Corticosteroids make you fat? How to maintain weight during treatment?

Corticosteroids make you fat? How to maintain weight during treatment?

Many people have used steroid medications, and even more people have heard that they gain weight. Although the treatment can cause fluid retention, this does not always happen, as it depends a lot on the time of use and dosage ingested.

Learn more about steroids and find out if they make you fat:

In this article you will find:

  1. What are steroids and what are they for?
  2. What are the side effects?
  3. Why steroids make you fat?
  4. I put on weight. Should I drop the treatment?
  5. How to prevent weight gain with the use of steroids?
  6. How to lose weight after treatment?


What are steroids and what are they for?

Corticosteroids, or also known as corticosteroids, cortisone or cortisol, are agents with anti-inflammatory and immunosuppressive action. That is, they are prescribed for different conditions that need to control inflammation or immune action.

Their use is not uncommon, as they can be part of the treatment of conditions, from oncologic conditions, rhinitis, herpes, allergies or rheumatologic diseases.

In fact, in some cases, it is the indiscriminate use of corticosteroids that raises concerns because, despite being extremely effective for the indicated conditions, they have adverse effects and, over long periods of use, they can pose health risks.

Therefore, in general, whenever there is another option to corticosteroids, it is preferred.

In general, punctual use and monitored by health professionals is safe and tends to have few or no side effects. The highest incidence occurs in patients who need to use it for a long time.

In these, it is common to experience tiredness, agitation, sleep disorders, headaches, reduced immunity. However, in addition to these adverse symptoms, it is common to fear the use of corticosteroids in relation to weight gain.

Corticosteroids are derived from cortisol, a hormone naturally produced by the body in the adrenal glands and essential for the body to function. A lot of people know cortisol as a stress hormone, but that doesn’t mean it’s necessarily bad, because at the right levels, stress is important.

But, in addition, cortisol is related to a series of actions in the body, such as the degradation of proteins, fats and sugars, it regulates the availability of energy and is related to anti-inflammatory and immunoregulatory actions.

Therefore, if used according to medical advice, the benefits outweigh the risks.

What are the side effects?

There are different active ingredients that make up the class of corticosteroids. In general, they have adverse effects according to the time of use and dosage. The most frequent reported by the package insert are:

Hydroelectrolytic changes

  • Sodium retention (favoring body swelling);
  • Potassium loss (at high doses or duration of use, hypokalemia is observed, which is low potassium due to increased urine flow);
  • Hypokalemic alkalosis (kidney response to extreme or severe potassium depletion)
  • Fluid retention;
  • Congestive heart failure in susceptible patients;
  • Hypertension.

Musculoskeletal changes

  • Muscle weakness;
  • Corticosteroid myopathy (progressive muscle weakness due to the use of corticosteroids);
  • Loss of muscle mass;
  • Worsening of symptoms of myasthenia gravis (an autoimmune disease that causes muscle weakness, difficulty in swallowing and chewing, drooping eyelids, among others);
  • Osteoporosis;
  • Vertebral compression fractures
  • Aseptic necrosis of the head of the femur and humerus;
  • Pathological long bone fracture;
  • Tendon rupture.

Gastrointestinal changes

  • Peptic ulcer with possible perforation and hemorrhage;
  • Pancreatitis;
  • Abdominal distension;
  • Ulcerative esophagitis.

Dermatological changes

  • Delay/difficulty in healing
  • Cutaneous atrophy, thin and fragile skin;
  • Petechiae and bruises (purple spots);
  • Facial erythema (redness of the face);
  • Excessive sweating;
  • Suppression of reaction to skin tests;
  • Reactions such as allergic dermatitis, urticaria, angioneurotic edema.

Edema: what is it, types and treatments

Neurological disorders

  • Seizures;
  • Increased intracranial pressure with papilledema (pseudotumor cerebri) usually after treatment;
  • Vertigo;
  • Headache.

Endocrine changes

  • Menstrual irregularities;
  • Cushingoid state development;
  • Suppression of fetal or infant growth;
  • Secondary adrenal or pituitary insufficiency, especially in cases of stress (surgery, trauma or illness);
  • Reduced tolerance to carbohydrates;
  • Manifestation of latent diabetes mellitus;
  • Increased need for insulin or oral hypoglycemic agents in diabetic patients.

What are the symptoms and causes of Hypoglycemia?

Ophthalmic changes

  • Posterior subcapsular cataract;
  • Increased intraocular pressure;
  • Glaucoma;
  • Exophthalmos (abnormal bulge in the eyeball);
  • Blurred vision.

Metabolic changes

Negative nitrogen balance due to protein catabolism (related to lean mass loss).

Psychiatric disorders

  • Euphoria;
  • Mood changes;
  • Severe depression with evident psychotic manifestations;
  • Personality changes;
  • Hyperirritability;
  • Insomnia.


Hypersensitivity or anaphylactoid reactions and shock or hypotension-like reactions.

What is Corticoid for?

Why steroids make you fat?

Among the possible adverse effects reported in the package insert are fluid retention, change in appetite and decreased lean body mass. That is, it can trigger a change in weight.

The swelling, which in this case is known as hypercortisolism, results from an alteration in the elimination of sodium. It is also common for the treatment to lead to increased hunger so that the person will eat more – this then helps with weight gain.

However, these adverse effects are observed in those who use it for a longer period of time. For most people, usage is short-lived (such as pain, tooth extraction, inflammation, and severe allergies).

In addition, it is worth remembering that the increase in body mass is related to a series of factors, such as genetics, diet, time of use of the drug and the practice of physical activities.

I put on weight. Should I drop the treatment?

Not! First, it’s important to know that steroids will only bring about noticeable and significant changes in body mass if used for a long time—that is, long weeks.

In many cases, the drug is prescribed for a few days, and there is not enough time to change the weight.

But, in addition, even if the treatment is long, it is essential to maintain it correctly, following the medical recommendations. If there is any adverse effect that impairs the well-being and quality of life, it is important to notify the doctor to assess the need to change the treatment.

However, if the only complaint is weight gain, it is likely that a series of care will be integrated into the treatment, helping with weight control.

How to prevent weight gain with the use of steroids?

Weight gain during the use of steroid medications has some correlated aspects, so that not everyone who uses it will gain weight. In fact, one of the main points is the usage time and dosage.

People with punctual conditions, such as acute pain or temporary inflammatory control, tend to need treatment for short periods—sometimes as much as 5-7 days.

In this type of use, it is uncommon for significant weight changes to occur. However, in any case, the ideal is always to combine the use of medication with a balanced diet and the practice of physical activities.

It is common for steroids to increase hunger, causing caloric intake to be high as well. Therefore, investing in natural and healthy foods is important. But, to help control appetite, practicing relaxing activities and reducing stressful ones can control anxiety and, consequently, the desire to eat.

How to lose weight after treatment?

The same tips during treatment should be followed and continued after using steroids, in order to regain weight prior to using the drug.

Good tips are the practice of aerobic activities, as they generate a high caloric expenditure. It is always worth observing the glass and respecting your own limits, especially after undergoing any type of medical treatment.

The choice of light, natural and less industrialized and/or processed foods as possible is important, as they help in good nutrition (giving essential nutrients to the body’s functioning) and also promote satiety.

Following medical and nutritional recommendations is valid for life. At this time, professional help in setting up the menu and monitoring weight loss is essential for this to occur in a healthy way.

In addition, reducing the load of stress, betting on relaxing activities and controlling anxiety are precious tips for after-treatment.

The use of corticosteroid drugs is safe and has excellent results as long as it is done under medical supervision. However, adverse effects can still occur.

One of them, which usually generates great discomfort and doubts, is about weight gain. In general, this only occurs with patients who take longer treatments and at higher doses. But there are ways to control weight without abandoning treatment.

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