ILD Nutrition Manual: Prednisone and Weight Gain

Weight gain is a common side effect of prednisone. Prednisone can also cause a redistribution of fat to the face, back of the neck and the abdomen, although these changes vary from person to person. Generally speaking, the higher the dose and the longer the treatment, the greater the changes.

Weight gain while taking prednisone is typically due to fluid retention and increased calorie intake because of increased appetite. In addition, those with lung disease have more difficulty maintaining physical activity.

Fluid Retention

Fluid retention can be controlled by eating a diet low in sodium – no more than 2,000 mg a day – and higher in potassium. You can find a list of high-sodium foods to avoid in the General Guidelines for Healthy Eating.

You can increase your potassium intake by eating potassium-rich foods such as:

• Apricots
• Baked potatoes
• Bananas
• Cantaloupe, honeydew
• Dates
• Dried prunes
• Grapefruit
• Lima beans
• Milk
• Orange juice, grapefruit juice
• Oranges
• Raisins
• Spinach, cooked
• Stewed tomatoes
• Tomato juice
• Winter squash
• Yogurt

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Increased Calorie Intake

Prednisone increases appetite, resulting in increased calorie intake. This increased appetite can be difficult to control. Below are a few tips for controlling the amount of calories and the quality of nutrients you eat:

Eat small, frequent meals of high nutritional value.

Eat a high-protein, low-carbohydrate diet. There is evidence that a low-carbohydrate, high-protein diet is at least as effective for losing weight as a traditional low-calorie diet that’s low in fat and portion-controlled. A high-protein diet may also help suppress appetite.

Eat carbohydrates in the form of fresh fruits and vegetables. Prednisone has a tendency to raise the level of glucose, or sugar, in the blood, which can cause increased body fat or diabetes in some people. It is important to avoid “simple” carbohydrates and concentrated sweets, such as cakes, pies, cookies, jams, honey, chips, breads, candy and other highly processed foods. This helps keep blood sugar low.

Limit saturated fat and cholesterol. Choose lean meats, poultry and fish. Avoid fried foods and foods with extra oil, butter, margarine, mayonnaise and the like.

Eat foods rich in calcium. Prednisone may alter your body’s ability to use calcium. Try to get four servings of calcium-rich foods per day to help prevent osteoporosis. Check with your doctor to see if you would benefit from calcium supplements.

Foods rich in calcium include:

• Calcium-fortified orange juice
• Cheese (American, Swiss, Colby, Cheddar and Jack)
• Cottage cheese
• Milk
• Non-fat dry milk powder
• Oranges
• Sardines (canned, with bones)
• Shrimp
• Yoghurt

Decreased Physical Activity

Having a lung disease makes physical activity more difficult. A daily exercise program such as walking, working out at a gym or at home or practicing tai chi will burn calories, help prevent muscle and bone loss and improve your sense of well-being.

Your exercise program should include aerobic exercises, which burn calories and improve cardiovascular fitness, and moderate weight training, which strengthens muscles and slows bone loss. Start with a simple walking program. If you’re ever too fatigued to exercise, try harder tomorrow. Eat your main meal early in the day so you’ll have more energy throughout the day and if you need it, be sure to wear your oxygen.

The key is to have a program of regular exercise. A pulmonary rehabilitation program is an excellent way to learn how to exercise despite shortness of breath and fatigue — plus you’ll learn about lung disease and get lots of encouragement.

For more information on eating healthy with chronic lung disease, please see our General Guidelines.

ILD Nutrition Manual Index:

• ILD Nutrition Manual: General Guidelines for Eating Healthy
• ILD Nutrition Manual: Body Mass Index
• ILD Nutrition Manual: Increasing Protein in Your Diet
• ILD Nutrition Manual: Tips for Gaining Weight
• ILD Nutrition Manual: High-Calorie, High-Protein Sample Menu
• ILD Nutrition Manual: High-Calorie Shakes and Smoothies
• ILD Nutrition Manual: Tips for Losing Weight
• ILD Nutrition Manual: Plate Method for Healthy Meal Planning
• ILD Nutrition Manual: Prednisone and Weight Gain

Prednisone and Weight Loss — Foundation for Sarcoidosis Research

Sleep problems, increased appetite, headaches, dizziness, nausea, bloating, and weight gain; all of these are symptoms that many sarc warriors have experienced while on prednisone. Since prednisone, a corticosteroid, is able to suppress inflammation leading to improved symptoms and possible prevention of permanent organ damage, despite side-effects, it remains a first line treatment for sarcoidosis. For many patients, the one side effects that causes the most discomfort is weight gain. Weight gain from prednisone is usually caused by water retention and an increased appetite. Some people also experience body fat redistribution, a symptom that is characterized by fat deposits collecting in unusual areas like the base of the neck or back. Trying to figure out how to deal with rapid weight gain can seem overwhelming at times, but there are a few things you can do limit weight gain from prednisone and slowly reverse the process.

FSR understand that not all diets and exercise routines are right for everyone. The following recommendations were not reviewed or approved by FSR’s Scientific Advisory Board. Any changes to your diet or exercise routine should be discussed and reviewed with your physician in advance.

Prednisone Friendly Diet

Gaining weight while on prednisone is commonly caused by fluid retention. One way to limit the amount of water you retain, is to eat a low sodium diet. Sodium binds to water inside of the body and helps maintain the balance of fluid inside and outside of cells. When you have a diet high in sodium, your using the extra salt to also hold on to extra water causing fluid retention. The University of San Francisco Medical Center recommends keeping your daily intake below 2,000 milligrams. Another way to control fluid retention is to make sure you eat enough potassium rich foods, about 4,700 milligrams daily. Potassium helps to decrease sodium levels and also increases urine production which helps flush out extra fluids.

Tips for a Low Sodium Diet

High Potassium Foods

• Ways to Avoid Sodium
  • Do not eat processed, canned and prepacked foods
  • Don’t add extra salt at the table
  • Do not use high sodium seasoning mixes
• Low Sodium Foods to Look For
  • Fresh or frozen produce
  • Low or non-fat dairy products
  • Whole grains
  • Fresh, lean meat, seafood and poultry

• High Potassium Foods
  • Dried plums
  • Spinach
  • Raisins
  • Bananas
  • Winter squash
  • Yogurt
  • Milk

Lean protein can also help promote weigh loss for patients on prednisone. Following a diet where approximately 34% of the calories come protein resulted in people feeling less hungry and promoted weight loss when compared to people on a high-carbohydrate diet.

Last, it is always important to make sure you are drinking the recommended about of water every day, about 15.5 cups for men, and 11.5 cups for women. Drinking water is a great way to help you feel full and can help prevent over eating. Drinking water also can help flush unwanted toxins from your body.

Exercise Tips

While you are making your diet more prednisone-friendly, you can slowly begin to exercise. To begin, pick an easy activity that does not put too much stress on your body. Check out some sarc-inspired yoga tips if you need a starting point!  Don’t forget to include some cardiovascular exercise in your routine- this could be swimming, taking a walk, joining a class at a local gym, or making up your own personal routine at home. It might seem intimidating, but don’t give up!

Sarcoidosis, like many chronic diseases, wears down your psyche. You fall into the rut of “I can’t do that.” If people can be motivated to just walk to the end of the driveway, then the end of the block, then around the block, they are on their way.

Walking is an exercise that nearly anyone can do. Don’t make any excuses. Start with 100 feet the first day. It’s still 100 feet more than you would have gotten. Your body will quickly get used to it, and soon you’ll go farther and farther. The key is movement instead of sitting.

Bob Owens

sarcoidosis warrior

Read the rest of Bob’s story, Step by Step >

Finding a workout buddy can also help keep you motivated- sarc warrior Gretchen found that by teaming up with her friend to start working out, she had more confidence and accountability. Not to mention, it also makes exercising more fun!

Once you have decided on an exercise, follow the chart below, remembering to only increase the level when you feel comfortable. Always talk to your doctor before starting a new exercise regimen.

Getting Off Prednisone

If you want to explore alternative medications other than prednisone, try sharing our FSR Treatment Guide with your physician. Created by our Scientific Advisory Board, this protocol details numerous medications that can be prescribed for sarc, including off-label therapies. A lot of doctors find resource this useful for choosing a treatment method other than long-term use of steroids like prednisone.

Read more about treatment options.

Interested in using your skills to help the sarcoidosis community in your area? Consider applying to become an FSR Global Sarcoidosis Clinic Alliance Volunteer!

Learn more.

How To Lose Weight Taking Prednisolone – Telegraph

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How To Lose Weight Taking Prednisolone
MedCircle / Health A…Z / Rheumatology / Systemic lupus erythematosus / Discussions / How to lose weight with SLE and the simultaneous use of Prednisolone and Plaquenil
How to lose weight with SLE and the simultaneous use of Prednisolone and Plaquenil
0003 I was diagnosed with subacute SLE (discoid lupus) in March 2011 in Kazan. After treatment with Prednisolone, I gained 35 kg in 6 months! A nightmare! She weighed 65, and became 100. From October 2011 she took 2 tablets per day of prednisolone – 10 mg (started from 8 in March) and 2 tablets of Plaquenil. They said to keep this dose for 2 years, what then I don’t know …. The doctors also said that by reducing the dose of hormones, I would start to lose weight and advised me not to eat bread and not to eat after 18.00.
After another examination by a rheumatologist in 2012, they decided to change Prednisolone to Metipred (8 mg) – 2 tabs .. and leave Plaquenil 2 tabs – 400 mg, thereby reducing the amount of the hormone ….. And during this time I managed to gain more 5 kg. I tried to lose weight – nothing works! Lord, what to do, how to get rid of this nightmarish excess weight? And is it real or not? Please, who knows, help!!!!!
Post edited by MiliiSvetik 06/11/2012 – 04:44 PM
Do not worry, you will gradually lose weight on 2 tablets. I bounced back after about a year. And Plaquenil does not give weight.
Same problem. I was on 6 tablets, reduced to 2 in six months. But the weight continues to grow. She also weighed 65 a year ago. Now I weigh 82 and it seems that this is not the limit. The weight does not go away on 2 tablets, at least for me, it has been increasing and continues to increase, I myself don’t know what to do. Homeopathic injections and pills may possibly be concomitant treatment, but not the main one.
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Post edited by Nadezhda-K 10.04.2015 – 11:38
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Proper nutrition + daily sports if possible! There was a time when I couldn’t walk. So I worked out on the couch. The main thing is to have fun, without forcing yourself! But still, not completely relaxed! And when there is that very dose, from which the weight will stop growing, everything quickly goes away! How you are blown away! This is what happens to me. The main thing is not to despair and keep practicing!
And the Doctor doesn’t know for sure, it seems. ..
Sit down on cottage cheese with sour cream with a lower fat content, at least twice a day. Apples. Eliminate pastries, limit salt and sweets. The rest are smaller portions. Tea with lemon. Food until six, seven in the evening. Put a taboo.More walking. And everything will return to normal.
I had an exacerbation, I took 10 tablets of prednisone, now 1.5 tablets of metipred. Talk to your doctor to switch to metipred, it is more expensive, but it has fewer side effects, incl. and by weight. Your excess weight is not fat, it is liquid and it will definitely begin to come off. I had an exacerbation in May 2009of the year, since January of this year I have been drinking 1.5 tabs, and only in August I began to lose weight, without any diets and sports myself. I lost 18 kg in 5 months. Slowly but surely. With age, this period increases. I lost weight in a year before. Don’t worry, you will definitely lose weight. And eat normal food, do not starve, we definitely need protein. I wish you health and good luck))
In September, when I started taking prednisolone 12 tablets, I weighed 73 kg, now I drink 5 tablets and continue to reduce the dose by 1/4 every week, now I weigh 85 kg. I’m wondering when will I start losing weight. When will I lower my dose? I practically do not eat carbohydrates, I exclude everything fatty, baked, and the weight as it is, does not go away a single gram, my cheeks are just awful.
natasha17, you are not overweight because you eat carbohydrates and fats. And due to the fact that prednisolone retains fluid in the cells, it is not excreted, the cells are stretched. When you are on about 2 tablets, the weight will begin to go away and the cheeks too. It also depends on age, the older the person, the slower the process of losing weight. And so that the skin does not sag later, do light exercises, walk on foot and swim.
I have had SLE for 6 years. For the first year, I was on prednezalone and gained 10 kg from it, then I switched to Medrol and the weight stabilized. In general, you should always be on a diet.
I took 10 tab. prednisolone, gained an extra 6 or 7 kg (“started” with 52 kg, which is already too much for me with my height and constitution). BUT! Every day, in addition to the main meals, I ate 1-2 more rolls, cottage cheese with jam, and in general, my mouth did not close, bulimia was terrible! I constantly wanted something kusnenko, and I could not refuse myself … When the doctor saw me during a planned hospitalization, she gasped and ordered her mouth to be sewn up. As best I could, I gradually switched to a different diet, for more than six months I managed to lose only 4 kg. Now (for more than 2 months) I try to stick to two meals a day (breakfast and lunch as late as possible), the rest of the time – only fruits (1 banana, apple, manarine, orange each), I try to exclude sweet, salty, etc. .d., and generally do not eat after 16 pm. Then he manages to lose a few hundred grams from himself. Which immediately return, it is worth eating a candy or my favorite grape. And if he eats for dinner, then by the morning he gains as much as 1.5 kg! I got tired. I’m afraid to starve completely – it’s quite extreme for the body, and I’m afraid that it can cause an exacerbation.
At the moment I’m taking 2 and 1/4 tablets, reducing the dose from the summer to 1/4 per week.
Probably, physical education should also be added, but here the replacement of fat with muscles can happen (the body strives to preserve what it has, including maintaining weight))))) )
Probably, after all, eating less and moving more is the only way to lose weight. And you need to be patient
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How To Take Prednisolone And Stay In The Same Physical Form.

A true story from our reader:

In the life of every person there are certain difficulties. Maybe some trials are sent to us from above? And they just need to be adequately experienced, accepted and understood?

Everyone should decide for himself: to fight for himself, or give up, “go with the flow” and whine that everything is bad.

So not so long ago I had a test in the form of a serious illness. Accordingly, I had to take a lot of pills, of which one of the strongest hormonal drugs was “prednisolone”. In order not to beat around the bush, I will be more specific, the doctors diagnosed me – “subacute thyroiditis” . Of course, there was a shock! Of course, upset. After looking at the list of medicines prescribed by the doctor, I decided to look into the omniscient Internet. I read the forums, and everything that directly or indirectly relates to my disease. This is where I got a double shock! What I read did not inspire optimism, even a little bit. To say that I was discouraged is to say nothing! She cried, drank sedative pills, cried again. And at some point I decided – that’s it, stop whining and become limp, you need to do something.

The first thing I did in this situation was to accept and understand that I still need to be treated. That other, alternative, sparing methods of treatment have not yet been invented. In any case, you will have to drink this whole set of drugs, And tears and stress can only aggravate the situation.

Secondly, I pulled myself together and decided to take the disease and treatment under control and not let everything take its course.

The treatment regimen, specifically in my case, was as follows:

• Prednisolone (5 mg tablets) 2 tablets 3 times a day.
• “Panangin” 1 tablet 3 times a day.
• “Omez” – 1 tablet in the evening.

Total 10 tablets per day and almost everything (except omez) after meals. The question arose, how to eat so as not to harm the figure? I will say more: “prednisolone” slows down metabolic processes, inhibits the breakdown of simple (sweet) carbohydrates, proteins and fats. It is not for nothing that many, taking hormones, complain about a significant increase in weight. Another “prednisolone” removes potassium from the body. And potassium supports the heart, in particular its rhythm. And throughout the course of treatment with this drug, severe insomnia torments. It also retains fluid in the body, from which the whole body swells, and there are “bags” under the eyes. This is not a very large part of the side effects from this hormonal drug, but, in my opinion, quite significant.

Considering the side effects of prednisolone and the treatment regimen, I decided;

• for the duration of treatment, avoid sugary carbohydrates (sweets and all confectionery)
• eat every 2 hours, but portions should not exceed the volume of a glass.
• in each serving try to combine the correct proportions of proteins, fats, carbohydrates (30:20:50)
• include in the diet, foods containing the maximum amount of potassium – baked potatoes, raisins, millet.
• temporarily give up coffee (it caused severe tachycardia in me). I replaced it with chicory with milk.
• fight insomnia with non-drug means.
• Avoid salt as much as possible and try not to drink liquids 3 hours before bedtime.

Upon the successful completion of my treatment, I decided to write a positive article to support those who faced a similar problem and want to help themselves.

As a result: since the evening I have been thinking over my menu for tomorrow, so as not to panic and eat whatever comes to hand. I ate every 2 hours (set the alarm).

And since the medication regimen was as follows:

• from 6 to 7 o’clock the first time I took 2 tablets of “prednisolone” (I got up on an alarm clock, ate oatmeal with water, drank “prednisolone” and, if I didn’t have to get up early, went to bed again)
• from 9 a.m. to 10 a.m. – taking “panangin”,
• from 12:00 to 13:00 again 2 prednisolone tablets,
• from 14 to 15 hours – “panangin”,
• from 4 to 5 pm, the last dose of “prednisolone”,
• 18-19 last reception of Panangin
• 21. 00 “omez” reception.

then so, respectively, and ate, taking into account the time.
Tablets of “prednisolone” washed down with milk.

Sweet confectionery, replaced with a mixture of dried apricots, raisins, walnuts, prunes, lemon and honey (all one to one), twisted in a meat grinder. I took this mixture in the morning 1 dessert spoon. Moreover, this mixture is “rich” in potassium.

I cooked millet milk porridge without butter in milk and without sugar.

The potatoes were baked in the oven with the skin on for 1 hour, at a temperature of 200 degrees, having washed them cleanly in advance and pierced them through with a knife in several places.

In order to somehow fall asleep, I bought essential relaxing oils with hypnotic and anti-inflammatory effects (clary sage, jasmine, lemongrass) and washed the floor in the bedroom before going to bed with the addition (10-12 drops per basin, having previously dissolved the oil in 50 gr. milk), laid out napkins moistened with these oils around the room, lit an aromatic lamp, wiped her body with olive oil before going to bed with the addition of a few drops of one of these oils. True, the fight against insomnia went on with periodic success.

A week after the start of treatment, I not only gained weight, I lost 1 kg! After 2 weeks, another 2 kg. In the future, the weight was maintained throughout the course of treatment.

Before the illness, I was regularly engaged in shaping, but during the illness, the doctor forbade me to exercise and everything that increased metabolic processes, so as not to aggravate the course of the disease. But I decided to tighten my muscles and relax them 100 times a day. For example: I strained the press on the exhale and relaxed on the inhale. Buttocks, back, legs also – strained on exhalation, relaxed on inhalation.

As a result, after the end of the treatment (only 4 months), I with dignity endured the trials given to me, lost weight, pumped up muscles in problem areas, recovered, gained experience, wrote an article.

Of the minuses:

• these are grown cheeks, like a hamster’s, which disappeared only 2 months after the last intake of “prednisolone”
• I still slept very badly,
• I love the bath, but it is impossible, in no case.