My Dr. Recently Started Me On Methotrexate And I Am Gaining Weight. No Matter How I Try To Diet I Am Always Starved. Is It This Medicine? I Have Seen Varying Opinions

Question

Asked by Peg

My Dr. Recently Started Me On Methotrexate And I Am Gaining Weight. No Matter How I Try To Diet I Am Always Starved. Is It This Medicine? I Have Seen Varying Opinions

Answer

normally, weight gain is not a common side effect with methotrexate, so there could be another couple of things going on. First, methotrexate can be hard on the stomach and in my personal experience, when this happens, it can be as if there's a giant hole where your stomach should be. It can feel like hunger, as if the hole can never be filled no matter what you eat. Check out my post on managing side effects for tips on handling the stomach issue (acidophilus can be especially helpful). If it helps a little, but not enough, talk to your doctor about medications like Losec, Pantoloc or Nexium. RA meds can be really hard on the stomach, so it's quite common for people who live with this illness to need something extra to protect the stomach.

the second reason could be that you're just simply hungry. When we are in a flare, it can cause loss of appetite and it could be that as you start to feel a bit better, your body is asking for fuel to help it heal and get strong again. Do your best to eat a balanced diet full of healthy foods, snack on fruits and vegetables, things that are rich in fiber such as hummus, whole grain, granola, etc. - fiber takes up more room in your stomach and can keep you full longer. You may also ask your doctor for referral to a dietitian or nutritionist who can help you put together of food plan that will work for you.

the last question is related to your comment about dieting. It's definitely a good idea to maintain a healthy weight when you have RA, because it's easier on your joints - when I interviewed Dr. White from The Arthritis Foundation, she mentioned that losing 1 pound takes 4 pounds of stress off your knee joints. However, the ideal weight these days as seen in magazines and on TV is actually underweight. Being a little more round is not necessarily a bad thing. Again, I would recommend you speak to your doctor about your weight and whether it's a good idea for you to diet at this moment.

Answered by Lene Andersen, MSW