Does Humira cause weight gain?

In this article:

• Humira weight gain
• Indirect factors influencing weight
• Weight gain with chronic illness
• Navigating your weight on Humira
• When to talk to your doctor

In this article

• Humira weight gain
• Indirect factors influencing weight
• Weight gain with chronic illness
• Navigating your weight on Humira
• When to talk to your doctor

If you have an autoimmune disease, you might be familiar with biologic medications that block an overactive immune system response. Humira (adalimumab) is a brand-name biologic injection that is classified as a tumor necrosis factor (TNF) inhibitor. It is FDA-approved to treat autoimmune conditions, including arthritis, plaque psoriasis, ankylosing spondylitis, Crohn’s disease, and ulcerative colitis. 

Humira is not known to cause weight gain, but it’s important to tell your healthcare provider if you experience unexplained weight changes on this medication. 

Can Humira cause weight gain?

Clinical trials of Humira did not pinpoint weight gain as a side effect. However, research has linked TNF-inhibiting drugs to a slight increase in body weight or body mass index (BMI).

That said, findings are mixed. “In one study, it was found that people with rheumatoid arthritis did not gain more weight,” says Oluwatosin Ajao, MD, a board-certified obesity medicine specialist in Houston, Texas. “Another study showed that in people with psoriatic arthritis, TNF blocker treatment may cause weight changes to happen, but they are usually small and may be part of normal weight gain over time.”

Data shows that when weight gain does occur during TNF blocker treatment, it’s relatively mild and slow, about five pounds over time, according to Chrissie Ott, MD, a double board-certified internist, pediatrician, and metabolic health expert in Portland, Oregon. 

Perhaps most importantly, experts suggest that Humira-related weight gain may be a case of correlation, not causation. “It is likely caused by a few things,” Dr. Ajao says.

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Indirect factors influencing weight

Research is unclear on whether Humira has a direct effect on weight, but there are several reasons you may gain weight on Humira.

“In many cases, what we’re actually seeing is a reflection of improved disease control,” Dr. Ott says. “Chronic inflammation suppresses appetite and alters metabolism, so when we treat that inflammation effectively, the body can normalize. People feel better, they eat more, [and] they absorb nutrients more efficiently.”

Of course, weight fluctuations are also deeply tied to lifestyle factors. Dr. Ajao points out that if Humira is keeping symptoms under control, you might start socializing more often, which could involve eating more. Conversely, feeling better might allow for more regular exercise, which could lead to weight loss.

Other potential reasons for weight changes on Humira include:

• Age: In the United States, adults typically gain 10 to 25 pounds between their 20s and 40s, according to the National Institutes of Health. 
• Possible side effects: Common side effects of Humira include upper respiratory infections, headaches, nausea, and flu-like symptoms. These could affect diet and exercise habits, leading to changes in weight. 
• Other medications: If you’re on Humira, you have at least one chronic illness, which could mean you are also on another medication that causes weight gain, such as corticosteroids or certain mood stabilizers.

Weight gain on Humira could be a sign that your body is healing, that your lifestyle habits have changed, or that another condition- or drug-related factor is impacting your body weight.

Weight gain with chronic illness

Research shows that obesity is common among people with chronic pain conditions, an umbrella term that includes diseases such as rheumatoid arthritis and inflammatory bowel diseases. Living with pain and fatigue can make exercise difficult or unappealing. Plus, people with chronic pain sometimes cope by “comfort eating” foods that are high in fat, sugar, or salt. Eventually, reduced activity and increased calorie consumption lead to weight gain. 

Ultimately, if you’re experiencing weight gain with chronic illness, you’re not alone. Seek personalized medical advice from your healthcare provider if you’re concerned about maintaining a healthy weight during flare-ups.

Navigating your weight while on Humira

If you’re concerned about weight gain while on Humira, there are several strategies to help maintain a healthy body weight. 

1. Don’t discontinue Humira

Don’t panic and quit Humira without guidance, says Richard Terry, DO, a family medicine provider and Vice President of Health Sciences at Lake Erie College of Osteopathic Medicine at Elmira. “[TNF blockers] are remarkably effective, and relapse of symptoms will certainly occur if they’re stopped abruptly.” 

Dr. Ott reminds patients that small weight changes are common and manageable. “If weight is climbing in a way that concerns you, that’s a conversation, not a failure,” she says.

2. Track your weight

Not obsessively, but pay attention enough to notice gradual changes over the first six to 12 months, Dr. Ott emphasizes. Dr. Ajao suggests weighing yourself once per week and telling your provider if you gain several pounds within one month.

3. Pay attention to what (not just how much) you eat

Symptoms such as joint pain and exhaustion can make you crave easy-to-heat, processed foods. But experts recommend prioritizing protein, fiber, and minimally processed meals and snacks. Processed foods tend to introduce a lot of “empty” calories to your diet, but lean proteins, fiber-rich whole grains, vegetables, and fruits can help you feel full while also nourishing your body. 

Not sure where to start? Dr. Ajao recommends either the DASH or Mediterranean diet. 

4. Try intermittent fasting

Intermittent fasting requires alternating between periods of unrestricted eating and fasting. A common setup involves eating for five days, followed by two days of fasting, but Dr. Terry recommends that people on Humira try a gentler approach, such as an eating window of 8-10 hours, followed by 14-16 hours of fasting. 

For instance, limit your eating hours to 8 a.m. to 6 p.m. each day. “At least avoid heavy meals at least three hours before sleep,” he says. Intermittent fasting can be a helpful tool for weight management, but you should consult your healthcare provider for medical advice before trying it. 

5. Exercise

All three experts recommend regular exercise to help navigate weight changes on Humira. “Build movement back in gently,” Dr. Ott says. “As inflammation improves, this is a great opportunity to reintroduce strength and activity in a slow and sustainable way.”

Specific recommendations:

• Aim for at least 30 minutes of brisk movement each day, five days per week. This includes brisk walking, jogging, swimming, or resistance training.
• Start to incorporate strength training, aiming for two to three times per week. Dr. Ajao says this helps preserve muscle and prevent fat gain.
• Change it up to stay motivated. If you’re bored with jogging or cycling, why not try yoga, a fitness class, or a weight training circuit?

6. Get enough sleep

“Sleep is critical to weight management. Inadequate sleep does contribute to weight gain, ” Dr. Terry says. “Patients should aim to have at least six to eight hours of solid sleep each night.”

Weight management can vary from person to person. Don’t hesitate to consult your healthcare provider for specific advice on nutrition, exercise, and other strategies to maintain a healthy weight while on Humira.

When to talk to your healthcare provider about weight concerns

It’s important to tell your healthcare provider if you experience:

• Rapid weight gain: The Cleveland Clinic defines rapid weight gain as gaining five pounds in a week or 5% or more of your body weight in a month.
• Unexplained weight gain: Significant weight gain without increased food intake or decreased physical activity could indicate an underlying health condition.
• Weight gain with other unexplained symptoms: For instance, weight gain in women that is accompanied by hair thinning and irregular periods could be a sign of hypothyroidism. Weight gain in men that is accompanied by fatigue and erectile dysfunction could be a sign of low testosterone. 

Only a provider familiar with your medical history, conditions, and other medications can help identify the underlying causes of weight gain and determine whether it is unhealthy or a sign that your body is healing. A healthcare professional can also offer personalized, actionable tips to help you keep your weight under control while on Humira.

Note: Unrelated to weight loss, it’s important to seek emergency medical attention for serious side effects of Humira, such as heart failure, allergic reaction (shortness of breath, hives, facial swelling), and serious infections.