Lupus flare-ups often require the anti-inflammatory corticosteroid prednisone to get symptoms under control. However, steroids can also cause side effects like swelling and weight changes.

“I feel like a balloon, and it’s very uncomfortable!” shared a MyLupusTeam member. “I feel like I can’t breathe or fit into my clothes.”

Prednisone is a steroid, so it typically causes increased appetite and water retention. As a result, your body weight might increase, your clothes might not button as easily, and you may feel heavier than before. “I gain weight within a few days of starting a dose of prednisone. I hate it, but it’s a lifesaver,” said another member.

It’s important to be gentle with yourself while your body is adjusting to medications that can help your lupus symptoms. Changes are common and may be part of finding a new treatment plan that helps you manage lupus more effectively.

You can always talk to your doctor if any prednisone side effects are negatively affecting your quality of life. They can recommend dosage adjustments or lifestyle changes to help bring you back to balance. Here are some ways to manage swelling and weight gain while taking prednisone.

1. Avoid Added Sugar

Prednisone changes the way your body handles blood sugar, so limiting excess sugar in your diet can help prevent weight gain caused by the drug. It may help to choose more fresh fruits and vegetables and whole foods while you’re taking prednisone.

One MyLupusTeam member shared an experience of weight gain and weight loss on prednisone. “Once I eliminated the unhealthy foods, my insatiable hunger disappeared, and my weight remained the same with a normal BMI, on or off prednisone,” they said.

Sometimes there is added sugar in prepared foods that aren’t even sweet. Common sources of added sugar include flavored yogurt, instant oatmeal, cereal, fruit canned in syrup, granola bars and protein bars, jarred pasta sauce, and condiments like ketchup and BBQ sauce. Check the Nutrition Facts label to see how much sugar is in a serving of the item you’d like to buy.

2. Cut Back on Sodium

Following a low-sodium diet is a healthy choice for people with lupus because it’s good for high blood pressure and kidney health. Sodium also causes fluid retention. Reducing your intake while on prednisone can help minimize excessive swelling.

You can lower your sodium intake by checking food labels and cooking at home rather than eating at restaurants. Most restaurants use more salt when preparing food than you might expect. Salt not only boosts flavor, but it also acts as a preservative, making it easier to store food for longer. That’s why processed foods tend to be higher in sodium.

Learning to read food labels will help you choose products that have less sodium. You may see claims like “no added salt” or “low sodium” on canned and frozen foods. For a low-sodium diet, you may find it easier to avoid canned foods altogether. But if you eat canned beans, rinse them with water to wash off some of the sodium.

3. Ask Your Doctor About Potassium

Unlike sodium, potassium has the opposite effect on fluid retention. Eating plenty of potassium can help keep swelling to a minimum. However, you should ask your health care provider for medical advice before increasing your intake. Some people with lupus nephritis need to limit their potassium consumption.

If you’re cleared to eat more potassium, you can boost your intake with the following foods:

• Apricots
• Baked potatoes (not boiled)
• Bananas
• Cooked spinach
• Kidney beans
• Lentils
• Lima beans
• Melons
• Oranges
• Stewed tomatoes or tomato juice

Many high-potassium foods (like fresh fruits) are also low in calories and high in fiber. That means you can snack on them more often to quell your prednisone-related appetite and cravings. The natural sweetness in fruit can also be a good substitute for more concentrated sweets, like candy and desserts. Choose fresh or frozen fruit for maximum nutritional value.

4. Fill Up on Protein, Safely

Protein-rich foods help you feel full, which is especially helpful for the increased appetite caused by prednisone. One MyLupusTeam member described their constant hunger while on prednisone. “I feel hungry quickly, even if I just ate,” they explained.

While there are many benefits to eating enough protein, people with lupus may need to be careful not to overdo it, particularly those with lupus nephritis. Excessive dietary protein puts added strain on the kidneys. You may want to consider meeting with a registered dietitian nutritionist to learn more about finding the right balance of protein to keep you satisfied without harming your kidneys.

5. Be as Active as You Can

Prednisone can give you a boost of energy. Burning that off with physical activity can help you sleep better and maintain a balanced weight. If you have joint pain or other issues that limit your activity, talk to your doctor about safe ways to exercise. For example, swimming is easier on your joints and can keep you from feeling overheated (a common symptom with lupus). You can also use the temporary hyperactivity to get things done around the house, like yard work, cleaning, or projects you might not normally be motivated to tackle.

6. Discuss Concerns With Your Doctor

If your health care provider recommends long-term use of prednisone, take note of any side effects that bother you and share them at your appointments. For example, prednisone doesn’t only cause swelling and increased appetite, it can also cause headaches, trouble sleeping, mood changes, and more. It can also affect how your body stores fat in a process called fat redistribution. As a result, some people experience fat in new areas, such as the back of the neck.

Prednisone side effects are related to the dosage and length of treatment. If you are bothered by significant swelling or weight changes, your health care professional may consider tapering down a high dose to a low-dose option. Don’t be afraid to speak up. Advocating for yourself during health care appointments can help you get the care you need.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 people with lupus come together to ask questions, give advice, and share their stories.

Have you noticed weight changes on prednisone? Post your thoughts in the comments below, or start a conversation by sharing on your Activities page.