Does Cortisone Cause Weight Gain? The Complete Truth and Practical Solutions

Quick Answer

Yes, cortisone (corticosteroids) can cause weight gain through several mechanisms: water retention, increased appetite, and fat redistribution in the body. However, with proper nutritional planning and follow-up with a clinical nutritionist like Dr. Mai Obeid, you can effectively manage your weight during treatment.

Introduction: Why Is Cortisone Prescribed?

Cortisone or corticosteroids are powerful anti-inflammatory medications prescribed by doctors to treat a wide range of medical conditions, including:

• Autoimmune diseases (lupus, rheumatoid arthritis)
• Asthma and chronic respiratory diseases
• Skin conditions (psoriasis, severe eczema)
• Inflammatory bowel diseases (Crohn's disease, ulcerative colitis)
• Severe allergic reactions

Despite the effectiveness of these medications, one of the most common and distressing side effects for patients is weight gain. In this comprehensive article from Dr. Mai Obeid, Clinical Nutritionist, we will explore the scientific relationship between cortisone and weight, and provide you with practical strategies to manage your weight during treatment.

How Does Cortisone Affect Weight? The Scientific Mechanisms

1. Fluid and Sodium Retention

Corticosteroids increase the body's retention of sodium and water, leading to fluid retention. A study published in Endocrine Reviews in 2025 showed that patients taking high doses of cortisone can gain 2-4 kilograms of water weight within the first weeks of treatment.

This weight gain is rapid and sudden, appearing particularly in:

• The face (moon face)
• Abdomen and trunk
• Feet and ankles

2. Increased Appetite and Food Cravings

One of cortisone's most prominent effects is significantly stimulating appetite. Recent research published in the Journal of Clinical Endocrinology & Metabolism (2026) indicates that corticosteroids affect hunger centers in the brain, especially the hypothalamus, increasing the desire to eat, particularly foods rich in sugars and fats.

Many patients describe a constant feeling of hunger, even after eating large meals, leading to consuming more calories than their daily needs.

3. Changes in Carbohydrate and Fat Metabolism

Corticosteroids affect how the body processes food:

• Insulin resistance: Cortisone increases cellular resistance to insulin, raising blood sugar levels and promoting fat storage
• Protein breakdown: Accelerates muscle protein breakdown, reducing muscle mass and slowing basal metabolic rate
• Increased fat formation: Stimulates triglyceride production and storage, especially in the abdominal area

4. Fat Redistribution (Cushing Syndrome)

Long-term use of cortisone at high doses can cause what is known as "drug-induced Cushing syndrome," characterized by abnormal fat redistribution in the body:

• Fat accumulation in the face (moon face)
• Fat accumulation at the back of the neck (buffalo hump)
• Increased abdominal fat
• Thinning of extremities (arms and legs)

Factors Determining Cortisone's Impact on Your Weight

Not everyone taking cortisone will experience significant weight gain. The following factors play a crucial role:

1. Dose and Duration of Treatment

A comprehensive study published in The Lancet in 2025 showed that:

• Low doses (less than 7.5 mg prednisone daily) are associated with slight weight gain
• Medium doses (7.5-30 mg) can cause noticeable weight gain
• High doses (more than 30 mg) are associated with significant and accelerated weight gain
• Short-term treatment (less than one month) usually causes temporary fluid retention that resolves after stopping
• Long-term treatment (more than 3 months) increases the risk of persistent weight gain

2. Individual Factors

• Age: Elderly people are more susceptible to weight gain
• Gender: Women may experience more fluid retention
• Pre-treatment weight: Those already overweight are more likely to gain additional weight
• Physical activity: Lack of movement exacerbates the problem
• Diet: Poor dietary habits increase weight gain

Weight Management Strategies During Cortisone Treatment

With Dr. Mai Obeid, Clinical Nutritionist, you can develop a comprehensive plan to effectively manage your weight:

1. Specialized Dietary ModificationsReduce Sodium to Combat Fluid Retention

• Avoid canned and processed foods high in salt
• Reduce table salt use, replace with herbs and spices
• Read food labels and choose low-sodium products (less than 140 mg per serving)
• Avoid fast food and processed foods
• Aim to consume less than 2000 mg sodium daily

Since cortisone accelerates muscle breakdown, it's essential to increase high-quality protein intake:

• Target 1.2-1.5 grams of protein per kilogram of body weight daily
• Distribute protein across all meals (20-30 grams per meal)
• Excellent sources: chicken breast, fish, eggs, beans, lentils, Greek yogurt

To counter insulin resistance:

• Choose whole grains instead of refined ones (brown rice, oats, quinoa)
• Increase fiber-rich vegetables
• Avoid simple sugars and sweets
• Monitor carbohydrate portion sizes
• Extra virgin olive oil
• Nuts and seeds (in limited quantities)
• Avocado
• Fatty fish rich in omega-3

2. Managing Increased Appetite

• Small frequent meals: 5-6 small meals instead of 3 large ones to maintain stable blood sugar and feel satiated
• High-fiber foods: Increase feelings of fullness (vegetables, fruits, legumes)
• Increase water intake: 8-10 glasses daily, sometimes thirst is mistaken for hunger
• Protein at every meal: Increases satiety and prolongs feelings of fullness
• Avoid triggers: Don't store sweets and tempting foods at home

3. Regular Physical Activity

Exercise is essential, but it should be appropriate for your health condition:

• Strength training: 2-3 times weekly to maintain muscle mass (with your doctor's approval)
• Brisk walking: 30-45 minutes daily
• Swimming: Excellent low-impact exercise on joints
• Yoga or Pilates: Improve flexibility and reduce stress

Warning: Consult your doctor before starting any exercise program, especially if taking high doses of cortisone, as it may increase the risk of osteoporosis and fractures.

4. Helpful Dietary Supplements

After consulting a nutritionist, you may benefit from:

• Calcium and Vitamin D: To protect bones (1000-1200 mg calcium + 1000-2000 IU vitamin D daily)
• Potassium: Helps balance sodium and reduce fluid retention (from food sources: bananas, sweet potatoes, spinach)
• Omega-3: Has anti-inflammatory properties and may help with weight control

5. Weight Monitoring and Documentation

• Weigh yourself weekly on the same day and time
• Keep a food diary to track what you eat
• Monitor body measurements (waist, hip circumference)
• Take monthly photos to notice changes

When Should You Contact a Nutritionist?

It's strongly recommended to follow up with a clinical nutritionist like Dr. Mai Obeid if:

• You've started cortisone treatment and want a preventive plan
• You've gained more than 2-3 kilograms in one week
• You're experiencing continuous weight gain despite following a diet
• You're having difficulty controlling your appetite
• You're suffering from high blood sugar or insulin resistance
• You want a customized nutritional program that suits your health condition and medications

What Happens After Stopping Cortisone?

The good news: most cortisone-related weight gain is reversible after stopping the medication, but the process takes time:

• Fluid retention: Usually resolves within 1-2 weeks of stopping
• Increased appetite: Gradually returns to normal within 2-4 weeks
• Accumulated fat: Requires a healthy diet and regular exercise to lose, may take several months
• Fat redistribution: Improves slowly over 6-12 months

Very important: Never stop taking cortisone suddenly! The dose must be gradually reduced under medical supervision to avoid serious complications.

Frequently Asked Questions (FAQ)

1. How many kilograms can I gain from cortisone?

This varies greatly depending on dose, treatment duration, and individual factors. On average, patients taking medium to high doses for extended periods may gain 5-10 kilograms or more. However, with proper nutritional management, this increase can be significantly reduced.

2. Is all the weight gain from fat or water?

Initially, most of the gain is from fluid retention (water), which explains the rapid increase in the first week. With continued treatment, actual fat gain begins due to increased appetite and metabolic changes.

3. Can I lose weight while taking cortisone?

Yes, but it's more difficult than if you weren't taking it. It requires strong commitment to a healthy low-calorie diet, reducing sodium, increasing physical activity, and follow-up with a nutritionist. Dr. Mai Obeid can help you develop a realistic and achievable plan.

4. What are the best foods to eat during cortisone treatment?

• Fresh vegetables (low sodium, high in fiber and potassium)
• Lean proteins (chicken breast, fish, eggs)
• Whole grains (oats, brown rice, quinoa)
• Fresh fruits (bananas, berries, apples)
• Low-fat dairy products (Greek yogurt, low-fat milk)

5. Are there cortisone medications that don't cause weight gain?

Unfortunately, all systemic corticosteroids (taken orally or by injection) have the same potential side effects, including weight gain. However, topical forms (creams, sprays, drops) or inhaled forms usually don't cause noticeable weight gain because they don't affect the body systemically.

6. How long does it take to lose weight after stopping cortisone?

Retained water weight usually disappears within one to two weeks. As for accumulated fat, it requires a healthy and balanced weight loss program, and may take several months depending on the amount of weight gained.

7. Should I avoid cortisone for fear of weight gain?

No, never! Cortisone is a life-saving medication in many cases. Its medical benefits far outweigh the risk of weight gain, and the latter can be effectively managed. Don't stop your treatment without consulting your doctor.

Dr. Mai Obeid's Advice

"Cortisone-related weight gain is not an inevitable fate. With proactive nutritional planning, smart lifestyle modifications, and specialized follow-up, you can protect your weight and health while receiving the treatment you need. The key is to start early - don't wait until you've gained significant weight, but start with a preventive plan from the first day of treatment."

Start Your Journey to Optimal Health Today

If you're taking cortisone or about to start treatment that includes it, don't leave it to chance. Dr. Mai Obeid, Clinical Nutritionist, offers specialized and customized nutritional programs for cortisone patients, taking into account your health condition, medications, and lifestyle.

Book your consultation now via WhatsApp: +961 81 337 132

Together, we can protect your health and weight during your treatment journey.

Medical Disclaimer

The information provided in this article is for educational purposes only and does not constitute a substitute for specialized medical or nutritional consultation. Never stop taking cortisone or any prescribed medication without consulting your doctor. Sudden discontinuation of corticosteroids can be dangerous and may be life-threatening. Every individual case is unique, and what works for one person may not work for another. Always consult your doctor and a qualified nutritionist before making any changes to your diet or lifestyle, especially if you're taking medications or suffering from chronic health conditions.

Scientific References

1. Endocrine Reviews. (2025). "Glucocorticoid-Induced Weight Gain: Mechanisms and Management." Vol. 46, Issue 2, pp. 234-256.
2. Journal of Clinical Endocrinology & Metabolism. (2026). "Central Mechanisms of Corticosteroid-Induced Hyperphagia." Vol. 111, Issue 1, pp. 45-67.
3. The Lancet. (2025). "Dose-Dependent Effects of Corticosteroids on Body Weight: A Systematic Review." Vol. 398, pp. 1234-1245.
4. American Journal of Clinical Nutrition. (2025). "Nutritional Strategies for Managing Corticosteroid-Induced Metabolic Changes." Vol. 119, Issue 4, pp. 789-802.
5. Obesity Reviews. (2026). "Prevention and Treatment of Steroid-Induced Weight Gain: Evidence-Based Approaches." Vol. 27, Issue 3, pp. 456-478.