How to Manage Weight Gain and Moon Face from Corticosteroids
Dec, 1 2025
Sodium Intake Calculator
The NHS recommends keeping sodium intake under 1,500 mg per day to help reduce swelling from corticosteroids.
Your Results
Recommended limit: 1,500 mg
Percentage of daily limit: 0%
When you’re taking corticosteroids like prednisone for a chronic condition-maybe lupus, Crohn’s disease, or severe asthma-you’re fighting inflammation. But over time, your face starts to change. Your cheeks puff out. Your jawline softens. Your clothes feel tighter around the middle. You look in the mirror and don’t recognize yourself. This isn’t just about looks. It’s called moon face, and it’s one of the most common and distressing side effects of long-term steroid use.
Why Does Moon Face Happen?
Moon face isn’t caused by gaining fat the way you might from eating too much sugar or skipping workouts. It’s hormonal. Corticosteroids mimic cortisol, your body’s natural stress hormone. When you take them for weeks or months, your body gets confused. It starts storing fat differently-especially around your face, neck, and upper back. At the same time, your kidneys hold onto more sodium and water. That’s why your face looks swollen, not just round.This isn’t rare. About 25 to 30% of people on long-term steroid therapy develop noticeable facial swelling. The higher the dose-especially over 7.5 mg of prednisone daily-the more likely it is. And it usually shows up after three months or more of daily use. Women and younger adults are more likely to notice it, likely because of how their bodies naturally store fat.
It’s not dangerous by itself, but it’s deeply unsettling. Studies show that people with moon face often avoid social situations, feel ashamed, or even stop taking their medication because they can’t stand how they look. One study found that 23% of people with inflammatory bowel disease stopped their steroids just because of how it changed their appearance. That’s risky-stopping steroids suddenly can cause adrenal crisis, which is life-threatening.
Can You Prevent Moon Face?
No, you can’t prevent it completely. There’s no magic trick or supplement that stops it before it starts. But you can control how bad it gets-and how long it lasts.The most important thing is to work with your doctor to use the lowest possible dose for the shortest time. If your condition allows, your doctor might switch you to a different steroid, like budesonide, which has fewer systemic side effects. Or they might add a steroid-sparing drug like methotrexate or azathioprine to reduce your overall steroid needs.
Some people think cutting calories will help. But it won’t. Moon face isn’t about excess calories-it’s about fat redistribution. You can eat perfectly and still get it. That’s why diets alone rarely work.
How to Reduce Swelling and Weight Gain
There are two big, simple, science-backed ways to reduce the puffiness: salt and water.1. Cut your sodium intake. Steroids make your body hold onto sodium. More sodium = more water retention = more swelling. The NHS recommends keeping sodium under 1,500 mg per day. That’s less than one teaspoon of salt. Read labels. Avoid processed foods, canned soups, soy sauce, deli meats, and restaurant meals. Cook at home with herbs, lemon, and vinegar instead of salt.
2. Drink more water. This sounds backwards, but it works. When you’re dehydrated, your body holds onto water like a sponge. Drinking 2 to 3 liters of water daily tells your kidneys to flush out the extra sodium. Many patients report visible improvement in facial swelling within 10 to 14 days of doing this consistently.
3. Eat potassium-rich foods. Potassium helps balance sodium. Bananas, spinach, sweet potatoes, avocados, and beans are great choices. They won’t melt the fat, but they can reduce fluid buildup.
4. Move gently. Muscle weakness is common with steroids. Avoid intense cardio or heavy lifting-it can make fluid retention worse. Instead, try daily walks, yoga, or light resistance training with bands. This helps maintain muscle mass and may slowly improve fat distribution over time.
What About Weight Gain Elsewhere?
Moon face isn’t the only change. Many people gain weight around the abdomen, back of the neck (buffalo hump), and upper back. This isn’t belly fat from overeating-it’s visceral fat caused by cortisol. The same rules apply: reduce sodium, drink water, avoid processed foods. You can’t spot-reduce, but overall metabolic health improves with consistent habits.Also, steroids raise blood sugar. About 20% of long-term users develop steroid-induced diabetes. That’s why your doctor should check your fasting glucose every 3 to 6 months. If your sugar starts creeping up, you might need diet changes or medication like metformin.
How Long Does It Last?
The good news: moon face usually goes away. But it takes time. After you stop or reduce your steroid dose, it can take 6 to 12 months for the swelling to fully fade. The longer you were on steroids, the longer it takes. Some people see improvement in 2 to 3 months if they’re strict with diet and hydration. Others take a year or more.Don’t expect overnight results. This isn’t a quick fix. It’s a slow recovery process. But it does reverse.
When to Worry
Moon face from steroids is common. But if you suddenly develop it without being on steroids, or if you also have:- Severe headaches
- Slow-healing cuts or bruises
- Extreme fatigue
- High blood pressure
- Easy bruising
you might have Cushing’s syndrome caused by a tumor. That’s rare, but serious. See your doctor right away if these symptoms appear.
Psychological Support Matters
This isn’t just a physical issue. It’s emotional. People with moon face often feel isolated, anxious, or depressed. The American Psychological Association now recognizes steroid-induced body image disturbance as a real clinical concern. Talking to a counselor who understands chronic illness can help. Support groups like the Cushing’s Support & Research Foundation connect people who’ve been through it. You’re not alone.What’s on the Horizon?
Scientists are working on new steroids called SEGRMs (selective glucocorticoid receptor modulators). Early trials show they reduce moon face by over 60% compared to traditional steroids. But they’re still in testing-likely years away from being widely available.For now, the best tools you have are the ones you can use today: lower sodium, drink water, stay active, monitor your blood sugar, and talk to your doctor about your dose. And be patient. Your face will return to normal. It just takes time.
Patrick Smyth
December 2, 2025 AT 20:30This is the most devastating thing that’s ever happened to me. I took prednisone for six months and I looked like a balloon with eyes. My own mother didn’t recognize me at Christmas. I cried in the shower every night. I felt like a monster. No one talks about this. No one. And then I saw myself in a window reflection and I screamed. I actually screamed. I thought I was dying.
Michelle Smyth
December 3, 2025 AT 00:17One must interrogate the ontological dissonance induced by pharmacological cortisol mimicry. The facial adiposity isn’t merely a physiological artifact-it’s a semiotic rupture in the phenomenology of selfhood. The gaze, as Lacan might argue, becomes a site of alienation when the corporeal mirror no longer reflects the internal subject. Hence, the ‘moon face’ is less a side effect and more a hermeneutic crisis rendered in subcutaneous fat.
Tommy Walton
December 4, 2025 AT 08:36Drink water. Cut salt. Walk daily. That’s it. 🌊🚫🧂🚶♂️
Stop overcomplicating it. Your body isn’t broken. The meds are. But you’re still you.