Does Humira Cause Weight Gain?

Weight gain is not a recognized side effect of Humira. But research and patient experiences suggest this isn’t the full story.

It can be difficult when your experience with a medication is different from clinical expectations.

As a nurse practitioner and someone living with rheumatoid arthritis (RA), I know that medications don’t always work and might have side effects that you’re not expecting.

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What is Humira?

Humira is the brand name of a biologic medication. Its active ingredient is adalimumab.

There are different types of biologics, and Humira is classified as a tumor necrosis factor (TNF) inhibitor.

People living with RA often have too much TNF in their joints, which can lead to inflammation and pain. Humira can be used to treat RA and other inflammatory and autoimmune conditions.

Can Humira cause weight gain?

The simple answer is no. According to the information provided by the manufacturer, weight gain or weight loss is not a side effect of Humira.

But there are some reported side effects of Humira that could affect your weight. Side effects such as serious infections and gastrointestinal symptoms could contribute to weight loss from associated nausea and reduced calorie intake.

Heart failure is also a documented side effect of Humira, which can cause a rapid increase in weight from fluid retention.

Is this the whole story?

Despite weight gain not being recognized as a side effect, it has been reported by people taking Humira.

Dr. Irwin Lim, a rheumatologist of BJC Health in Australia, started noticing that some of his patients using TNF inhibitors like Humira reported weight gain that was not linked to any other recognized side effects.

Although it did not happen to all of his patients, it happened enough for him to post a blog in 2013.

After the interest in his initial blog, he posted a reply including some evidence-based literature that shows how TNF inhibitors can lead to an increase in weight, BMI, and abdominal adipose tissue.

This wasn’t only reported by people with RA using TNF inhibitors. People with other inflammatory conditions, such as psoriasis, psoriatic arthritis, and spondyloarthritis, also reported weight gain.

For example, one study from 2012 found that weight gain was associated with TNF inhibitor use and may even be a reason for discontinuing therapy.

Still unclear to Dr. Irwin Lim and other researchers is why weight gain did not happen to all patients on this same treatment.

A more recent 2020 research review suggests that TNF inhibitors can lead to increased body weight and body mass index (BMI), even stating this “as a potential side effect.”

A study published in 2022 looked at any reports of drug-induced weight gain in the FDA Adverse Event Reporting System (FAERS) between 2012 and 2021. FAERS allows anyone to report the side effects of a drug once it’s already gone to market.

The second most common drug reported by patients associated with weight gain was adalimumab, the active ingredient of Humira.

Of the 137,370 total reports about weight gain, 3.94% of them were about adalimumab. While still a small number, it was enough for the study to conclude that “drug-induced weight gain is a common side effect of several medications frequently used to treat chronic diseases.”

A patient experience of weight gain while using Humira

In 2016, Lene Anderson posted a blog about her experience with Humira and weight gain.

Interestingly, she previously lost weight while using a different TNF inhibitor called Enbrel. But while using Humira, her experience changed:

“When I switched to Humira, I started gaining weight. I, who had never before spent much time past a size 6, became a 10. After years of being literally skin and bones, it suited me just fine. And then the gaining continued, until finally settling around a weight that requires a 16 pant.”

Reflecting on this past experience, Lene said: “It is extremely frustrating to not lose weight despite eating a largely healthy diet. It is also extremely frustrating when you cut down on certain things within that diet to not see your weight budge at all. And it is beyond frustrating when your disability and chronic pain levels prevent you from exercising.”

What are the reported side effects of Humira?

According to the manufacturer, common side effects of Humira include:

• injection site reactions, including pain, redness, rash, swelling, itching, or bruising
• upper respiratory infections (aka sinus infections)
• headaches
• rash
• nausea

Rare but serious side effects of Humira include:

• serious infections
• hepatitis B in carriers of the virus
• allergic reactions
• nervous system issues
• blood issues (for example, decreased blood cells that help fight infections or stop bleeding)
• heart failure (new or worsening)
• immune reactions, including a lupus-like syndrome
• liver problems
• psoriasis (new or worsening)

These are not all the possible side effects of Humira. Be sure to tell your doctor right away if you have any new symptoms that occur while using Humira.

Tips for weight management

There are a number of reasons why managing your weight can be difficult when living with RA. Movement and exercise can be difficult when you’re fatigued and in pain. And your medication might be contributing to changes in your weight, which are out of your control.

It’s not always easy, and I know I’ve struggled. But here are five tips that can help you maintain your weight:

1. Follow a Mediterranean diet full of nutrient-dense foods to help you maintain a healthy weight for your body and even help your arthritis.
2. Increase your fiber intake to help you feel full for longer. Supplements can be a good option if you can’t get enough fiber in your foods.
3. Minimize processed and fried foods. These tend to be high in saturated fats and low in nutritional content.
4. Make sure you stay hydrated with water. This has many benefits, such as improving energy levels.
5. Move whenever you can, however you can. Learn to listen to your body and do what’s best for you. Ever heard of “exercise snacking”? It refers to breaking up your workouts into bite-sized bouts. When my pain is bad, or I don’t have time for a workout, I do laps around my kitchen island!

The takeaway

Weight gain is not a side effect of Humira, according to the manufacturer. But some research and patient experiences suggest that weight gain and changes in body composition — especially around the abdomen — can occur while using Humira and other TNF inhibitors.

There may also be side effects that the manufacturer does recognize that could lead to changes in weight, both weight loss and weight gain.

If you have unexplained weight loss or weight gain while taking Humira, you should tell your doctor right away so you can discuss treatment options and evaluate your symptoms.

*All quotes were shared with permission.