Can you advise on weight gain (steroid induced) 3.5 years post gastric sleeve?

Question

I had a gastric sleeve surgery back in March 2018 at 33, I was 5'6 & 185 lbs and wasn't able to lose the weight with diet/exercise. After surgery I hit my goal weight of 135lbs in Sept 2018... I've managed to stay at or under 135lbs since Sept 2018. The end of March 2021 my adrenal gland stopped producing enough Cortisol. I was put on steroids in March & went from 138-195lbs, (4 months I've gained 60lbs) & dont eat any more or different. How is this possible? Dr says not H2O retention, but fat?

Jorge Maytorena, MD · Answer

Are you still taking steroids? As long as you continue taking them it will be more difficult to lose weight, no matter what you do you will not lose weight, in case you are no longer taking them I would recommend starting a phased diet, reset

Ali Solmaz, MD · Answer

Steroids, especially corticosteroids like prednisone or hydrocortisone, can cause significant weight gain even without changes in diet. This happens because they alter the way your body stores fat, slow down your metabolism, and increase insulin resistance. Your body is likely storing more fat instead of burning it, which explains the rapid weight gain.
Your doctor is correct that this is fat rather than water retention. Steroids cause fat to accumulate in specific areas like the abdomen, face, and upper back, a pattern often seen in people with conditions like Cushing’s syndrome, which is caused by excess cortisol. They can also lead to muscle loss, meaning that even if your weight has gone up, a significant part of the gain is from increased fat rather than muscle.
Since your adrenal glands aren’t producing enough cortisol, your body isn’t regulating hormones properly. Cortisol affects metabolism, insulin levels, and fat storage. When you take steroids to compensate, your body responds by storing excess fat much more easily. If you’re still on steroids or haven’t been able to taper off, this could continue.

Islam Abdelkhalek, MD · Answer

Now you should do a revisional surgery in the form of gastric bypass surgery. This means cutting down scars of the previous sleeve surgery and converting dleeve to reux en y gastric bypass. Hope that helps

Pablo Garcia, MD - Account Suspended · Answer

Hello, I am sorry to hear you are struggling with various health issues. Unfortunately, due to your adrenal insufficienc ou are required to be placed on long term steroids. Steroids cause both weight gain and fat distribution, mos specifically to the axial skeleton. It will be hard for you to maintain weight as long as you are on steroids. My recommendation is to be evaluated by a bariatric team, which includes a certified nutritionist, in order to determine what would be best for you.

Can you advise on weight gain (steroid induced) 3.5 years post gastric sleeve?

Answers (4)

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