Q: I've been on prednisone for five years now—down to 20 milligrams. I want to lose some weight. Is it possible to lose weight while on it? Do I have to wait for the meds to leave my body before I see any progress in weight loss?
A: Prednisone has more knocks against it than a front door on Halloween night. It causes abnormalities in the way your body metabolizes fat, carbohydrates and protein. And it also causes you to retain salt, which can contribute to your inability to lose weight. But the bottom line to your bottom line is that you still need to think of weight loss like the kitchen doors in a restaurant: One door's for going in, and one door is for going out. In your case, it's a matter of calories in through food, and calories out through physical activity and metabolism. So, yes, you can lose weight while taking the medication. And, no, you don't need to wait to get started. Start with small changes—walk 30 minutes a day, and take charge at a restaurant: Ask for cut vegetables instead of a breadbasket. Ask for the fish to be grilled in sesame or peanut oil. Tell them to hold the cheese, bacon bits and croutons from your salad. Small changes—when you add them all up—can make a big difference.
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