The use of steroids, both in the medical field and among athletes and bodybuilders, has always been a topic of interest and controversy. It is essential to clarify that the term "steroids" is broad, encompassing both anabolic steroids used by athletes and bodybuilders and corticosteroids commonly prescribed for medical purposes. Anabolic steroids are a synthetic derivative of the hormone testosterone, and these types of steroids have gained specific attention due to their ability to promote muscle growth and enhance athletic performance. Commonly prescribed steroids include prednisone, prenisolone, cortisone, hydrocortisone, and budesonide.

However, one major concern associated with steroid use - either anabolic or corticosteroids - is the potential for weight gain. While steroids can lead to weight gain, the mechanisms behind this phenomenon are complex and multifaceted.¹ In this article, we will explore the relationship between steroids and weight gain, discuss the various factors that contribute to it, and provide valuable prevention and control tips for individuals considering or already using steroids.

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How Do Steroids Work?

Before delving into the weight gain side effects, it is essential to clearly understand what steroids are and how they work. Steroids are a group of chemical compounds that play various physiological roles. Some steroids are naturally occurring (often as hormones), helping your organ tissues and cells do their jobs efficiently. You need a healthy balance of them to grow and maintain homeostasis. However, two types of man-made steroids come in the form of medications: corticosteroids and anabolic steroids.¹⁰ 

In their various forms, steroids work by interacting with the body's endocrine system, which regulates hormones. Anabolic steroids, for example, bind to androgen receptors in muscle cells, stimulating the production of proteins necessary for muscle growth and repair. This process, known as protein synthesis, increases the size and strength of skeletal muscles. 

Corticosteroids, like prednisone, are synthetic versions of cortisol (a hormone made by the adrenal glands) and act as anti-inflammatory agents by inhibiting the production of inflammatory chemicals in the body. Their primary purpose is alleviating inflammation and treating allergies, autoimmune diseases, joint pain, and inflammatory conditions. For both anabolic steroids and corticosteroids, these chemical compounds have targeted effects on the body's physiology, and their potential for side effects and consequences should be carefully considered before use.^4,10 

Do Steroids Make You Gain Weight?

Yes, steroids can make you gain weight, but the extent and nature of this weight gain depends on the type of steroid used. Anabolic steroids promote muscle growth by enhancing protein synthesis in the body. The increased production of proteins aids in building and repairing muscle tissue, leading to significant muscle gains. Therefore, anabolic steroids primarily contribute to weight gain by increasing lean muscle mass. 

On the other hand, corticosteroids like prednisone and dexamethasone exert their effects differently.¹² While they do not directly stimulate muscle growth, they can cause the body to retain water, resulting in a temporary increase in body weight. This weight gain is primarily due to fluid accumulation instead of increased muscle mass. Furthermore, both anabolic steroids and corticosteroids can lead to increased appetite, which, if not managed carefully, can lead to additional calorie intake and potential fat gain. Some steroids can also alter metabolism rates, the way the body uses and stores lipids, amino acids, protein, carbohydrates, and glucose. Therefore, both anabolic and corticosteroids have the potential to affect body weight, with the specific outcome varying based on a variety of factors.¹⁰ 

The factors contributing to the extra weight - whether fat, water, or muscle - include more than just the type of steroid you are taking. Here are just a few examples of specific factors that can affect the type and amount of weight gain you experience while taking steroids: 

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1. Type of Steroid: Anabolic steroids are much more likely to cause weight gain from increased muscle mass, whereas corticosteroids will cause weight gain from increased water retention.² It is also possible that different medications within each type will have more significant or milder effects on the amount of muscle you gain or the amount of water you retain.¹¹ 
2. Dosage and Duration: The dosage and duration of steroid use significantly impact the degree of weight gain. Higher doses and longer cycles tend to result in more substantial gains through muscle growth or water retention.¹
3. Genetics: Genetics can profoundly influence how an individual's body responds to steroids. Some individuals may be genetically predisposed to gain muscle and retain less water when using steroids, while others may experience the opposite.
4. Diet and Nutrition: Diet is a pivotal factor in the equation. Steroid users often increase their calorie intake to support muscle growth, but the composition of these calories is critical. A well-balanced diet with the right macronutrient proportions ensures that weight gain is primarily in the form of muscle and not fat.^3,9
5. Exercise Regimen: The type and intensity of exercise also play a vital role in the distribution of weight gain. Individuals who engage in structured resistance training routines are more likely to experience muscle gain compared to those who do not exercise or just focus on moderate-intensity cardio.