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After treatment and remission

Getting back to a healthy weight

During leukaemia treatment some people lose weight, while others gain weight because of steroids. This topic explains why weight changes after treatment and how to bring it back to a healthy level.

Last updated: ~2 min read
An elegant glass scale with level pans.
Figure 1.A healthy weight is a balance.

01Short answer

After treatment, weight can change in either direction. Weight loss is linked to poor appetite, nausea, mouth sores, infections and loss of muscle. Weight gain is more often linked to steroids, inactivity and hormone changes; it is especially seen in people treated for acute lymphoblastic leukaemia in childhood. What matters is not only the number on the scale but body composition: rebuilding muscle and gradually reducing excess fat. The ACS and WCRF recommend a healthy weight, regular physical activity and balanced eating rich in plant foods after treatment. A doctor or dietitian makes the personal plan.

02Simple explanation

Weight can change in either direction.

Weight gain is often linked to steroids and inactivity.

What matters is body composition.

The basis is movement and balanced eating.

The personal plan is made with a dietitian.

03Scientific explanation

Weight loss: the ESPEN guideline advises early detection of weight and muscle loss in cancer and nutritional support.

Weight gain: people treated for ALL in childhood have a higher later risk of excess weight and metabolic changes (COG).

Sarcopenia: muscle mass can be low even at a normal weight; strength exercises help correct this.

Recommendations: the WCRF advises a healthy weight, daily activity, whole grains, vegetables, fruit and pulses, and limiting sugary drinks and processed meat.

04What happens in the body?

Why do people lose weight?

Poor appetite, taste changes, nausea, mouth sores and long hospital stays cause loss of both fat and muscle.

A clear arm cross-section with a glowing muscle core and thin fat layer.
Figure 2.The balance of muscle and fat matters.

Why do people gain weight?

Steroids increase appetite and can cause fat to collect around the abdomen. Inactivity and some hormone changes also play a part.

The scale is not everything

At the same weight you may have little muscle and more fat. That is why movement and strength exercises matter as much as eating.

A balanced plate

The general principle: vegetables and fruit, whole grains, protein sources, water. A dietitian sets the specific amounts.

A round plate divided into coloured segments of light.
Figure 3.A balanced plate is the general principle.

Do not rush

Crash diets and “detox” programmes can increase muscle loss. It is safer to let weight normalise gradually, over months.

When to call your doctor

Worrying signs — fever, bleeding, new pain, breathlessness — should be reported to your doctor between visits too. Getting in touch early is always better than waiting.

05Stabilising weight

Steps toward a healthy weight.

Track — Record weight once a week.1TrackRecord weight once a week.
Causes — Steroids, thyroid, fluid are checked.2CausesSteroids, thyroid, fluid are checked.
Advice — A personal plan with a dietitian.3AdviceA personal plan with a dietitian.
Stability — Weight settles over months.4StabilityWeight settles over months.
Stable weightNo sudden swings.
MuscleStrength recovers.
HealthLower cardiometabolic risk.

06Weight change: causes and steps (simplified)

SituationPossible causeWho can help
Weight lossPoor appetite, mouth soresDoctor, dietitian
Muscle lossInactivity, steroidsPhysiotherapist
Weight gainSteroids, little movementDoctor, dietitian
SwellingFluid retention, medicinesDoctor
Normal weight, but weakSarcopeniaPhysiotherapist

* Personal decisions are made with your doctor.

07Key terms

Body composition
The balance of muscle, fat and water.
Sarcopenia
Loss of muscle mass and strength.
Body mass index
Weight in relation to height.
Dietitian
A nutrition specialist.
Oedema
Fluid collecting in tissues.
Metabolic risk
Risk linked to blood sugar, cholesterol and blood pressure.

08Key points

  • Weight can change either way.
  • The scale is not everything.
  • Rebuild muscle.
  • Balanced eating is the general principle.
  • Avoid crash diets.
  • Make a personal plan with a dietitian.

09Frequently asked questions

How often should I weigh myself?

Once a week at the same time is enough.

Will steroid weight go away?

It often decreases gradually after they stop; movement helps.

Should I take supplements?

Only if your doctor or dietitian recommends them.

Is fasting OK?

No; long fasting and strict diets are not advised during recovery.

Does this information replace medical advice?

No. This is general education; only your treating doctor can assess your situation.

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. How often should I weigh myself?

  2. Will steroid weight go away?

  3. Should I take supplements?

  4. Is fasting OK?

  5. Does this information replace medical advice?

My questions

12Sources

  1. American Cancer Society. Nutrition for People with Cancer
  2. National Cancer Institute (NCI). Eating Hints: Before, during, and after Cancer Treatment
  3. Clinical Nutrition, 2021. Muscaritoli M et al. ESPEN practical guideline: Clinical Nutrition in cancer
  4. World Health Organization (WHO). Healthy diet — fact sheet
  5. MedlinePlus (U.S. National Library of Medicine). Weight Control
  6. National Cancer Institute (NCI). Follow-Up Medical Care
  7. National Cancer Institute (NCI). Cancer Survivorship
  8. Cancer.Net (ASCO). Follow-Up Care After Cancer Treatment
  9. Leukemia & Lymphoma Society (LLS). Long-Term and Late Effects of Treatment
  10. Cancer.Net (ASCO). Long-Term Side Effects of Cancer Treatment
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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