Set Back

Medication weight gain is usually caused by one of:

1. Increased appetite;
2. Water retention;
3. Fatigue, possibly subtle, so we move less and burn fewer calories;
4. Negative effects on sleep quality, also triggering fatigue.

Steroids in particular are associated with water retention, which can be surprisingly large. (I'm not saying other factors don't apply with steroids, just that water retention can be especially dramatic.)

Do you expect to need to continue the steroid permanently? If not, anything that is water weight should drop off on its own when you discontinue the steroid, though the time period may vary. (I took steroids temporarily during cancer treatment.)

Calorie counting can help identify increased appetite, but that doesn't mean it will be easy to manage. I suspect finding the most sating possible eating routine is about the best one can do. If eating quite a few highly processed/refined foods, shifting to more so-called whole foods may help satiation, with the small bonus that whole foods (and protein) may take a few more calories to digest/metabolize so that we net slightly fewer calories on the intake side, but that effect is small.

Sleep problems may be able to be identified and improved symptomatically, but that's also pretty individual, in my experience. I didn't particularly have a stimulant effect from steroids (maybe because the chemo had me so depleted), but some of my friends have said steroids interfered with their sleep. If that's a factor for you, talking with your doctor about it would be a good step to include.

Fatigue is tough. Obviously, we can strive to move more (in daily life, not just exercise), but there are limits when in the face of fatigue. It may be necessary to lower calories beyond the level that previously worked, but it's probably good to be gradual/cautious in doing that, since - obviously - getting too few calories can also increase fatigue. Getting overall good nutrition can possibly mitigate fatigue a little, if it's been a bit sub-par beforehand, but that's a small-returns investment, possibly, too.

There's a thread here where lots of MFP-ers share their strategies for increasing daily life (non-exercise) activity:

http://community.myfitnesspal.com/en/discussion/10610953/neat-improvement-strategies-to-improve-weight-loss/p1

Not all of those ideas will work for everyone, but perhaps some can.

If you lost muscle mass while ill, building that back up may help, but that's an inherently slow process in itself.

I know that (stuff above) isn't very satisfying or helpful, but it's all the ideas I have from my experiences (with drugs and hypothyroidism, which has some of those same 1-4 effects).

I hope you're able to find improvement!

How much longer do you have to be on the steroids?

Sorry to hear of your injury. Hope you're all healed up soon.

While regular, vigorous exercise is great health-wise, it's important to not rely on it to maintain our weight, simply because of this reason. Any injury or health issue can keep us from exercising and then weight is gained back.

Also, multiple meds and their many side effects are frustrating for sure! Hope you can get back to normal soon.