How do steroids affect weight and appearance?
If you’ve been prescribed steroids, it’s important to know that they can have a big impact on your appetite, causing a major increase in how much you want to eat. Steroids also alter your body’s metabolism in multiple ways that can lead to weight gain and changes in where your body stores fat. You may experience a change in the shape of your belly, your face (sometimes referred to as a “moon face”), and your neck (sometimes termed a “buffalo hump”). You may also notice that your arms and legs appear thinner than normal.
Steroids can alter your body's fat distribution (where it stores fat) and metabolism (how it turns food into energy). This can lead to visible changes that affect your weight and appearance:
Increased appetite and weight gain
The increased appetite associated with steroid use can lead to weight gain. This weight is typically distributed in a way that can be distressing for patients.
Fat redistribution
Steroids can cause fat to accumulate in specific areas, such as the face, neck, and abdomen, while arms and legs may appear thinner. Moon face: The term "moon face" has been used by some steroid-treated patients and clinicians to describe the rounded appearance of the face when patients are taking high dose steroids.
Buffalo hump
This term has been used by some steroid-treated patients and clinicians to refer to the buildup of fat on the back of the neck and upper back, creating a hump-like appearance.
Abdominal (belly) weight gain
Steroids can lead to an increase in abdominal fat, contributing to a larger belly. The skin of the abdomen is also a place where stretch marks or “striae” tend to occur in patients taking high doses of steroids.
Steroids can increase fat storage in some areas and reduce it in others.
Why does this happen?
Steroids impact the way our bodies metabolize (break down and use) fat. They can increase the storage of fat in certain areas while reducing fat in others. This is part of the way our bodies prepare us to handle stress by ensuring that energy, in the form of fatty acids, is readily available for when it’s next needed. Prolonged steroid use can disrupt normal fat distribution, leading to these noticeable, and often unwanted, changes.
Top tips for avoiding weight gain
Dr Meredith Marinaro, a registered dietitian, spent 15 years working with patients with end-stage kidney disease, helping them manage their diet and exercise needs. She says:
“Steroids are great anti-inflammatory medications that make people feel better right away, but as part of the process, they contribute to increased appetite. So people, by default, just want to eat more. Steroids also change our metabolism, the way we handle blood sugar, and the way fat is stored. Patients on steroids often have symptoms of bloating.”
Dr Marinaro’s top tips for coping with the weight gain associated with steroid treatments include:
Keep a close eye on your weight
Work with your doctor to regularly monitor your body weight and composition (how much of your body is made up of fat, water, bone, and muscle). This helps you and your doctor track any changes and adjust your treatment plan as necessary.
Try to eat a balanced healthy diet
Focus on a healthy diet rich in fruits, vegetables, whole grains, and lean proteins like chicken, fish, peas and beans. Do your best to limit your intake of saturated fats, trans fats and sugars, which can increase weight gain and fat redistribution.
Stay active
Regular physical activity can help you manage your weight and improve your overall health. Aim to stay as active as possible, but always in consultation with your doctor.
Discuss medication adjustments with your doctor
If you are unhappy with the changes to your weight and appearance, your doctor might adjust your steroid dosage or explore alternative treatments.
Ask for a referral to a dietitian
Dietitians are trained to look at what is going on across your body and can make suggestions that work for you and your lifestyle.
Dr Marinaro urges patients not to be too hard on themselves when it comes to weight gain:
“Don't take this as a personal failure. This is the medication. It is not something that we've done to ourselves. When it comes to gaining weight, it's an emotional thing. So, really being honest with your providers about the challenges that you're having and saying, ‘Hey, this is happening to me,’ ‘What can I do to counter it?’
“One really big important thing is to not stop steroids on your own without talking to your provider. They need to be tapered in a lot of cases so you know it is important to not take that matter into your own hands.”
To hear more from Dr Marinaro, watch our film on managing weight.
The bottom line
While steroids are incredibly effective at managing inflammation and autoimmune diseases, they do have a big impact on appetite and metabolism. By being proactive about lifestyle changes, regular monitoring, and maintaining open communication with your doctor, you can manage these side effects.
Remember, always consult your doctor before making any changes to your medication or lifestyle to ensure the best care for your specific health needs.