Does prednisone make you hungry?

In this article:

• Prednisone hunger
• Prednisone’s impact on your body
• Practical strategies to stay in control
• When to talk to your provider

In this article

• Prednisone hunger
• Prednisone’s impact on your body
• Practical strategies to stay in control
• When to talk to your provider

Steroid medications, also known as corticosteroids or glucocorticoids, are used for both short- and long-term treatment of many health conditions. One of the most common is prednisone, a prescription medication that is used to treat a variety of inflammatory and immune-related disorders, like rheumatoid arthritis and allergic conditions such as contact dermatitis. 

Like any medication, there are potential side effects of prednisone. One of the most frequently reported is feeling hungrier than usual. Here, discover exactly why that is, plus other ways prednisone can impact your metabolism, and what you can do to stay in control.

Save up to 80% on Prednisone with SingleCare

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.

Prednisone 20 mg (10 Tablets)

23666 - Hampton, VA

$3.15

i Price with signup

Get free coupon

$3.15

i Price with signup

Get free coupon

See Prednisone prices at all pharmacies

Why does prednisone make you hungry?

“While prednisone is a cornerstone for treatment of multiple diseases, it is associated with side effects such as increased appetite,” says Taylor Clark, Pharm.D., a clinical assistant professor at Binghamton University School of Pharmacy and Pharmaceutical Sciences. This is mainly due to its effect on certain hormones that make you feel hungrier.

Prednisone acts on several hormones that play a role in appetite:

• Cortisol: “Prednisone mimics cortisol, a natural stress hormone that plays a role in appetite regulation and blood sugar balance,” says Supriya Rao, MD, a gastroenterologist based in Lowell, Massachusetts. High cortisol levels can increase appetite and the motivation to eat.

• Leptin: “Glucocorticoids [such as prednisone] in excess decrease the effect of leptin on appetite suppression,” Dr. Clark notes. “Leptin, a hormone derived from adipose tissue, acts as a sensor for fat stores. Thus, when it is low, appetite increases, but when it is high, appetite decreases.” In other words, you might still feel hungry even when your body has had enough because prednisone makes it harder for your body to notice its natural fullness indicators.
• Insulin: Prednisone can also disrupt insulin signaling, the process by which glucose is transported into cells for energy, potentially leading to insulin resistance. “Insulin resistance prevents absorption of blood sugar into the cells, which leads to a starvation state despite high sugar content in the blood, which causes signals of continued hunger,” Dr. Clark says.

High blood sugar levels can cause spikes in hunger and sudden drops that trigger additional hunger and cravings, adds Dr. Rao. One review found that a third of people taking glucocorticoids like prednisone develop insulin resistance and high blood sugar. “This means your body might have a harder time using glucose efficiently,” Dr. Rao says. “It can also promote fat storage over time and make weight changes more likely even without major changes in your calorie intake.”

Prednisone’s impact on your body and weight

If prednisone makes you feel hungrier, you might eat more calories than you need while taking it, leading to weight gain. That’s not the only effect it can have on your waistline. It can cause body weight changes in the following ways:

• Increased fluid retention:  “Prednisone and other corticosteroids can lead to sodium retention, which often leads to fluid retention,” Dr. Clark says. This can cause uncomfortable bloating and swelling, and potentially lead to weight gain from water weight. 
• Changes in fat distribution: Prednisone can also lead to fat redistribution, causing fullness in your face or upper body, Dr. Rao explains. 
• Reduced muscle mass: “With long-term use, it can break down muscle tissue, which reduces lean muscle mass and can slow metabolism.” 

Prednisone can also negatively affect your sleep, mood, and bone health, all of which can indirectly contribute to unwanted weight gain if you don’t take steps to counteract the changes. 

One study found that people who took corticosteroids experienced significantly more weight gain over the study period than those who didn’t take the medications, especially people who were taking the drugs for the first time. However, this weight gain was modest, less than one kilogram (2.2 pounds) per year. 

Practical strategies to stay in control

Dr. Clark notes that for some people, weight gain may be an intended result or positive side effect of taking prednisone. But for others who don’t want to overeat, there are things they can do. The first is to remember that your increased appetite is really all in your head. “The impact appears to be mostly on perceptions of feeling hunger rather than a physiologic need for increased calories while taking corticosteroids,” Dr. Clark explains. For this reason, tricks like drinking water or distracting yourself with another activity may be enough to avoid snacking.

Beyond that, experts suggest the following strategies for managing hunger and avoiding unwanted weight gain:

• Eat small, frequent meals that include protein, fiber, and healthy fats to support satiety. 
• Follow a set eating schedule to avoid snacking and grazing, especially on carbohydrate-rich foods.
• Reduce excess sodium intake to limit water retention.
• Drink plenty of water so you don’t mistake thirst for hunger.
• Aim for at least 150 minutes of moderate physical activity per week, including resistance and strength training. Regular exercise can help to maintain metabolism and muscle mass. It can also help with weight loss when you discontinue the medication.

If you need to take prednisone long-term, Dr. Rao says that one of the best things you can do is to prepare yourself mentally. “Set expectations because some appetite and weight changes may be unavoidable if the medication is necessary,” she explains. 

When to talk to your healthcare provider

All that said, if you feel like your appetite is out of control while taking prednisone, don’t hesitate to seek medical advice from your healthcare provider. “Talk to your doctor if you notice rapid weight gain, swelling, mood changes, or if you feel like your side effects are impacting your quality of life or overall well-being,” Dr. Rao says. Drs. Clark and Rao both note that higher doses and longer durations are associated with more pronounced side effects, so it never hurts to talk to your provider about a dose adjustment. If that’s not possible, they may be able to connect you with a dietitian who can work with you to create a personalized eating plan.