Is weight gain a common side effect of Melanoma treatment? How can it be managed?

Weight changes can happen during melanoma treatment, and some people may gain weight while others may lose weight. ^[1] Weight gain can be linked to lower activity from fatigue, increased intake of sugary drinks or comfort foods, and changes in metabolism. ^[1] In addition, certain melanoma therapies can affect hormone glands like the thyroid, pituitary, or adrenal glands, which may lead to weight changes that need medical attention. ^[2] Targeted therapies and immunotherapies often include patient guidance to report recent weight loss or gain and seek dietitian support, reflecting that weight change is recognized during treatment. ^{[3] [4]} Weight changes are specifically noted among the possible effects when receiving combinations like ipilimumab plus nivolumab. ^[5]

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Why weight gain can happen

• Fatigue and activity drop: Feeling very tired during treatment can reduce daily movement, so you burn fewer calories. ^[1]
• Diet shifts: Some people increase carbohydrates or sugary drinks to manage nausea, which can add calories. ^[1]
• Hormonal changes (endocrine effects): Checkpoint inhibitors (such as pembrolizumab and nivolumab) can inflame the thyroid, pituitary, or adrenal glands, causing symptoms like changes in weight, mood, and energy; these require evaluation and sometimes hormone treatment. ^{[2] [6]}
• Steroid use: Short courses of corticosteroids are sometimes used to treat immune-related side effects; steroids can lead to fluid retention and increased appetite, which may contribute to weight gain. ^[7]

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When weight gain needs medical evaluation

• Rapid or “big” weight gain: Sudden increases can signal fluid retention or other treatment-related issues and should be reported promptly. ^{[6] [2]}
• Symptoms of hormone problems: Feeling unusually cold, very tired, changes in mood, deeper voice, constipation, or hair loss can suggest thyroid, pituitary, or adrenal involvement and deserve prompt testing and care. ^[2]
• Associated signs: If weight gain is accompanied by swelling, decreased urine, or shortness of breath, tell your care team immediately. ^{[6] [2]}

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Practical ways to prevent or manage weight gain

• Balanced plate and portion control: Aim for a well‑balanced diet with mindful portions to avoid extra calories during treatment. ^[8]
• Regular, gentle exercise: Consistent physical activity helps maintain weight and energy; choose activities that feel safe in your current condition. ^[8]
• Limit sugary beverages: Reducing juices and high‑sugar drinks can steadily cut excess calories. ^[1]
• Plan small, regular meals: If appetite fluctuates, smaller scheduled meals can help manage intake without overeating. ^[9]
• Work with a dietitian: If you notice recent weight gain or have diet questions, asking for a dietitian referral is encouraged during melanoma therapies. ^{[3] [4]}
• Track symptoms: Keep a simple log of weight, fatigue, and any new symptoms; bring it to visits so your team can adjust care, including checking thyroid and adrenal function if needed. ^[2]

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Treatment‑specific notes

• Checkpoint inhibitors (pembrolizumab, nivolumab): These medications can cause endocrine issues affecting weight; report significant weight changes and related symptoms promptly. ^{[2] [6]}
• Combination immunotherapy (ipilimumab + nivolumab): Patient materials include weight changes among potential effects, highlighting the need to monitor and manage early. ^[5]
• Targeted therapy (BRAF/MEK inhibitors like vemurafenib, binimetinib + encorafenib): Guidance encourages discussing recent weight loss or gain and getting dietitian help. ^{[3] [4]}

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What your care team may do

• Screen for endocrine side effects: Clinicians often check thyroid‑stimulating hormone (TSH), cortisol, and other labs if weight change and systemic symptoms appear. ^[2]
• Adjust medications: If steroid therapy is necessary for managing immune‑related side effects, teams balance dose and duration to limit steroid‑related weight gain. ^[7]
• Provide supportive care: Nutrition counseling and safe activity plans help maintain a healthy weight during treatment. ^[8]

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Key takeaways

• Weight gain can occur during melanoma treatment, often due to fatigue, diet changes, and hormonal effects from immunotherapy, and sometimes from steroid use. ^{[1] [2] [7]}
• Significant or rapid weight gain should be reported, especially when accompanied by symptoms suggesting endocrine or fluid retention issues. ^{[6] [2]}
• A balanced diet, regular exercise, limiting sugary drinks, and early input from a dietitian are practical steps to manage weight. ^{[1] [8] [3] [4]}

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