Gaining weight during cancer treatment (or any other chronic disease treatment) is something that is not often talked about or even associated with managing an illness. Most people think about undesired weight loss when it comes to treatment. Weight gain or weight loss is possible in treatment for chronic diseases like cancer, autoimmune diseases or even long COVID. However, medication-related weight gain is actually a really common side effect that I help a lot of people with in my practice, so I want to explore it with you a little more.
Receiving a cancer or other chronic disease diagnosis is a life-changing experience which means dietary habits might be the last thing on your mind at first. Treatment for cancer and chronic diseases varies from person to person, requiring an individualized approach. For some, certain chemotherapy treatments or steroid medications can cause major changes in appetite and weight. These changes might include constantly feeling hungry, feeling nauseous without food in your stomach, or even changes in taste to prefer sweets or other carbohydrate rich foods. What I find is that people come to my team and I when they’re ready for guidance once treatment has been decided on. It’s important not to wait too long to get a dietitian on your care team! Weight change issues are best caught early and often require an expert partnership to navigate without doing damage to your relationship to food or your body.
Cancer treatments cause side effects, but weight gain is not often addressed as one of them – in my experience. While a change in appetite is common, cancer and other chronic condition treatments can also cause extreme fatigue leading to inactivity and ultimately weight gain. It’s important to remember that restricting your diet, cutting calories, fasting, or making dramatic changes to your diet with a new cancer or chronic disease diagnosis is not always the right answer. Gaining weight during cancer or chronic disease treatment can be navigated – and some of this may include body acceptance. Besides accepting some changes in your body during treatment, there are diet and lifestyle adjustments that can be helpful to support your health during this time.
Cravings for carbohydrates and sweets
Going through cancer treatment/chronic disease treatment is hard, and it can be made even more challenging if you are not aware of what your body needs. Cravings for certain foods can indicate a need. If you find yourself craving that piece of chocolate cake or ice cream, think about what that craving may indicate; do you need more energy, more calories or maybe some comfort? This is where mindful eating can offer some help. Mindful eating involves being in tune with your body and listening to hunger cues. That can get a bit skewed when steroids, medications and chemo are involved. But, this can actually be a great time to consider what your body wants, what it needs and to let go of the “good” and the “bad” labels around foods. If you want an incredible resource for mindful and intuitive eating, one of my favorite podcasts is dietitian run Food Psych®. I hope this is a helpful resource for you!
The goal of nutrition during treatment is to find balance. There may be times during treatment it is almost impossible to eat at all, and you may just need to eat what you’re able to. There may be other times you can eat nutrient rich, healthy options. It’s also possible to have cravings for foods like french fries, ice cream or baked goods. It can be helpful during cravings to find foods that sound satisfying and also have supportive benefits like fiber, vitamins, minerals, and antioxidants. If you find yourself craving something sweet you might consider trying my Vegan Banana Chocolate Shake Treat or my Chocolate Chia Seed Pudding. They can satisfy your sweet tooth while filling you up with fiber, antioxidants, healthy fats, and protein.
Focusing on complex carbohydrates is a good idea for your health and when it comes to cancer and chronic diseases. Consuming a variety of fresh fruits, whole grains, beans, and lentils can help boost energy levels (great article on that here!) due to the longer time it takes to break them down compared to simple carbohydrates. These sources of high quality carbohydrates also provide an excellent source of vitamins and minerals, fiber, and B vitamins that help with energy, gut health and much more. Putting the focus on adding nutrients rather than cutting out foods can make a big difference in how you see food and how you feel.
Creating a balanced plate
For some, weight gain is a completely normal cancer or chronic disease treatment side effect but to see your body change in any way can be challenging. You’re already going through so many changes that sudden weight loss or gain can make your body not quite feel like itself. An easy way to create meals and snacks that will help you maximize nutrient rich foods and help you stay satiated is to use the “Plate Method”.
The idea of this balanced plate is to divide your plate into sections. One half of the plate is entirely filled with non starchy vegetables. These vegetables include spinach, brussel sprouts, peppers, mushrooms, leafy greens, asparagus, tomatoes just to name a few. The other half of your plate is then further divided in half making two ¼ sections. One of these quarters is for a protein source; this can be any source of protein whether it be plant or animal based – tofu, beans, chicken, lentils, tempeh, or even eggs can all be included in this section. The remaining ¼ section is starch or high quality carbohydrates. You might consider including a whole grain bread, ½ cup of potatoes, pasta, quinoa, or brown rice. This method also includes healthy fats as a side, think avocado and dressing on the veggies, olive oil to dip the whole grain bread in or some sunflower seeds to add some crunch.
The possibilities are endless with this method, but it allows you to plan meals around the three macronutrients – protein, fat and a source of carbohydrates. With half the plate being entirely vegetables, it provides you a power source of nutrients packed with vitamins and minerals and plenty of fiber! Making sure you have all these components at meals will help ensure they are full of nutrition and keep you feeling satisfied in between meals. Another bonus is that eating balanced meals can help reduce cravings.
Another suggestion for navigating weight changes with treatment is to consume smaller, more frequent meals during the day if your hunger has kicked up due to treatment or medications. Try eating 4 – 5 smaller meals throughout the day to keep blood sugar levels and hunger hormones steady which can help reduce cravings at night by ensuring you are getting adequate calories during the day.
If smaller, more frequent meals are not right for you then consider including more sources of protein with your snacks. For a snack pairing an apple with a nut butter is a great way to include a high quality carbohydrate and a source of protein. Pairing protein with carbs is a great way to avoid huge spikes in blood sugar that might cause you to crash later in the day.
If you’re drawn to fasting or intermittent fasting, I’ve got a newly updated post for you here. I’m not a fan of long fasts as I see it often working against my clients but an overnight fast may be a consideration for you. If you stop by that blog, definitely leave me a message and let me know what you think and if you have any questions.
Exercise and your weight
Fatigue is a common side effect of treatment and chronic diseases making it difficult to get up and move around. This level of inactivity can lead to changes in weight, especially when they’re already being fueled by treatment or medications, such as steroids. If possible, I would suggest walking as an alternative form of exercise if you’re cleared by your medical team. Walking is a totally acceptable form of exercise because it gets the body up and moving and your heart rate elevated.
To start walking daily, you might consider starting slowly and building yourself up. Start with 10 minutes after each meal and aim for 30 minutes per day of walking. If you find your endurance and energy levels building then slowly start increasing to 45 minutes or even an hour! The American Heart Association recommends adults aim for 150 minutes of moderate physical activity each week or 75 minutes of vigorous activity. By starting slowly and building up each day, you will be helping to manage your weight and improve your energy levels. Exercise can make dramatic changes in your mood, sleep patterns, dietary habits, and treatment.
What you need to know about cancer weight gain
Undergoing cancer and/or chronic disease treatment is a life altering event that requires so many changes in your daily life. These changes also extend to the diet and lifestyle with a major emphasis on proper nutrition and moderate exercise. Treatment is not the best time to try a popular fad diet or completely change your eating habits. Sometimes, treatment may make it hard to even eat at all. Eating a well-balanced diet and one that you enjoy is what matters the most during this time. Move as you can – and walking can be the best bet for you. I encourage you to listen to your body and indulge your sweet tooth from time to time. Let go of restrictions and rules and create new habits for yourself now.
Weight gain can sometimes be inevitable with the treatment or type of treatment involved, but weight can be managed through the diet and lifestyle in many ways. You may be living in a different kind of body but remember: all bodies are wonderful. Consider trying intuitive eating and listening to your hunger cues. The balanced plate is another great tool to try as it increases the amount of vegetables in your diet while also maintaining and eating balanced meals. Whatever suggestion you try is up to you and how your body is feeling. All of these suggestions are meant to support a healthy eating pattern that allows for weight management and satisfaction of appetite. Gaining weight might be a new and challenging journey, but it can be so much easier by making just a few simple dietary changes.