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Weight gain on steroids during blood cancer treatment | CION Cancer Clinics
Steroids used in blood cancer treatment often cause weight gain because they raise appetite, make the body hold salt and water, and shift fat to the face and belly. It usually eases over months after the course ends. Do not stop the steroid yourself. This page explains what kind of weight it is, how to eat with the hunger, and which swelling needs a same-day call. At CION Cancer Clinics, our haematology team supports patients and families through treatment, cost questions and life at home.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Why do steroids make you put on weight?
- What kind of weight is it, and where does it go?
- How can you eat well when steroids make you hungry all the time?
- What usually happens to your weight over a course of steroids?
- What do families believe about steroid weight, and what is true?
- Who should not try to lose weight now, and what can this page not tell you?
- Common questions about weight gain on steroids
The short answer
Why do steroids make you put on weight?
Steroids raise your appetite, make your body hold on to salt and water, and move fat towards your face, neck and belly. Most of the gain is fat and fluid, and it usually settles slowly once the course is over.
Why steroids are part of blood cancer treatment
Steroids such as prednisolone and dexamethasone are not an extra. In many blood cancers they work directly against the cancer cells. They are part of the treatment for lymphoma, myeloma and some leukaemias. That is why the weight is a side effect to manage, not a reason to question the plan.
The hunger is real, not a lack of willpower
Steroids act on the part of the brain that controls hunger. Many people describe waking at night wanting to eat, or feeling hungry an hour after a full meal. It is a drug effect. Knowing that helps you plan meals without blame.
Why the number on the scale can mislead you
Steroids also break down muscle, especially in the thighs and upper arms. So a person can gain weight on the scale while losing strength. The goal during treatment is not a lower number. It is keeping muscle, keeping blood sugar steady, and not letting salt and fluid build up.
Never stop, skip or reduce a steroid on your own because of weight gain. Stopping suddenly can be dangerous. Only your treating team can change the plan.What is changing
What kind of weight is it, and where does it go?
Steroid weight is not one thing. Each part behaves differently, and each needs a different response.
Extra eating
The biggest share for most people. Larger portions, more snacks and more sweet tea add up quickly over a few weeks of treatment.
Often shows as
- Night-time hunger
- Cravings for sweets and fried snacks
Fluid held in the body
Steroids make the kidneys keep more salt, and water follows the salt. Ankles and feet may look puffy, and weight can jump over a few days rather than creep up slowly.
Fat that moves
Fat tends to gather on the face, the back of the neck and the belly, while arms and legs may look thinner. A rounder face is common.
Muscle that is lost
This is the part you cannot see on the scale. Climbing stairs or getting up from a low chair becomes harder. Protein at every meal and gentle daily movement help protect it.
Not sure whether this applies to you?
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Weight changes that should not wait
Call your treating team the same day if you are very thirsty, passing a lot of urine or feeling confused, because steroids can push blood sugar very high. Go to the nearest emergency department or call 108 if one leg suddenly becomes swollen and painful, you are short of breath, or the swelling spreads quickly with chest discomfort. Do not wait to see whether it settles.
Day to day
How can you eat well when steroids make you hungry all the time?
You do not have to fight the hunger. Plan for it. Eat at fixed times, keep filling food ready, and let protein and vegetables do the work that extra rice, sweets and fried snacks would otherwise do.
Build the plate differently
Keep your usual meals, but change the balance. Half the plate can be vegetables such as beans, gourds, spinach or cabbage. A quarter can be protein: dal, chana, rajma, paneer, eggs, fish or chicken, cooked the way your team says is safe for your counts. The last quarter is rice, roti or millets. A second helping of dal or sabzi fills you up with less sugar than a second helping of rice.
Watch the salt you do not notice
Pickles, papad, namkeen, chutney powders and packaged snacks carry a lot of salt. Salt makes fluid build-up worse. Cook with the salt you need, but keep these extras for a small taste rather than every meal.
Drinks count more than you think
Sweet tea several times a day, fruit juice, cool drinks and sweetened lassi can add a meal's worth of sugar without filling you. Plain water, buttermilk without sugar and tea with less sugar are easier on both weight and blood sugar.
What to expect
What usually happens to your weight over a course of steroids?
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The first few days
Appetite often rises quickly. Sleep may be harder too. Weight may not change much yet, which can make it easy to ignore the extra eating.
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The first few weeks
Weight gain becomes visible, often with a puffier face and ankles. If you have diabetes, or a family history of it, your team may check your sugar more often. Tell them if your readings at home are running high.
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Steroids given in pulses
In many myeloma and lymphoma plans, steroids are given for a few days and then paused. You may notice hunger and sleeplessness on steroid days and a slump in mood and energy afterwards.
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When the course finishes
Your team will usually bring the steroid down step by step rather than stopping it at once. Fluid tends to go first. The face often becomes less round over the following months.
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Commonly believed
What do families believe about steroid weight, and what is true?
"Putting on weight means the cancer is going away."
Weight on steroids tells you about the drug, not about the cancer. Whether treatment is working is judged from blood tests, marrow results and scans. A good appetite is welcome, but it is not a result.
"She should eat less and skip dinner to stop the gain."
Crash dieting during treatment usually costs muscle, not fat, and can leave a person too weak for the next cycle. Skipping meals also makes sugar swing more on steroids. Regular, balanced meals do far more good.
"Ghee, dry fruits and sweets will build back strength."
Strength comes back through protein and movement. Rich sweets add weight and sugar without protecting muscle. Small amounts of nuts are fine, but they do not replace dal, eggs, paneer or meat.
"The round face and belly are permanent now."
For most people the face slims and the fluid goes once steroids are tapered and stopped. It takes months, not weeks, and belly fat is the slowest part.
Being straight with you
Who should not try to lose weight now, and what can this page not tell you?
Some people should not be cutting food at all during steroid treatment, even if the scale is rising. Your team, not a diet chart, decides which group you are in.
People who should not try to lose weight during treatment
If you lost a lot of weight before diagnosis, if you are having intensive chemotherapy, if you are older and already frail, or if you have mouth sores or loose motions, eating less is likely to do harm. For a child or teenager on steroids for leukaemia, never restrict food without the paediatric team's advice, because growth matters as well.
What this page cannot tell you
It cannot tell you whether your swelling is fluid, a clot or something else. It cannot tell you your blood sugar target, how long your own course will run, or whether your steroid can be changed. Those depend on your diagnosis, your other medicines and your tests. At CION, Dr. Basudev Pokhrel and the haematology team can review the whole plan with you and arrange a dietitian's advice where it is needed.
Questions we are asked
Common questions about weight gain on steroids
Can I ask the doctor to stop the steroids because of my weight?
You can and should tell your team how the weight is affecting you. Do not stop or reduce the steroid yourself. In blood cancers it is often a key part of the treatment, and stopping suddenly can make you seriously unwell. Your haematologist will weigh the side effects against the benefit and explain any change that is possible.
Why is my face so round? Will it go back to normal?
Steroids move fat towards the face and neck and make the body hold fluid. This rounder face is common and usually improves once the course is tapered and finished. It happens slowly, over months rather than weeks. Tell your team if it is hard to cope with.
Do steroids cause diabetes?
They can raise blood sugar, sometimes enough to need treatment while you take them. For many people the sugar settles after steroids stop. If you already take diabetes medicine, your team may adjust it; do not change it yourself.
My father is hungry at midnight. What should he eat?
Keep something filling but light ready: a boiled egg, a small bowl of curd or buttermilk if the team allows it, roasted chana, or a cup of warm milk without sugar. Avoid biscuits, sweets and fried namkeen at night. Check with his team that any food fits his counts and his sugar level.
Should I drink less water if my feet are swollen?
Not without advice. Some treatments need you to drink plenty to protect your kidneys. Cutting down on hidden salt usually helps more than cutting water. Tell your team about the swelling, especially if it is in one leg only or comes with breathlessness, because that needs checking the same day.
Can I exercise to control the weight?
Gentle, regular activity helps. A short walk after meals, standing up from a chair a few times, or light work with the arms can protect muscle and steady your sugar. Ask your team before starting anything harder, especially if your platelet or white cell count is low, or if you have bone disease from myeloma.
Is it safe to follow a weight-loss diet from the internet?
Not during treatment. Fasting plans, very low-carb diets, detox drinks and herbal powders can cause weakness, sugar swings or interact with your medicines. Tell your team about anything you are taking, and ask to see a dietitian if you want a structured plan.
My child on leukaemia treatment wants to eat all the time. Is that normal?
Yes, it is very common in children taking steroids, and it often comes with mood changes and poor sleep. Offer regular meals and healthy snacks rather than refusing food. Do not put a growing child on a diet. Tell the paediatric team if it is hard to manage.
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Sources
- NHS — Steroids
- Cancer Research UK — Steroids
- Macmillan Cancer Support — Steroids
- Blood Cancer UK — Understanding blood cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Protein Needs During Intensive TreatmentHow to protect muscle while steroids break it downEating Well During Blood Cancer TreatmentThe everyday eating plan this page builds onWeight Loss During Haematology TreatmentThe opposite problem, and why it needs a different responseNutrition in HaematologyEvery nutrition guide for blood cancer and blood disorders
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