ON the May Day Bank Holiday 2026, I was admitted to A&E following the crescendo of a sudden flare up of my Crohn's Disease. The medicine that I had been on for 3½ years had been silently failing to work for a good few months. I'd been at the final house viewing of a property that I was in the process of buying when my body developed a 40°C fever complete with rigors and stomach cramping so strong that it made me feel as if I'd just been in the octagon at the UFC.
Facing the expected battle with the NHS triage system head-on, I was finally seen by an urgent GP following the loopholes of 111 & A&E who very thoroughly examined me and came to the conclusion that I was indeed experiencing a flare and my body's inflammation mechanisms had gone into overdrive. He therefore prescribed the standard broad-spectrum antibiotics to fight off any potential infection along with Buscopan to relax the gut muscles as well as the staple corticosteroid: Prednisolone.
Corticosteroids are probably the most common form of steroid. Most people, including myself, make the mistake of assuming that steroid = bodybuilder drug. As I learned, this was so far from the truth that it can indeed be the complete opposite. Prednisolone is commonly prescribed for Crohn's flares as it broadly suppresses the immune system and does so quickly. A flare of Crohn's Disease can see the immune system go into overdrive so much so that it begins damaging perfectly healthy parts of the body, so the Prednisolone is often prescribed in order to suppress the immune response whilst secondary investigations & treatments can occur.
Once I was sent home, I was told to take Prednisolone 4 times a day for 1 week, 3 times a day for the second week, 2 times a day for the third week, and then 1 time a day until I had no pills left. The reason the drug is tapered off in the way it is, is due to the fact that your adrenal glands reduce their own production whilst you're on the drug — so you need to restore the balance gradually rather than risk zero cortisol production at all.
Thankfully, my symptoms began to settle within a couple of days and I was feeling better. However, within a couple of weeks of taking the pills I'd started to notice significant changes in the mirror. My face had become rounder and looser, and my belly had become plumper. As I started to notice these frankly rapid changes to my appearance, I also started to realise the amount I'd been eating alongside this. Initially, I'd just assumed I was making up for the food I was unable to eat during the flare alongside my common response to any kind of stress: gluttony. However, after some very quick research I discovered the by-product of Prednisolone: it makes you fat, and quickly.
A quick Google search and I'd discovered the frankly ridiculous phenomenon of Moon Face. A medically recognised side-effect of the drug that causes fat deposits in your body to be unevenly redistributed to the sides of your face. Making you appear swollen and round as if you'd just eaten a bee. This was particularly alarming to me as someone who, leading up to the flare, had been gaunt and also had been maintaining a severely consistent weight for over 3 years.
In addition to Moon Face, it's also known that the second-most common side effect of Prednisolone is weight gain in general. The drug suppresses the signals in your brain that make you feel full, meaning your appetite is significantly increased. The drug also results in increased fluid retention. So, in summary, being on the drug results in you facing a holy trifecta of lard-arse-itis — and it's most likely that you will gain weight on this drug.
For someone who has always been slightly underweight for their stature, age & BMI, discovering the side effects was quite a shock. The doctor hadn't warned me of any of them — and to be honest, that is probably for the best. It's better to be fat than to have your immune system eating away at your bowels. However, it is quite a humbling experience reaching a level of fatness you've never experienced before, and it being completely out of your control. With all of the hype surrounding GLP-1 weight loss drugs like Ozempic, it's quite something to be on a drug that has the exact opposite intended effect.
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