Steroids Weight Gain and How to Avoid it

Using steroids for medical reasons or muscle building may cause weight gain, but we have the solutions to avoiding this unwanted side effect.

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by
Sarah Zimmer, PT, DPT
— Signos
PT, DPT
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Updated by

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Science-based and reviewed

Updated:
October 17, 2024
Published:
December 10, 2024
October 22, 2023

Table of Contents

The use of steroids, both in the medical field and among athletes and bodybuilders, has always been a topic of interest and controversy. It is essential to clarify that the term "steroids" is broad, encompassing both anabolic steroids used by athletes and bodybuilders and corticosteroids commonly prescribed for medical purposes. Anabolic steroids are a synthetic derivative of the hormone testosterone, and these types of steroids have gained specific attention due to their ability to promote muscle growth and enhance athletic performance. Commonly prescribed steroids include prednisone, prenisolone, cortisone, hydrocortisone, and budesonide.

However, one major concern associated with steroid use - either anabolic or corticosteroids - is the potential for weight gain. While steroids can lead to weight gain, the mechanisms behind this phenomenon are complex and multifaceted.1 In this article, we will explore the relationship between steroids and weight gain, discuss the various factors that contribute to it, and provide valuable prevention and control tips for individuals considering or already using steroids.

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How Do Steroids Work?

Before delving into the weight gain side effects, it is essential to clearly understand what steroids are and how they work. Steroids are a group of chemical compounds that play various physiological roles. Some steroids are naturally occurring (often as hormones), helping your organ tissues and cells do their jobs efficiently. You need a healthy balance of them to grow and maintain homeostasis. However, two types of man-made steroids come in the form of medications: corticosteroids and anabolic steroids.10 

In their various forms, steroids work by interacting with the body's endocrine system, which regulates hormones. Anabolic steroids, for example, bind to androgen receptors in muscle cells, stimulating the production of proteins necessary for muscle growth and repair. This process, known as protein synthesis, increases the size and strength of skeletal muscles. 

Corticosteroids, like prednisone, are synthetic versions of cortisol (a hormone made by the adrenal glands) and act as anti-inflammatory agents by inhibiting the production of inflammatory chemicals in the body. Their primary purpose is alleviating inflammation and treating allergies, autoimmune diseases, joint pain, and inflammatory conditions. For both anabolic steroids and corticosteroids, these chemical compounds have targeted effects on the body's physiology, and their potential for side effects and consequences should be carefully considered before use.4,10 

Do Steroids Make You Gain Weight?

Yes, steroids can make you gain weight, but the extent and nature of this weight gain depends on the type of steroid used. Anabolic steroids promote muscle growth by enhancing protein synthesis in the body. The increased production of proteins aids in building and repairing muscle tissue, leading to significant muscle gains. Therefore, anabolic steroids primarily contribute to weight gain by increasing lean muscle mass. 

On the other hand, corticosteroids like prednisone and dexamethasone exert their effects differently.12 While they do not directly stimulate muscle growth, they can cause the body to retain water, resulting in a temporary increase in body weight. This weight gain is primarily due to fluid accumulation instead of increased muscle mass. Furthermore, both anabolic steroids and corticosteroids can lead to increased appetite, which, if not managed carefully, can lead to additional calorie intake and potential fat gain. Some steroids can also alter metabolism rates, the way the body uses and stores lipids, amino acids, protein, carbohydrates, and glucose. Therefore, both anabolic and corticosteroids have the potential to affect body weight, with the specific outcome varying based on a variety of factors.10 

The factors contributing to the extra weight - whether fat, water, or muscle - include more than just the type of steroid you are taking. Here are just a few examples of specific factors that can affect the type and amount of weight gain you experience while taking steroids: 

  1. Type of Steroid: Anabolic steroids are much more likely to cause weight gain from increased muscle mass, whereas corticosteroids will cause weight gain from increased water retention.2 It is also possible that different medications within each type will have more significant or milder effects on the amount of muscle you gain or the amount of water you retain.11 
  2. Dosage and Duration: The dosage and duration of steroid use significantly impact the degree of weight gain. Higher doses and longer cycles tend to result in more substantial gains through muscle growth or water retention.1
  3. Genetics: Genetics can profoundly influence how an individual's body responds to steroids. Some individuals may be genetically predisposed to gain muscle and retain less water when using steroids, while others may experience the opposite.
  4. Diet and Nutrition: Diet is a pivotal factor in the equation. Steroid users often increase their calorie intake to support muscle growth, but the composition of these calories is critical. A well-balanced diet with the right macronutrient proportions ensures that weight gain is primarily in the form of muscle and not fat.3,9
  5. Exercise Regimen: The type and intensity of exercise also play a vital role in the distribution of weight gain. Individuals who engage in structured resistance training routines are more likely to experience muscle gain compared to those who do not exercise or just focus on moderate-intensity cardio.
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Side Effects of Steroids

While steroids are often sought for their muscle-enhancing and anti-inflammatory properties, it is crucial to recognize that their use can also be associated with a litany of side effects.5 Here is a list of just a few common side effects:

  1. Raise Blood Sugar: Steroids can elevate blood glucose levels and contribute to insulin resistance. This can be problematic for individuals with diabetes or those with an increased risk of developing diabetes.7,9 
  2. High Blood Pressure: Steroids can cause an increase in blood pressure by promoting sodium and water retention and constricting blood vessels. This can ultimately contribute to the risk of cardiovascular disease for some individuals.8,9
  3. Suppressed Immune System:  Corticosteroids are prescribed to suppress the immune response and reduce inflammation in various medical conditions. By suppressing the immune system, corticosteroids can help alleviate symptoms, but they also increase the risk of infections and impair the body's ability to mount an immune response against pathogens. 
  4. Hormone Changes: Prolonged use of anabolic steroids can suppress the body's natural testosterone production. This can lead to testicular atrophy, reduced sperm production, and sexual dysfunction in males. In females, it can lead to irregular menstrual cycles, changes in sexual desire, and even potential fertility problems.6
  5. Insomnia: Some steroid users may experience difficulty falling asleep or staying asleep, leading to insomnia. This can affect overall well-being and energy levels.
  6. Gastrointestinal Problems: Steroid use can lead to gastrointestinal issues, including stomach irritation, indigestion, and, in some cases, ulcers.6
  7. Appetite Increase: Steroids can stimulate the appetite, leading users to consume more calories. This can contribute to weight gain, including fat gain, if not carefully managed.9
  8. Acne:  Steroids can stimulate sebaceous glands, leading to increased oil production in the skin. This excess oil can clog pores, causing acne outbreaks, particularly on the face, chest, and back.6 Steriods can also cause “moon face,” which is the swelling of facial tissues that make your face appear rounder.
  9. Mood Changes or Irritability: Steroid use can affect the balance of certain neurotransmitters in the brain. This disruption can lead to mood swings, increased irritability, and, in some cases, more severe psychological effects like aggression and even mood disorders.6

Steroid use should always be cautiously approached under the guidance of a healthcare professional, particularly when used for medical reasons. For non-medical purposes, especially in athletics, the potential risks and side effects should be carefully considered before use.

How to Prevent Weight Gain on Steroids: 5 Tips

To mitigate side effects and promote overall well-being, it is essential to implement effective prevention and control measures, many of which are rooted in careful lifestyle choices and professional guidance. 

  1. Choose the Right Steroid: If you're using steroids for medical reasons, work closely with your healthcare provider to select the most appropriate corticosteroid for your condition. For athletes and bodybuilders, research the anabolic steroids you plan to use and consider their potential side effects.
  2. Exercise Regularly: Incorporate a structured exercise regimen into your routine, focusing on resistance training, so you can continue to focus on your weight loss goals and increasing lean muscle mass while on steroids. According to the Centers for Disease Control and Prevention, adults should aim for 150 minutes of moderate-intensity physical activity and two days of muscle-strengthening activity a week.
  3. Increase Calcium and Potassium Intake: Consuming a calcium supplement or potassium-rich foods, such as bananas, potatoes, and leafy greens, can help counteract the potential increase in blood pressure and fluid retention associated with some steroids. In addition, steroid use can affect bone health, so maintaining adequate calcium intake is essential for strong bones. 
  4. Manage Fluid Retention: To mitigate water retention, monitor sodium intake and stay well-hydrated. Reducing sodium can help control bloating and minimize excessive water weight.
  5. Control Caloric Intake: While an increase in appetite is common with steroid use, it is essential to maintain control over calorie consumption. Calculate your daily calorie needs and strive to eat in moderation to avoid excessive fat gain.

Before stopping any medication, consult your healthcare provider. Stopping steroid use abruptly can cause health complications such as muscle stiffness, joint pain, and fever. 

Remember that pursuing a healthy and balanced lifestyle should always be the primary goal, and careful consideration of the potential side effects is essential when using steroids, whether for medical or non-medical reasons.

Learn How To Healthily Manage Weight with Signos’ Expert Advice 

If you have more questions on improving your health, fitness, and nutrition, seek the expert advice of the Signos continuous glucose monitor and Signos team. A continuous glucose monitor (CGM) can give you the insights to make smarter nutrition and exercise choices. The Signos app provides a unique, personalized program to help you lose weight and reach your health goals. Take this quiz to see if Signos is a good fit for you and reach your goals faster than ever before.  

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Frequently Asked Questions

How long does steroid weight gain last?

The duration of steroid-induced weight gain varies depending on several factors, including the type of steroid, dosage, and individual response. For example, water retention and bloating associated with corticosteroids may be relatively short-lived, decreasing once the medication is discontinued. In contrast, anabolic steroid-related muscle gain can be more long-lasting, but how long it stays depends on factors like continued exercise, diet, and overall lifestyle choices. 

How much weight does steroids make you gain?

The amount of weight gained due to steroid use depends on numerous factors. Anabolic steroids can lead to muscle gain, and the extent of muscle weight gain may range from a few pounds to more significant increases, like 10 pounds during a cycle. However, weight gain is not solely muscle; it can also involve water retention and if calorie intake is excessive, fat gain. Temporary increases in body weight from water retention are likely less substantial, often just a few pounds.

How do you avoid gaining weight on steroids?

To avoid unwanted weight gain while using steroids, focusing on a balanced diet and controlled calorie intake is essential. Monitor your food choices, exercise regularly, engage in resistance training to promote muscle gain, and be mindful of fluid retention by managing your sodium intake and staying well-hydrated.

Will five days of steroids make me gain weight?

The weight gain experienced over just five days of steroid use is typically minimal, primarily due to temporary fluid retention rather than significant muscle or fat accumulation. So weight gain - yes, but fat gain - not likely. 

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References

  1. Rogers, C. C., Alloway, R. R., Buell, J. F., Boardman, R., Alexander, J. W., Cardi, M., ... & Woodle, E. S. (2005). Body weight alterations under early corticosteroid withdrawal and chronic corticosteroid therapy with modern immunosuppression. Transplantation, 80(1), 26-33.
  2. Demling, R. H., & DeSanti, L. (1997). Oxandrolone, an anabolic steroid, significantly increases the rate of weight gain in the recovery phase after major burns. Journal of trauma and acute care surgery, 43(1), 47-51.
  3. Schols, A. M., Soeters, P. B., Mostert, R. O. B., Pluymers, R. J., & Wouters, E. F. (1995). Physiologic effects of nutritional support and anabolic steroids in patients with chronic obstructive pulmonary disease. A placebo-controlled randomized trial. American journal of respiratory and critical care medicine, 152(4), 1268-1274.
  4. Manson, S. C., Brown, R. E., Cerulli, A., & Vidaurre, C. F. (2009). The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use. Respiratory medicine, 103(7), 975-994.
  5. Henriksen, H. C. B., Havnes, I. A., Jørstad, M. L., & Bjørnebekk, A. (2023). Health service engagement, side effects and concerns among men with anabolic-androgenic steroid use: a cross-sectional Norwegian study. Substance Abuse Treatment, Prevention, and Policy, 18(1), 1-11.
  6. Horwitz, H., Andersen, J. T., & Dalhoff, K. P. (2019). Health consequences of androgenic anabolic steroid use. Journal of internal medicine, 285(3), 333-340.
  7. Cohen, J. C., & HICKMAN, R. (1987). Insulin resistance and diminished glucose tolerance in powerlifters ingesting anabolic steroids. The Journal of Clinical Endocrinology & Metabolism, 64(5), 960-963.
  8. Achar, S., Rostamian, A., & Narayan, S. M. (2010). Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm. The American journal of cardiology, 106(6), 893-901.
  9. Freed, D. L., Banks, A. J., Longson, D., & Burley, D. M. (1975). Anabolic steroids in athelics: crossover double-blind trial on weightlifters. Br Med J, 2(5969), 471-473.
  10. Bond, P., Smit, D. L., & de Ronde, W. (2022). Anabolic–androgenic steroids: How do they work and what are the risks?. Frontiers in Endocrinology, 13, 1059473.
  11. de Oliveira, C. M. C., Moura, Á. E., Gonçalves, L., Pinheiro, L. S. F., Pinheiro Jr, F. M. L., & Esmeraldo, R. M. (2014, July). Post-transplantation weight gain: prevalence and the impact of steroid-free therapy. In Transplantation proceedings (Vol. 46, No. 6, pp. 1735-1740). Elsevier.
  12. Mithoowani, S., Gregory-Miller, K., Goy, J., Miller, M. C., Wang, G., Noroozi, N., ... & Arnold, D. M. (2016). High-dose dexamethasone compared with prednisone for previously untreated primary immune thrombocytopenia: a systematic review and meta-analysis. The Lancet Haematology, 3(10), e489-e496.

About the author

Sarah is a Doctor of Physical Therapy, graduating from the University of Wisconsin Madison in 2017.

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