How To Prevent Weight Gain On Steroids – If you have ulcerative colitis (UC), you are probably familiar with corticosteroid medications such as prednisone, powerful anti-inflammatory drugs that are very effective in quickly reducing inflammation during a flare-up.
According to a study published in January 2020 in the journal Lung, participants who took prednisolone reported an increase in appetite, which led to weight gain. And a review published in February 2021 in the journal Obesity notes that long-term use of prednisone affects body weight, appetite, and body composition.
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Weight gain from prednisone often appears as deposits of fat in different parts of the body, such as at the base or back of the neck, around the abdomen, or as a so-called “moon face” when the location of the fat changes. make your face appear. rounder and wider.
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Weight gain in people taking prednisone is related to how long you take the drug, says Rudolph Bedford, MD, a gastroenterologist at Providence St. Joseph Medical Center in Los Angeles, California. The longer you take prednisone, the more likely you are to gain weight. Why is this happening? In addition to increasing appetite, prednisone also causes fluid retention, which leads to swelling, often in the arms, legs, and feet, as well as the face, according to Dr. Bedford. Prednisolone can also disrupt the normal sleep-wake cycle, leading to insufficient sleep and disruption of hormones that help regulate appetite, says Kate Scarlata, a Boston-based nutritionist who lists inflammatory bowel diseases like ulcerative colitis as one of her specialties.
If weight gain is particularly bothersome, talk to your doctor about changing your medication regimen. You should never stop taking medication on your own. Steroids should be tapered off gradually under the guidance of a doctor. Rapid withdrawal of steroids can cause fatigue, joint pain, muscle stiffness, or fever, according to the Hospital for Special Surgery.
Your doctor may prescribe another corticosteroid, such as budenoside. This variant is “rapidly metabolized in the liver, thereby reducing the side effects associated with corticosteroids, and appears to be as effective as prednisone,” says Bedford.
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Plus, using a few simple eating strategies while on prednisolone can help you avoid the most weight gain and stay healthier overall, says Scarlata:
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Strategies such as acupuncture, meditation, and hypnotherapy can help relieve stress and potentially prevent ulcerative colitis symptoms from worsening.
Treatment of ulcerative colitis is essential for both quality of life and health. Find out what can happen if your ulcerative colitis is undertreated… More than half of the prednisolone users I interviewed said that their main problem with prednisolone was weight gain. Larger studies show that 70% of prednisolone users gain weight.
Subjects who took low doses of prednisolone (5–10 mg per day) for 2 years gained 4–8% of their initial body weight. This means that a person who previously weighed 120 pounds gains 5-10 pounds. Doses of prednisolone below 5 mg are unlikely to cause weight gain.
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The longer you take prednisone, the more likely you are to gain weight. Surprisingly, it is possible to lose weight within the first few weeks because prednisolone first causes lipolysis, the breakdown of fat cells. Later, prednisolone has the opposite effect and causes an increase in fat cells.
Taking prednisolone for less than seven days has no significant effect on body weight. Long-term treatment causes significant weight gain.
As the dose increases, your face will take on a round shape like the moon. This means that at low doses, the face of the moon looks unusual. At high doses of prednisolone, such as 60 mg, most people have round faces. The moon face will gradually disappear as you gradually decrease the dose of prednisolone. About two weeks after stopping prednisone, most people report that the moon face has completely disappeared. A moon-shaped face is a symptom of Cushing’s syndrome, symptoms of elevated cortisol. A moon-shaped face is one of the ways prednisolone redistributes fat:
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First, taking prednisolone replaces the body’s natural hormone, cortisol. Prednisolone looks almost the same as cortisol, so the body is fooled into thinking they are the same thing. In addition, enzymes break down prednisolone so that it becomes even more like cortisol. Cortisol is a hormone that keeps us alive by helping to regulate our fight-or-flight response, and does so by increasing wear and tear.
If you’re being chased by a tiger, you’ll need a lot of energy to either run away and “fly” or turn around and “fight” the tiger. Your body does its best to give you this energy in the form of blood sugar. The liver releases sugar. Fat cells block the absorption of sugar. All that sugar makes your muscles work fast to run away or fight back.
The problem is that when we take prednisolone, the tiger doesn’t go anywhere. There’s always a little bit of prednisone that makes you still feel that stress, that “Oh my god, I’m about to be eaten!” feeling. But we are not being chased by a real tiger, so the extra energy circulating in our body due to high blood sugar levels is not being used.
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The energy storage hormone insulin sees this extra energy and signals the body to store high blood sugar as fat.
Prednisolone intercepts normal metabolic signals in order to maintain normal weight. For example, leptin is a satiety hormone produced by fat cells. Leptin tells you that you feel full and can stop eating. Somehow, prednisolone blocks leptin signals, so there is no normal feeling of hunger. You can eat junk food until your stomach hurts from being full, but you may not get to the point where you feel full.
Your body is trying to compensate by releasing more and more leptin, but somewhere in the signaling cascade it is not being delivered. Too high leptin levels lead to leptin resistance, similar to insulin resistance, where even high levels no longer work. It also leads to fat accumulation.
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Prednisolone destroys bones, leading to bone loss and possibly osteoporosis. Prednisolone also destroys muscles, which causes the arms and legs to become thinner despite a rounded belly and face. Bone mass and muscle mass make up the total lean body mass. The percentage of lean body mass determines the resting metabolic rate, which is the number of calories you burn while resting. As lean body mass decreases, so does the amount of calories you normally consume while sitting.
Prednisolone affects the salt balance in the body. Normally, your kidneys maintain an even salt balance of sodium and potassium, which are opposites in the body. There is a lot of potassium inside the cells, and a lot of sodium outside the cells. Prednisolone causes the kidneys to retain sodium, which results in a loss of potassium. The high sodium content causes bloating, water retention and promotes a moon face.
Going back to the fight-or-flight changes, prednisolone makes it possible for your tolerance levels to drop. For example, maybe you can tolerate when someone cuts you off on the highway. But on prednisolone, your reaction is enhanced, faster, and perhaps less sensitive. Scientifically, the prefrontal cortex has less ability to modulate your response.
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Mood swings while taking prednisone can lead to decreased willpower to cope with food because you use up all your willpower to keep your mood stable. Personality changes can lead to a decrease in the ability to resist overeating. This means that starving yourself while taking prednisolone is not a good idea. Maintain a consistent intake of healthy foods so you never get hungry to the point of overeating.
The use of prednisolone can lead to the #1 side effect of insomnia. Sleep is a very important time for maintaining a normal metabolism. Fewer hormones released during sleep lead to fat storage. Less sleep results in less willpower to resist temptation.
Now that you understand how prednisolone causes weight gain, you have the information you need to know what strategies may and may not work to maintain weight. Focusing on eating high-quality, low-refined sugar foods is the foundation for preventing weight gain with prednisone. Use prednisone appetite to eat nutrient rich foods. Improving sleep and getting enough exercise, but not too much, can also help shed those extra pounds. The goal of taking prednisone should be to slow or stop weight gain, not worry about weight loss. Dr. Megan is here to help you through this process.
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