Weight gain is a common side effect of prednisone. Prednisone can also cause a redistribution of fat to the face, back of the neck and the abdomen, although these changes vary from person to person. Generally speaking, the higher the dose and the longer the treatment, the greater the changes.
Weight gain while taking prednisone is typically due to fluid retention and increased calorie intake because of increased appetite. In addition, those with lung disease have more difficulty maintaining physical activity.
Fluid retention can be controlled by eating a diet low in sodium — no more than 2,000 mg a day — and higher in potassium. You can find a list of high-sodium foods to avoid in the General Guidelines for Healthy Eating.
You can increase your potassium intake by eating potassium-rich foods such as:
Apricots
Baked potatoes
Bananas
Cantaloupe, honeydew
Dates
Dried prunes
Grapefruit
Lima beans
Milk
Orange juice, grapefruit juice
Oranges
Raisins
Spinach, cooked
Stewed tomatoes
Tomato juice
Winter squash
Yoghurt
Prednisone increases appetite, resulting in increased calorie intake. This increased appetite can be difficult to control. Below are a few tips for controlling the amount of calories and the quality of nutrients you eat:
Eat small, frequent meals of high nutritional value.
Eat a high-protein, low-carbohydrate diet. There is evidence that a low-carbohydrate, high-protein diet is at least as effective for losing weight as a traditional low-calorie diet that’s low in fat and portion-controlled. A high-protein diet may also help suppress appetite.
Eat carbohydrates in the form of fresh fruits and vegetables. Prednisone has a tendency to raise the level of glucose, or sugar, in the blood, which can cause increased body fat or diabetes in some people. It is important to avoid “simple” carbohydrates and concentrated sweets, such as cakes, pies, cookies, jams, honey, chips, breads, candy and other highly processed foods. This helps keep blood sugar low.
Limit saturated fat and cholesterol. Choose lean meats, poultry and fish. Avoid fried foods and foods with extra oil, butter, margarine, mayonnaise and the like.
Eat foods rich in calcium. Prednisone may alter your body’s ability to use calcium. Try to get four servings of calcium-rich foods per day to help prevent osteoporosis. Check with your doctor to see if you would benefit from calcium supplements.
Foods rich in calcium include:
Calcium-fortified orange juice
Cheese (American, Swiss, Colby, Cheddar and Jack)
Cottage cheese
Milk
Non-fat dry milk powder
Oranges
Sardines (canned, with bones)
Shrimp
Yoghurt