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Nutrition and daily life

Weight gain: steroids, appetite and swelling

With some leukemia treatments, especially steroids (prednisolone, dexamethasone), weight can go up. Appetite grows, fluid is retained and the face and belly change. This section explains the causes and how to approach weight gain.

Last updated: ~1 min read
Vegetables and yogurt in front, pastries behind.
Figure 1.A healthy snack choice.

01Short answer

Steroids increase appetite, cause fluid retention, raise blood sugar and can redistribute fat. Do not start a weight-loss diet during treatment; the aim is healthy choices. Fill up on vegetables, protein and fibre, and cut down on sweet and very salty foods. Tell your team about leg swelling, breathlessness or rapid weight gain. After the steroid course, weight usually comes down gradually.

02Simple explanation

Steroids increase appetite.

No weight-loss diet during treatment.

Less salt and sugar.

Swelling? Tell us.

03Scientific explanation

MedlinePlus: prednisolone can cause increased appetite, weight gain, fluid retention and raised blood sugar.

ESPEN: enough energy and protein matter for preventing weight and muscle loss in people with cancer, and nutritional status should be assessed regularly.

NCI: practical eating tips exist for treatment side effects such as nausea, taste changes and mouth sores.

04What happens in the body?

Filling choices

Vegetable soup, cooked legumes, yogurt and eggs: filling with fewer calories.

A salt shaker pushed aside on a table.
Figure 2.Push the salt aside.

Salt

Salt increases fluid retention; cut down on ready-made foods and pickles.

A park path in golden light.
Figure 3.A gentle walk — Weight gain: steroids, appetite and swelling

Dietitian

If you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.

Food safety

Food-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

05Nutrition: four steps

Assess, swap the risky, cook safely, eat regularly.

Assess — Weight and appetite.1AssessWeight and appetite.
Swap — A safe choice.2SwapA safe choice.
Cook — Hot throughout.3CookHot throughout.
Eat regularly — Small portions.4Eat regularlySmall portions.
StrengthEnergy.
ProteinFor muscle.
SafetyFood rules.

06Key points at a glance

TopicIn brief
Filling choicesVegetable soup, cooked legumes, yogurt and eggs: filling with fewer calories.
SaltSalt increases fluid retention; cut down on ready-made foods and pickles.
DietitianIf you are losing weight, have no appetite or need a special diet, ask to see the hospital dietitian.
Food safetyFood-safety rules for neutropenia (see “Handwashing: the simplest protection” and “Eggs and dairy: safe choices”) apply at every stage.

07Key terms

Corticosteroids
Strong anti-inflammatory medicines.
Oedema
Fluid build-up in tissues.
Dietitian
A nutrition specialist.
Protein
A nutrient for repairing muscles and tissues.
Neutropenia
Low neutrophils.

08Key points

  • Healthy choices, not a diet.
  • Cut down on salt.
  • Report swelling.
  • A diet is not a treatment.
  • Talk to a dietitian.

09Frequently asked questions

Can I reduce my steroids?

No; stopping on your own is dangerous. Talk to your doctor.

Will the weight come off?

Usually gradually after the course; healthy habits help.

Can a special diet cure leukemia?

No. Good nutrition helps you cope with treatment, but it does not cure.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can I reduce my steroids?

  2. Will the weight come off?

  3. Can a special diet cure leukemia?

My questions

12Sources

  1. MedlinePlus. Prednisone
  2. National Cancer Institute. Eating Hints: Before, During, and After Cancer Treatment
  3. ESPEN. ESPEN practical guideline: Clinical Nutrition in cancer (2021)
  4. Leukemia & Lymphoma Society. Food and Nutrition
  5. World Health Organization. Healthy diet fact sheet
  6. British Dietetic Association. Fibre: Food Fact Sheet
  7. American Cancer Society. Eating Problems
  8. MedlinePlus (U.S. National Library of Medicine). Vitamins
  9. NHS. Vitamins and minerals: B vitamins and folic acid
  10. NHS. Vitamins and minerals: Vitamin K
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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