Q: A dietician told me that steroids do not make you put on weight but what they do is increase the appetite, is there anything we people on steroids can take to decrease the appetite which would then help with the weight problem which so many Addisonians have.

A: It is vital to distinguish between the administration of steroids for disease involving inflammation on the one hand and the use of steroids as replacement therapy for adrenal insufficiency. It is only when steroids are used in doses that exceed that which the body normally produces and which are used for treatment of inflammatory disease that appetite and weight may increase. Properly arranged steroid replacement therapy for hormone deficiency disease involving lack of adrenal steroid production exposes the tissues to no more steroid than that which they would normally see in a healthy person. Therefore they do not increase appetite of weight. Weight gain in these circumstances is due to other effects usually over eating.