Steroids, obesity, and WLS

[BoiledDenim 9]

Heeeyyy!

So I'm wondering for those of you on steroid regimens, how has it affected your weight loss efforts before and after WLS?

I'm on the filthy bastards (decadron 6mg x2 daily for 5 days/month) and unfortunately don't have a choice at the moment. They cause a ravenous hunger, elevate my normal blood sugar, and blood pressure to an alarming degree. Amongst a litany of other horrible side-effects, of course.

I digress. I'm in the pre-op phases for gastric sleeve and this long-term usage of these monsters are worrisome. Does anyone have any experience dealing with this? Thanks in advance!

[FluffyChix 17,409]

@BoiledDenim I'm so sorry you have to use them!! I take daily inhaled steroids and have for years. I also have cortisone injections into certain joints as needed about every 6 months. I go up about 2-4lbs for a couple of weeks following each injection.

When I have to take oral steroids I drop SUPER low on my carbs--like under 20g net/daily. I average between 10-20g of net carbs daily during that time and take my calories down super low also. I would average around 800cals/day, keeping fat super low also. It really helps with appetite suppression. But I'm already a low carber, so never have to go through any of the conversion from glucose burning to fat burning. But, if I was taking steroids and eating high carb? Holy moly. Binge City.

[BoiledDenim 9]

I think low carb is solid advice, and I do/feel the best while eating super low carb (under 20g) .

But cha'know, I fell off that wagon some time ago and got ran over by it! So yes it's a struggle currently. I do think your advice is wise and prudent and I will try that.

Yes, steroid-induced binge city is definitely a real thing!

The issue with low carb now is I have a hard time eating very low carb and very low fat. I don't have my gall bladder anymore, and fat just ain't friendly like he used to be. I suspect the way I feel about that will change/need to change as the days tick closer to surgery. Do you eat HF/LC?

Thank you for your time

[FluffyChix 17,409]

I know, you hear you're not supposed to combine low fat and low carb and low calorie (which it will be de facto) cuz it will make your thyroid tank. Ask your doc though. For me, I was still getting enough fat in the Protein (I aim for 60-70g per day currently) and also eat some avocado. When I was eating around 1000cals/day, my fat was around 60g daily. At 800cals/day it was around 40g. It's hard to stay on the low carb wagon, but totally worth it not to balloon up with the steroids and deal with hunger/binging all the time. ((hugs))

Edited September 29, 2017 by FluffyChix

[MarinaGirl 608]

2 hours ago, FluffyChix said:

I know, you hear you're not supposed to combine low fat and low carb and low calorie (which it will be de facto) cuz it will make your thyroid tank. Ask your doc though. For me, I was still getting enough fat in the Protein (I aim for 60-70g per day currently) and also eat some avocado. When I was eating around 1000cals/day, my fat was around 60g daily. At 800cals/day it was around 40g. It's hard to stay on the low carb wagon, but totally worth it not to balloon up with the steroids and deal with hunger/binging all the time. ((hugs))

FluffChix - Have you had WLS?

I'd be curious to hear about the impact of steroids post-surgery. Do you still have the wicked hunger or does that vary by procedure and patient?

[FluffyChix 17,409]

@MarinaGirl I'm working toward WLS with my surgeon and bariatric team. Sorry, can't help you with post WLS. I would seriously talk to your bariatric team/doc about it and about how steroids will affect your new anatomy.

[Taylor5 98]

On 9/29/2017 at 9:51 AM, FluffyChix said:

I also have cortisone injections into certain joints as needed about every 6 months. I go up about 2-4lbs for a couple of weeks following each injection.

My heart literally just skipped a beat! I have been telling my neurologist/neurosurgeon/orthopedic surgeons and pain doctors this same thing for years...and no one believes me! Every time I get an injection or take a Medrol dose pack, I gain a few pounds, most of which do not come off! I have a print out of all my procedures the past 4 years in pain management as well as my weight at my first visit (165) and my weight at my last visit (205). Obviously some of this also has to do with limitations on exercise due to pain, but I KNOW the steroids caused so much of it. I am up almost the whole night after I get an injection and somehow always forget it's going to happen until 3 a.m. and I'm wide awake thinking about food!

Anyway, I apologize for going somewhat off topic from OP point, I was just really excited to find someone else w/the same issue. Also, I love the advice about going low carb during that time. I'd never thought to alter my diet to help prevent/minimize that gain, but I am betting it would help. So thanks for the tip!

[2Bsmaller18 435]

On 9/29/2017 at 9:51 AM, FluffyChix said:

@BoiledDenim I'm so sorry you have to use them!! I take daily inhaled steroids and have for years. I also have cortisone injections into certain joints as needed about every 6 months. I go up about 2-4lbs for a couple of weeks following each injection.

When I have to take oral steroids I drop SUPER low on my carbs--like under 20g net/daily. I average between 10-20g of net carbs daily during that time and take my calories down super low also. I would average around 800cals/day, keeping fat super low also. It really helps with appetite suppression. But I'm already a low carber, so never have to go through any of the conversion from glucose burning to fat burning. But, if I was taking steroids and eating high carb? Holy moly. Binge City.

I came across this old comment but wanted to ask if you take anything to protect your pouch form steroids? My plastic surgeon wants to do some local injections for scars on my arms but my bypass surgeon is super conservative and said to never take any anti inflammatory or steroids. Not just orally he said to never get a steroid injection in a joint etc.

[BriarRose 432]

8 hours ago, 2Bsmaller18 said:

I came across this old comment but wanted to ask if you take anything to protect your pouch form steroids? My plastic surgeon wants to do some local injections for scars on my arms but my bypass surgeon is super conservative and said to never take any anti inflammatory or steroids. Not just orally he said to never get a steroid injection in a joint etc.

the reason I got a sleeve was so that I could continue steroids if and when I need them. I have had my sleeve for 10 years. I have fairly well controlled asthma, with the use of inhaled steroids 365 days a year and when I get sick,.. bronchitis or anything else that might hit my lungs hard, antibiotics and oral steroids usually with decadron injection to start it out. I end up on fairly high doses 60 mg for a week then descending doses for 2 to 3 weeks to insure breathing.... at least once or twice a year. I get ravenously hungry. I gain some weight. Then I lose it over the next couple months. It is a pain in the butt. But I do really well, as far as I am concerned. My sleeve has handled the steroid use. And I am still kicking at 64 years old.

[LaLaDee 519]

I got put on prednisone after my WLS and unfortunately, the prednisone does make you hungrier. Fortunately the sleeve stops you binging too much. But yeah, I did gain some weight. The first year of steroids, I was OK, I was strong mentally, but then I went through some tough times and really struggled with slider food like chocolate and ice cream. At all times, I maintained a loss of over 110lbs so it's not like I returned back to square one.

Edited September 10, 2020 by LaLaDee