Lupus is a chronic autoimmune disease in which your immune system mistakenly attacks healthy tissues throughout your body. Weight changes are common with lupus. Some people gain weight, while others lose weight. Both can affect health and response to treatment. Understanding what’s causing weight changes when you have lupus can help you better manage the condition.
With lupus, weight gain and loss may occur for several reasons. These weight changes aren’t always easy to predict and can vary from person to person.
Treatments used to manage lupus can affect your weight. For example, many people notice weight gain when taking certain lupus medications, including steroids. Complications and symptoms associated with lupus can lead to weight changes, as well. Some people may lose weight due to decreased appetite or gut health issues.
Carrying extra weight can also make lupus symptoms worse. People living with obesity and lupus tend to have more inflammation, joint pain, and a higher risk of complications such as heart disease.
Lupus affects everyone differently, and weight gain or loss can happen for several reasons.
Medication Side Effects
Medications used to treat lupus are a common reason for weight changes. These medications include corticosteroids, such as prednisone, that can help reduce inflammation and control lupus flares.
While steroid medications can work well for symptoms, they often cause weight gain. That’s likely because steroids can increase appetite, make your body hold onto extra fluid, and change how your body stores fat.
Many people who have taken steroids for a long time develop Cushing’s syndrome. This condition causes fat to build up around the belly and upper back. A common symptom is moon face, where the face becomes rounder and puffier due to fluid retention and fat redistribution.
The longer you take steroids, the more likely you are to notice changes in your weight.
Lupus-Related Medical Conditions
If lupus causes kidney disease (lupus nephritis), you may develop edema. Edema is swelling that occurs when too much fluid builds up in your body’s tissues. With edema, you might notice puffy eyes, swollen ankles, or swollen fingers. This fluid build-up may appear as weight gain on the scale.
Another common issue with lupus is thyroid problems. Hypothyroidism (underactive thyroid, where your body doesn’t make enough thyroid hormones) is more common in people with lupus. It may slow down your metabolism. If you develop hypothyroidism with lupus, you might gain weight, feel extra tired, or have a puffy face.
Your healthcare provider can check your thyroid levels with a blood test and prescribe medication if needed.
Reduced Physical Activity
Many people with lupus experience extreme fatigue, which can make it more challenging to stay physically active.
Joint and muscle pain are other lupus symptoms that can limit your physical activity. Your joints might feel stiff, swollen, or painful, especially in the morning or after sitting. Muscle pain and weakness can make even minimal physical activity feel challenging. When these symptoms flare up, it’s natural to want to move less to avoid pain.
Mental Health Challenges
Living with lupus and adjusting to life with a chronic illness can increase your stress levels. When you’re stressed, your body also produces more cortisol, often called the stress hormone. High cortisol levels are linked to a build-up of belly fat.
Higher cortisol levels can also boost your appetite, especially for comfort foods high in fat and sugar. Turning to food for comfort when you feel stressed, anxious, or depressed can lead to unwanted weight gain.
Sleep Difficulties
Many people with lupus struggle with sleep. Sleep helps regulate hormones, maintain metabolism, and manage appetite, which are all connected to weight. When you don’t sleep well, your body’s hunger hormones can get thrown off balance, which can lead to weight gain.
Reduced Appetite
While stress and a depressed mood can sometimes lead to weight gain, it can also reduce appetite. When mood changes decrease your appetite, you may experience weight loss.
If lupus affects your digestive system, you may also experience decreased appetite and unintentionally lose weight.
A serious form of weight loss called cachexia can occur in some people with lupus. Cachexia is an unintended loss of both fat and muscle tissue. It doesn’t improve with increased eating. You’re more likely to develop this type of weight loss if lupus affects your kidneys, blood cells, or blood vessels.
It may not always be possible to control weight changes with lupus, but these strategies may help support your overall health and decrease the risk of weight changes:
- Talk to a healthcare provider about medications: You can ask if your current medications might be affecting your weight. Sometimes, adjusting your dosage or switching to alternatives can help minimize weight-related side effects.
- Focus on anti-inflammatory foods: Colorful fruits, vegetables, fatty fish, and nuts can help fight inflammation.
- Find joint-friendly exercises: Swimming, walking, and yoga can be gentle on your joints while still providing weight management benefits.
- Break activities into short sessions: If longer workouts are too tiring, try movement breaks of 5-10 minutes instead.
- Prioritize sleep quality: Creating a consistent bedtime routine and keeping your bedroom cool and dark may help improve sleep.
- Practice stress management daily: Meditation, deep breathing, or gentle stretching may help lower stress hormones associated with weight gain.
- Build a support network: Support groups, whether online or in-person, can provide encouragement and practical tips for managing weight changes associated with lupus.
Notify your healthcare provider if you notice unexplained weight changes, including weight gain or loss, without changes to your diet or activity level. It’s important to mention any fatigue or swelling in your legs or face. These symptoms could mean that lupus is affecting your organs or that your medication needs adjustment.
Try to attend your follow-up visits so your healthcare provider can monitor weight changes. Be open about any weight management challenges you’re having, whether it’s medication side effects, pain that limits activity, or emotional eating. Being open allows your healthcare team to support you in managing your weight and lupus symptoms.
With lupus, you may gain weight from medications like steroids, which can increase appetite and change how your body stores fat. Lupus symptoms like joint pain and fatigue make staying physically active difficult, contributing to weight gain. Medical issues like kidney problems or thyroid disease can also lead to weight gain.
Weight loss can also happen, especially if lupus affects your digestive system or appetite.
Managing your weight with lupus means working with your healthcare team, possibly adjusting medications, eating a balanced diet, and finding ways to move your body. Regular check-ups with your healthcare provider can help you monitor any weight changes and keep both your weight and lupus under control.
