If you have lupus, you know it’s not easy to live with the condition. This autoimmune disease can affect many parts of your body, from your skin and joints to your internal organs. You might be facing fatigue, rashes, joint pain and fevers.
You might also find it challenging to manage your weight, especially when you’re extremely tired, your symptoms flare up or you’re dealing with medication side effects. You might feel confused or frustrated.
“If you struggle with obesity and lupus, you are not alone,” said Jennifer Meyfeldt, MD, an obesity medicine specialist with Banner - University Medicine. Understanding what causes these changes and how to respond can help you feel more in control. Here’s what to know.
Why does lupus cause weight fluctuations?
If you have lupus, you may notice both weight gain and weight loss. These changes can be linked to disease activity and medications you are taking to treat it. They may make you feel frustrated, and they can impact your energy levels, self-esteem and overall health.
Lupus weight gain
"There are lots of factors that can cause weight gain. Some of them are well known, such as not getting enough activity or eating high-calorie or processed foods, but often there is more to it. People affected by lupus often struggle with joint pain, which can make it harder for them to move and can lead to unhealthy food choices. In addition, they have chronic inflammation, which can lead to weight gain," Dr. Meyfeldt said.
You might also notice weight gain due to:
- Corticosteroids like prednisone
- Fluid retention
- Medications that can increase your appetite
Lupus weight loss
You may notice weight loss due to:
- Ongoing nausea
- Loss of appetite
- Mouth sores
- Inflammation that impacts your metabolism
- Effects on your hormones and your immune system, which may disrupt how your body stores and burns fat
How can medication impact weight changes?
Several medications used to treat lupus can affect your weight. One of the most common is prednisone, a steroid that helps control inflammation.
Steroids
"People with lupus often receive medications like steroids to treat disease flares. These medications are similar to your body's stress hormones, which cause you to be hungrier and also lead to fat storage, especially in your belly, face and back," Dr. Meyfeldt said. Steroids may also cause fluid retention.
Other medications
Immunosuppressants or antimalarials like hydroxychloroquine, may affect your digestive system or appetite.
If you’re noticing lupus medication side effects, it’s important not to stop or change any medication without talking to your doctor. The right care plan will help you control your symptoms and support your overall well-being.
"The most important thing in lupus is to get proper treatment to keep the disease under control. Frequent flares can limit your ability to move due to pain and may require steroid treatments. Keeping your scheduled visits with your rheumatologist and taking the medications prescribed to control the disease activity is key," Dr. Meyfeldt said.
How can you manage a healthy weight with lupus?
While lupus can make it challenging to manage your weight, taking these steps can help:
1. Eat a balanced, anti-inflammatory diet
- Include plenty of fruits, vegetables, whole grains and lean protein.
- Limit processed foods, added sugars and salty snacks.
- Drink plenty of water, especially during flares or medication changes.
- Try following an anti-inflammatory diet or the Mediterranean diet for lupus.
"Most people don't know that the common saying ‘eat less, move more’ is a myth. There is more to weight management than those lifestyle factors," Dr. Meyfeldt said.
2. Choose physical activity that works for you
- Try low-impact exercises like walking, swimming or yoga.
- Listen to your body — on some days it may be tougher to be active than on others.
- Stay consistent on good days and let yourself rest when you need to. Exercise with lupus can sometimes be hard.
3. Track your habits and symptoms
- Use a journal or app to monitor your meals, symptoms and energy.
- Review your tracking system to spot patterns.
- Share your information with your care team so they can adjust your treatment plan if needed.
When should you talk to your doctor or a dietitian?
Anytime you have unexplained weight gain or loss — especially if it’s rapid — it deserves a closer look.
You should also talk to your health care provider if you notice:
- Major changes in appetite
- Swelling or bloating that doesn’t go away
- Weight loss when you’re not trying to lose weight
- Muscle loss
- More fatigue than you usually have
"Even if your disease is well controlled, you may still struggle with weight problems. If your body mass index is over 30 or if you hold most of your weight in your belly, you may have obesity, which is a disease on its own and should be addressed by your primary care provider or an obesity specialist. If you have health problems like high blood pressure or type 2 diabetes, you should also talk to a health professional about your weight," Dr. Meyfeldt said.
"Your obesity specialist or primary care provider can identify underlying health problems that can cause weight gain and support you with the tools you need to succeed, which may include medications to treat obesity," Dr. Meyfeldt said.
Your doctor may recommend working with a registered dietitian who can offer lupus nutrition advice and help you build a plan that works with your lupus symptoms, medications, activity level and health goals.
How can you support your overall wellness with lupus?
Your emotional and mental health play a big role in managing your weight. To improve your quality of life with lupus, it can help to:
- Sleep well. Lupus can cause sleep issues, and poor sleep can affect your weight.
- Manage stress. Stress management for lupus can help with inflammation, poor eating habits or inactivity.
- Check in on your mental health. If you’re feeling overwhelmed, depressed or anxious, talk to your provider. Support is available.
Why choose Banner Health for lupus care?
At Banner Health, we understand what it means to live with lupus. Our team includes rheumatologists, dietitians, primary care providers and wellness specialists who work together to support your quality of life.
As part of lupus treatment at Banner Health, we offer:
- Personalized care plans
- Nutrition counseling
- Medication management
- Support for lifestyle changes, including physical activity and mental health
“Every step you take is a step toward better health. And if you don't know where to start, just talk to your provider about your concerns," Dr. Meyfeldt said.
Need support managing lupus? Find a rheumatologist at Banner Health or schedule a visit to get started. Let us help you manage your symptoms and feel your best.
