Humira and Weight Changes: What You Need to Know

Humira (adalimumab) is a biologic medication used to treat various autoimmune diseases. While the manufacturer doesn't list weight gain or weight loss as direct side effects in the product labeling, changes in weight can occur for several reasons while taking this medication. This article explores the potential links between Humira and weight changes, examining the reasons behind these fluctuations and offering guidance on how to manage them.

Understanding Humira

Humira is a biologic Tumor Necrosis Factor (TNF) alpha inhibitor administered via injection. Biologic medications are derived from living organisms. The active ingredient in Humira is adalimumab. It is prescribed to treat autoimmune diseases where inflammation leads to symptoms. These conditions include:

• Rheumatoid arthritis (RA)
• Juvenile idiopathic arthritis (JIA)
• Psoriatic arthritis (PsA)
• Ankylosing spondylitis (AS)
• Crohn’s disease
• Ulcerative colitis (UC)
• Plaque psoriasis
• Hidradenitis suppurativa (HS)
• Uveitis

Humira works by targeting a protein in the body called tumor necrosis factor (TNF), which increases inflammation. By blocking TNF, Humira can help reduce the symptoms and progression of these autoimmune diseases. Biosimilar versions of Humira, such as Amjevita and Cyltezo, are also available and considered as safe and effective as the brand-name drug, often at a lower cost.

Does Humira Cause Weight Gain or Weight Loss?

According to the manufacturer, Humira doesn't directly cause weight gain or weight loss. However, there are several indirect ways Humira and related treatments can influence your weight.

Potential Causes of Weight Gain

• Improved Appetite: When inflammation and pain are controlled with Humira, you may feel better and your appetite may return, potentially leading to weight gain. This typically happens slowly over time.
• Concomitant Medications: Humira is often used with other medications like corticosteroids (prednisone) or nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen or ibuprofen. These medications can cause fluid retention and weight gain.
• Congestive Heart Failure (CHF): Although rare, cases of congestive heart failure (CHF) have been reported with Humira use. CHF can lead to fluid retention, causing weight gain.
• Return of Appetite After RA Treatment: When RA first starts, a lot of folks lose weight because active untreated RA suppresses the appetite. Once treated, the appetite returns and RA patients can gain the weight back.

Potential Causes of Weight Loss

• Infections: TNF blockers affect the immune system, potentially increasing the risk of infections. Infections can lead to a loss of appetite and subsequent weight loss.
• Gastrointestinal Side Effects: Some gastrointestinal side effects, such as nausea, vomiting, and abdominal pain, can lead to short-term weight loss.
• Lymphoma: Although rare, cancers like lymphomas have been reported with TNF blockers. Lymphoma can lead to weight loss.
• Liver Problems: Liver problems can occur in people who use TNF-blocker medicines like Humira and might affect your weight. These problems can be serious and may lead to liver failure and death.

Research and Patient Experiences

While weight gain is not listed as a direct side effect, some research and patient reports suggest a link between Humira and weight changes.

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• A study examining people taking TNF-suppressing medication found that around 13% of patients experienced weight gain, with an average increase of just over 12 lb.
• A retrospective study that followed 168 people with rheumatoid arthritis taking TNF-suppressing drugs also found that more than 60% of the participants gained weight after 2 years.
• In a 2012 study, after 24 months of therapy, there was an increase of weight only in patients treated with the TNF blockers. The mean weight change after 12 months of treatment was a 1.58 kg (3.5 lb) gain and after 24 months was a 1.80 kg (4 lb) gain.

However, it's important to note that not everyone gains weight on Humira, and some studies show no weight changes among participants.

Managing Weight Changes While on Humira

If you experience weight changes while taking Humira, here are some steps you can take:

• Consult Your Doctor: Discuss any unexplained weight gain or loss with your doctor. They can help determine the cause and recommend appropriate management strategies.
• Exercise Regularly: Engage in an effective and safe exercise regimen to combat weight gain due to increased appetite.
• Maintain a Healthy Diet: Focus on a balanced diet to manage your weight and overall health.
• Monitor for Fluid Retention: If you experience swelling in your legs, ankles, or feet, rapid weight gain, shortness of breath, or swelling in your stomach, contact your doctor immediately, as these could be signs of CHF.

Lifestyle Changes to Support a Healthy Weight

In addition to medical interventions, lifestyle changes can play a significant role in managing your weight and autoimmune condition:

1. Movement: Regular exercise can help with weight management, reduce inflammation, and improve physical function. Aim for gentle activities like walking, yoga, or Pilates, and gradually increase intensity as you feel stronger.
2. Nutrition: Focus on anti-inflammatory foods such as omega-3-rich fatty fish, leafy greens, nuts, and seeds. Consider an elimination diet, like the autoimmune protocol (AIP), to identify food sensitivities that may worsen symptoms.
3. Stress Management: High stress levels can exacerbate autoimmune symptoms and contribute to weight gain. Practice stress-reducing activities like meditation, journaling, or spending time in nature.
4. Gut Support: Prioritize gut health by incorporating fiber-rich and probiotic-rich foods into your diet. Address any gut inflammation through diet and lifestyle adjustments.
5. Sleep: Aim for 7-9 hours of quality sleep each night to support your immune system, metabolism, and nutrient processing.

Other Important Considerations

• Side Effects: Be aware of the potential side effects of Humira, including serious infections, allergic reactions, and liver problems.
• Precautions: Discuss your health history with your doctor before starting Humira, especially if you have a history of hepatitis B, tuberculosis, heart failure, or nervous system problems.
• Pregnancy and Breastfeeding: If you are pregnant or breastfeeding, talk with your doctor about the benefits and risks of Humira treatment.
• Drug Interactions: Inform your doctor about all medications, vitamins, and supplements you are taking to avoid potential interactions.

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