Sjögren’s Syndrome (SS) is a chronic autoimmune disorder where the immune system attacks the body’s moisture-producing glands, primarily the salivary and lacrimal glands, leading to persistent dryness of the eyes and mouth. This condition is also systemic, affecting other organs and systems throughout the body, causing symptoms like joint pain, fatigue, and organ inflammation. Many people living with Sjögren’s report experiencing weight gain. While Sjögren’s does not directly cause weight gain like some endocrine disorders, its underlying mechanisms and the common treatments used to manage it can significantly alter metabolism and lifestyle in ways that promote weight gain.
The Link Between Sjögren’s, Inflammation, and Metabolism
The weight changes observed in Sjögren’s patients are often linked to the chronic systemic inflammation inherent in the disease. The immune system’s persistent activity generates pro-inflammatory cytokines, which are signaling proteins that circulate throughout the body. These cytokines can interfere with the normal regulation of metabolic processes and hormone signaling.
Chronic inflammation disrupts the body’s sensitivity to insulin, leading to insulin resistance, a condition where cells do not respond effectively to the insulin hormone. This resistance promotes the storage of excess glucose as fat, contributing to weight gain, and is associated with a higher frequency of metabolic syndrome in Sjögren’s patients compared to the general population. Furthermore, the inflammatory state can influence hormones that control appetite, such as leptin. Inflammation can lead to leptin resistance, meaning the brain does not register the fullness signal, which may result in increased food intake.
Weight Changes Caused by Medication and Lifestyle Adjustments
The most common and direct cause of weight gain for individuals managing Sjögren’s is the medication used to control disease activity. Corticosteroids, such as prednisone, are often prescribed during flares or for managing systemic complications. These potent anti-inflammatory drugs are well-known to promote weight gain by increasing appetite and causing the body to retain fluid.
Steroid use can also redistribute fat tissue, leading to increased fat storage around the abdomen and face. Even certain immunosuppressants can have metabolic side effects. The goal is always to use the lowest effective dose for the shortest duration possible to minimize these side effects.
Beyond medication, the daily symptoms of Sjögren’s significantly alter physical activity and dietary habits. Chronic fatigue and joint pain (arthralgia) are common and can be highly debilitating, leading to a substantial reduction in energy expenditure. When daily activities become a struggle, physical exercise is often limited, creating a caloric imbalance that favors weight gain.
The profound dryness of the mouth, known as xerostomia, can also indirectly affect diet. Patients may gravitate toward softer, easier-to-swallow foods, which are often processed, higher in calories, and lower in nutritional density.
Associated Autoimmune Conditions That Promote Weight Gain
Sjögren’s Syndrome frequently co-occurs with other autoimmune disorders, a phenomenon known as an overlapping disease. These secondary conditions may independently cause weight gain, leading to a mistaken assumption that the weight change is solely due to Sjögren’s. The most common overlap is with autoimmune thyroid diseases, particularly Hashimoto’s thyroiditis.
Hashimoto’s thyroiditis causes the immune system to attack the thyroid gland, resulting in an underactive thyroid (hypothyroidism). Since the thyroid hormones regulate metabolism, a slowdown in function can lead to symptoms like mild weight gain, fatigue, and cold intolerance. Individuals with Sjögren’s are at a higher risk of developing Hashimoto’s than the general population. Other conditions like systemic lupus erythematosus (Lupus) and rheumatoid arthritis also frequently overlap with Sjögren’s. This complex interplay of multiple conditions often requires careful diagnosis to determine the true source of any weight change.