Do Steroids Make You Gain Weight?

Dr. Christopher McGowan
August 15, 2022

In popular culture, the term “steroids” tends to evoke images of swollen weight lifters and professional athletes with ethics problems. These types of anabolic steroids contain compounds that are designed to maximize strength by increasing the protein content in skeletal muscles. In  a more general sense, however, steroids make up some part of cell membranes and function as messenger molecules. When used as medication, steroids are typically prescribed to treat instances of inflammation, and in some cases they may even lead to weight gain.     

What Are Steroids?   

In the strictest sense, a steroid is an active organic compound with a molecular structure arranged in a particular way. In most medical contexts, however, the term steroids usually refers more specifically to corticosteroids, a type of hormone that is produced in the outer layer of our adrenal glands. Though there are some corticosteroids that are produced naturally in the body, the term is most often used when talking about medication that is primarily prescribed to treat inflammatory conditions.  

Glucocorticoids and mineralocorticoids are the two main classes of corticosteroids. Glucocorticoids play a role in the metabolism of glucose as well as being involved in how and why inflammation develops in the body. Mineralocorticoids, by contrast, have a regulatory effect on the body’s electrolyte and fluid balances. But together these steroid hormones have influence over a wide variety of physiological processes such as behavior, stress responses, and immune system function. 

And it is because of these functions that steroids are used so often in medical settings to treat inflammation. As a hormone messenger, the corticosteroids trigger an anti-inflammatory response in the immune system that can bring substantial relief to patients. Prednisone and methylprednisolone are commonly prescribed for both their anti-inflammatory and immunosuppressive effects, but corticosteroids can be used to treat a number of different conditions: 

  • asthma
  • allergies like hay fever
  • inflammatory bowel disease (IBD) 
  • hives
  • eczema 
  • lupus 
  • multiple sclerosis 
  • sciatica
  • vasculitis (inflammation of blood vessels)
  • myositis (inflammation of muscle tissue)

What Are the Side Effects of Steroids?    

The nature of steroid hormones makes them very unlikely to cause significant side effects or complications, especially when taken at low doses or for a limited period of time. The manner of treatment can sometimes make side effects more likely; for instance, steroids in tablet form can lead to mood changes, difficulty sleeping, and an increase in appetite. For the most part, any unpleasant side effects will cease once the course of medication is complete. Below are some common side effects of systemic steroids (as opposed to those that might be administered locally): 

  • muscle weakness
  • blurred vision
  • greater than average body hair growth 
  • acne
  • bruising easily
  • swelling or puffiness in the face (moon face) 
  • osteoporosis 
  • high blood pressure
  • water retention 

Can Steroids Cause You to Gain Weight?  

One of the other side effects that can sometimes be a factor is an increase in body weight, and this is especially true of prednisone (or prednisolone). Since prednisone is a glucocorticoid and a synthetic version of the hormone cortisol, it can have a significant impact on the regulation of blood sugar and the metabolism of carbohydrates, fats, and proteins. Prednisone doesn’t have the same effect on every person, but it’s more likely to lead to weight gain with high doses over a longer period of time. 

One of the main reasons prednisone (and some other corticosteroids) can cause weight gain is fluid retention. Prednisone can alter the fluid balance maintained by the kidneys by causing the body to hold on to sodium at the same time as losing potassium. Increased sodium in the body also increases the amount of water retained in the body’s tissues. This imbalance causes swelling in the face, arms, and legs. This kind of weight gain, however, does not necessarily mean an increase in fat deposits (though that can happen independent of fluid retention). 

Another way prednisone can lead to weight gain is through increased appetite. By mimicking cortisol, prednisone binds to receptors in the area of the brain that controls hunger and satiety. This means an increase in appetite and calorie intake, usually without a comparable increase in physical activity level. Additionally, prednisone has been known to disrupt sleep cycles; this also can lead to increased appetite and an altered metabolism. Over time, these effects can lead to higher amounts of body fat. 

Between fluid retention and increased appetite, it’s not uncommon for people on prednisone to have a noticeable increase in body mass. A separate but related phenomenon that can sometimes occur is known as fat redistribution. This means that fat deposits can begin to be stored in other (often less desirable) areas of the body, like the back of the neck, the face, or the abdomen. The good news is that this kind of redistribution often goes away on its own once the course of prednisone is complete.    

How to Prevent Steroids-Related Weight Gain         

Even though some corticosteroids can lead to weight gain, it isn’t a certainty, and there are ways to prevent it. To counter the increase in appetite, for example, you can increase the fiber and protein content of your meals; this will lead to feeling fuller for longer. To stave off fluid retention, switch to low-sodium foods and aim for 1500mg of sodium per day at most. Also, to maintain a good sodium-potassium balance, consider adding more potassium-rich foods to your diet like bananas, oranges, spinach, and collard greens. 

True You Weight Loss 

For most people, any weight gain related to a steroid prescription will be temporary and won’t last once they stop taking the medication. Long-term weight loss, however, is a concern for many more people, especially as obesity continues to increase in the United States. In theory, losing weight is as simple as achieving a caloric deficit by taking in fewer calories than you burn. In practice, however, there’s nothing simple about it. The truth is that there are many factors involved in weight gain, and that often means taking a different approach to weight loss. 

At True You Weight Loss, we understand the challenges involved with losing weight, and we’re here to assist you in your journey. If, like many others, you’ve tried traditional weight loss methods without much success, there is another way. With minimally invasive solutions like ESG and gastric balloons, you can get help gaining more control over hunger and appetite levels. This can lead to a change in eating habits that results in long-term weight loss. To learn more about what we offer at True You, please contact us today to request a consultation.

Dr. Christopher McGowan
Dr. Christopher McGowan
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