RA & Prednisone: Battling the Steroid Weight Gain

by Niki Wyre

Women with Rheumatoid Arthritis tend to have a love / hate relationship with their steroid treatments like Prednisone. Whereas most of the time it is necessary and often crucial to keep painful symptoms at bay, some of the side effects can be distressing for the women sufferers. Most complain of hot flashes, cold sweats, headaches, dizziness, insomnia, increased anxiety and most often than not, unwanted weight gain. The weight gain is caused by fluid retention, increased appetite and changes in sleeping behaviors. So what is a RA Chick to do to stay above the weight gain?

I know that I personally have become tired of having what I call my “steroid wardrobe”. I have my skinny clothes, my normal clothes, and my Oh My Goodness Prednisone Blimp clothes. It is not uncommon for women on prednisone or other steroids therapy to gain five, ten, twenty, and sometimes more pounds in a month! The added weight gain adds stress to our bodies that RA already is bombarding. Normally the first place to gain weight in this face, causing a rounded moon appearance, and followed by added pounds around the midsection. These seem to be the two places that steroid gain is mostly reported.

Many women choose to try to forgo their steroid therapy unless necessary to try to get their metabolism and weight back under control. As one of these Chickies, I decided to find ways to help steady my weight and lose some weight as well. After researching, talking to my rheumatologist and primary care provider, I found some tips that work well and decided to share them on to you.

1. Talk to you doctor. I cannot express this one enough. Between the limitations with my RA and the depression I was fighting from the RA and weight gain, I felt like a sinking ship. After talking to my doctors, I not only got some tips, but they increased my depression med as well increased one of my other medications, where the side effect is decreased appetite. That’s a win / win.

2. Stock your pantry or fridge. Most of the women I talk to on steroid therapy, often felt like me, that you were constantly hungry. It didn’t matter if you just ate, you were hungry! So I started using Ziploc bags to prepackage snacks I could grab and munch on but still not go overboard with the calories or fat. Some of my favorites are grapes, apple slices, pita chips, pretzels, cereal and special K products like their fruit crisps (yum!). This way you are less likely to be added too many high calories into your diet while on the Prednisone.

3. Spread out your meals. I find one of the greatest tactics in fighting the steroid weight gain and getting my appetite back on track was by cutting back the portions I would eat but having more of the meals spread out throughout the day. Yes the steroids would make me have to eat 4 to 6 times a day, but I was consuming around the same amount of calories. This also kept me from eating too much in one sitting after a few days once my stomach shrunk back down. I personally love to drink water flavored with Special K’s protein flavor packet. It helps me hold of the hunger for a bit with minimal calories.

4. Don’t eat when not hungry. I know that sounds obvious but I found my insomnia and steroid hunger / cravings would have me eating at odd times. I would end up eating an hour before the family meal. I sometimes would then eat again because that’s when everyone ate, right? No. Listen to your body, when you are hungry eat, but pace yourself. You can take more bites, or take breaks in eating to see if you are really full before you end up stretching your stomach out anymore.

5. Move around. RA limits me pretty severely but I do have some good days or I have some things I can do that don’t put too much strain on my injured joints. Don’t hurt yourself, but a little bit more movement every week can make a big difference. The Arthritis Foundation (arthritis.org) offers some videos and links to different exercises that work well with damaged or injured joints. Some favorites exercise programs from RA patients are water therapy, chair yoga, or beginner pilates. Those who do not suffer from limitations in legs say walking does wonders.

6. Adopt a good sleeping schedule. Many RA patients complain of excessive fatigue or insomnia. If you suffer from insomnia or abnormal sleeping patterns you need to discuss with your doctor, especially if aren’t getting a minimum of 7 hours restorative sleep. Some RA patients show some results with over the counter sleep aids, but the majority require a nighttime sleeping aid or pain med prescription to help them get some rest as the RA pain can worsen during nights and cause sleep to be interrupted. Studies show that not getting enough sleep or not getting good quality of sleep can slow your metabolism causing weight gain as well.

7. Never underestimate the power of a short nap. Sometimes when fatigue hits, it triggers hunger for some reason. When you start feeling fatigued and you are able to, lay down for a short power nap. It will help with your energy levels, curb your hunger, and boost your metabolism.

I have found some great results so far by using this plan. Instead of gaining weight on daily prednisone and steroid injections over the past few months, I ended up losing over 35 pounds. I’m out of my steroid bloat clothes, and some of my regular closet are too loose.  I may even fit into my skinnier clothes soon. I have to admit I had a setback last week.  I ran out of my med that helps with my depression and appetite. I ended up wanting to eat everything in sight and gained back 5 lbs in a week. So now I’m following my own advice and getting back on track. Good luck to all you Chickies that are experiencing this as well and remember to talk to your doctors if you are concerned about your weight gain. They may not think much of it, but it’s your body and their main concern is trying to stabilize your RA.

Interested in becoming a writer for rachicks.com? We are looking for volunteers to keep the knowledge going to all our members. Interested individuals can email Niki by filling out the form below.