Does MS Cause Weight Gain?

MS may indirectly lead to weight gain but carrying extra pounds isn’t a symptom of the disease itself.

People who live with multiple sclerosis (MS) may experience weight gain and wonder if it’s related to their disease, and if so, what can be done about it.

While multiple sclerosis weight gain can occur in some people, it’s not a direct symptom of MS. Rather, you may gain weight if your symptoms prevent you from getting regular exercise, or if you’re taking certain medications that can cause weight gain as a side effect.

You can take steps to help achieve a more optimal weight. Often, changes in diet and exercise can help, but if these have no effect, you may want to discuss changes to treatment with your doctor.

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Does MS cause weight gain?

MS can cause a variety of issues but weight gain is not a direct symptom of the disease.

However, there’s a high prevalence of weight problems among people with MS. One recent study found that 67% of people with MS had either overweight or obesity. If you’re living with MS and having a difficult time managing weight, you’re not alone.

While MS itself may not cause weight gain, some evidence suggests that the reverse may be true — that having obesity earlier in life puts a person at higher risk for developing MS later in life.

While researchers don’t yet know why this is, one area of research is focusing on the role of adipokines, molecules produced by fat tissue, which contribute to low grade inflammation. Certain types of adipokines appear to be present in higher levels among people with MS, suggesting a possible explanation for the link between obesity and MS.

Can MS affect metabolism?

There’s a link between your gut health and MS, but this doesn’t necessarily lead to weight gain or fluctuations.

The gut microbiome — a dynamic, complex group of microorganisms living in the gastrointestinal (GI) tract — is an important component in many aspects of human health. Numerous studies have shown that the gut microbiota and metabolic pathways in people with MS are different than in those without the disease.

In fact, certain changes that occur to a person’s gut microbiota may increase the risk of developing MS and may also predict disease severity. Researchers hope to discover more about the link between MS and metabolic processes, which may help lead to improved treatment and outcomes.

However, no studies to date have shown that MS affects metabolism in a way that influences weight.

Why is it so hard to lose weight with MS?

Losing weight is hard, and MS can make it harder.

For one thing, MS causes symptoms that can make weight gain more likely, such as:

• Fatigue: This can make it harder to find the energy you need to work out or engage in physical activities.
• Weakness: Nerve damage and lack of movement can lead to weakened muscles, making exercise more challenging.
• Movement issues: MS symptoms such as spasticity (muscle stiffness and unintentional movement) and poor balance can make it difficult to exercise.
• Pain: MS may cause pain, tingling, or numbness in different areas of the body. This can include the MS hug, a tight squeezing sensation around the abdomen or chest. Any sort of pain can make exercise unappealing.
• Sensory issues: Vision and balance problems may make it more challenging to get regular exercise.

MS can also cause depression, which can lead to weight gain or loss.

MS treatment may also lead to fluctuations in weight. Doctors often prescribe corticosteroids to reduce the severity of MS flares. Weight gain can be a side effect of corticosteroids, especially when they’re used long-term.

But even when they’re used for a relatively short term during a flare (typically a high dose for 5 days, then tapered for up to a few weeks), you can gain weight that can be hard to shed while you’re recovering from an MS exacerbation.

These combined effects can make it difficult to lose weight when living with MS.

In fact, a 2020 study showed that people living with MS were no more likely to adopt a healthy diet than people without MS — even though obesity can lead to worsening disease severity, relapse, and development of comorbid conditions (diseases that occur alongside another medical condition).

What are some tips for losing weight with MS?

It’s no surprise that the top recommendations involve making changes to what, how, and how much you eat, as well as increasing your activity level.

The American Heart Association suggests managing portion sizes to help prevent overeating. It also recommends making healthy food choices that keep you feeling full for longer periods of time, which can also help prevent overeating.

This may mean substituting low fat and low sugar versions of your favorite foods and upping the amount of fruits, vegetables, and whole grains you eat.

One of the most commonly recommended eating approaches for weight loss involves adhering to a Mediterranean-style diet, but other dietary approaches like a plant-based diet or intermittent fasting may also prove successful for you.

Exercise can also help with weight management. If you find that your symptoms prevent or discourage you from engaging in regular physical activity, try scheduling exercise for a time of day when your symptoms are not usually as severe, or when you have more energy.

Keep in mind that you may have good days where exercise is easier and bad days where you do not want to move. Do not forget to give yourself some grace when it comes to taking a day off from exercise because you can always get back to it tomorrow or the next day if needed.

The Centers for Disease Control and Prevention (CDC) suggests that a reasonable weight loss goal is between 1 and 2 pounds per week. In addition to diet and exercise, the CDC recommends to:

• Write out your reasons for weight loss: These might include improving MS symptoms, feeling better, or having increased energy. The act of writing these down helps you commit to your goals.
• Track what you’re currently eating: This can help you become more mindful and prevent mindless eating. It can also help you determine where you can make changes.
• Setting specific exercise goals: Such as walking 15 minutes a day, 5 days a week. Make it even more concrete by including where and when you’ll do it.
• Look to family and friends for support and motivation: Let them know your goals so they can encourage you when your commitment is waning. Researchers have suggested that social support may be a crucial component of weight loss with MS.
• Track and monitor your progress: And make adjustments to your goals as needed.

Working with a dietitian may also help. They can create a structured dietary plan to help you reach your goals and achieve overall health.

The takeaway

MS symptoms, as well as the steroids used to treat MS flares, can lead to weight gain.

Symptoms can make exercise more difficult, but you may be able to find times during the day when your energy levels are higher or your symptoms are not as bad.

If your symptoms seem to interfere with exercise on a regular basis, you may want to discuss this with your doctor, and ask whether changes to your treatment plan are a good option for you.

Likewise, if you suspect that your weight gain is due to medication, you can ask your doctor about alternatives.

You also may find that setting realistic goals, revisiting your motivation for weight loss, and engaging the support of family and friends — and possibly a dietitian — can help.