Tsunami. We gradually put ourselves back together. 3 years PMR on 5 mgs Prednisalone, surveying the damage.
I started on 60mg for GCA, quite quickly got the puffy face and hump, the steroids make you very hungry so rocked from one meal to another, just couldn't think of anything else but food! Luckily I had started off underweight because of the illness so after a few months and when my bloods showed early onset diabetes I cut out carbs and sugar & salt (I hadn't appreciated that steroids inhibit the breaking down of carbs'and that salt increases water retention) so have managed to stay at the right weight. When I got to 15 the puffy look started to reduce and now at7.5 it's nearly gone (wrinkles coming back!).
All my puffiness went as soon as I got below10mg. I put 2 kilo on and quickly lost it but I find it impossible to lose any more. I am overweight but have been exactly the same size for 10 years apart from the 2 kilo blip. I have stopped blaming Pred. I love cooking and my weight is human frailty now I am below 10mg.
My GP too told me at the outset that I would gain weight on steroids. In fact I lost another 10 lbs on top of the 10 lbs I lost before being diagnosed with GCA. I started off on 60mg pred and am now down to 10mg. People tell me I don't look like someone on steroids. I have regained a few pounds because I needed to, and I needed to rebuild the muscle mass I had lost. I find that if I eat too many carbs I get that carb face, but it goes once I resume eating sensibly. Everyone is different of course as regards weight gain in response to certain foods, with or without steroids, and I agree that GPs shouldn't assume everyone will balloon.
Like some of the others, I have gained no weight since being on pred for nearly 3 years. It is not a 'given' and doctors should be less alarmist and more encouraging.
I'm a retired dietitian and have always eaten healthily. However, I cut my portion sizes, as my energy expenditure fell with not being able to walk as much as before, or work in the garden due to shoulder pain. I never add salt at table or to vegetables, but just get what might be in foods. I eat loads of vegetables and fruit for bulk and for the 'goodies' they contain - OH is vegan, so it helps.
I don't look like 'someone on steroids', but that leads to the "You don't look ill" comments - no win situation when you try to look after yourself!
When I told Prof Sarah Mackie about cutting carbs to reduce weight gain she was surprised. I don't think it occurs to them that there are ways to avoid or minimise most pred side effects - and she did say perhaps they should start counselling patients on diet.
Like one or two others I have to cut carbs to almost nil to lose weight and even then it is slow, half a pound a week was good! But I did lose 35lbs of "PMR inactivity and comfort eating" and steroid-associated weight over a period of about 18 months by being quite strict. The first places it went was around my midriff (trousers started to fall down after about a months) and then face and arms. I had been in hospital a few months before and top of the diagnosis list at admission was "Cushingoid" - all my doctors now say you would never know I've been on pred for well over 9 years.
Like Rimmy I adjusted portion size first - I found the 5:2 diet did that very effectively - and then worked on carbs. I use next to no salt (just what is in the herbes de Provence grinder I use, can't find a salt-free one here) - and when I eat out I see the difference in fluid retention immediately. I eat no fruit but barrowloads of above ground veggies.
I have been back up to 15mg pred since last October - and haven't gained but I haven't really tried to lose weight as it's been winter and a bit complicated.
So what can you eat for breakfast if you can't have fruit, or cereal, or anything. I shudder at the thought of fish and veggies for breakfast. Ugh. I need to get off the carbs myself!
Eggs, cheese, meats, unsweetened yoghurts, Skyr, berries are better than most fruit. Google low carb recipes - dietdoctor.com/low-carb has good reliable info. It's not a problem for me I don't "do" breakfast, it is part of my interval fasting timetable as it happens, but even when I did eat breakfast there was never a shortage of items!
But I have also lived abroad - it changes your world view of what food belongs to which meal Though my absolutely favourite breakfast is Scottish: Arbroath smokies (smoked haddock) and a poached egg! You can keep kippers though!
When I was first diagnosed in July 2017, I was very euphoric, firstly because it was such a relief to have a diagnosis and secondly because the pain and stiffness melted away with the 60 mg of pred I was prescribed. As a result I gave in to the rampant steroid hunger and put on about 20 lbs very quickly, which wasn't good as I was already rather plump. I've never had a moon face or a hump, just increased general weight, but I went from being officially 'overweight' to the edge of the 'obese' category - scary. It was thanks to the good advice on this forum that I managed to curb my eating and, as the pred dosage decreased, I found that the hunger diminished and became more normal. I've now lost all of the pred 20 lb plus a little bit more, including 13 lbs since I started Slimming World at New Year. I'm now so content with my no sugar, no white carbs régime that I'm going to continue until I'm slim for the first time since I was 35. Progress is slower than it might be if I wasn't taking pred, but it isn't impossible and it's well worth it.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Though my absolutely favourite breakfast is Scottish: Arbroath smokies (smoked haddock) and a poached egg! You can keep kippers though!
Prednisolone -weight gain? Moon face?
Steroid weight gain
Weight Loss on prednisolone taper
Prednisone Weight Gain 
Weight gain
