If you currently regularly exercise, then you’ll have to ramp it up even more (as if you were trying to build a muscular physique or six-pack) to offset the side-effects of the ADT.

You will very likely lose muscle (and strength) while on ADT, but weight gain depends on what you do to counter the change in metabolism that you’ll experience.

(I actually lost about 45 lbs and 3 belt sizes while on ADT.)

In this 2023 paper, they fully describe a study and the rigorous resistance-training program that they used and the outcome: https://journals.lww.com/acsm-msse/fulltext/2023/04000/resistance_exercise_training_increases_muscle_mass.2.aspx

We often hear about the physical benefits of exercise to minimize the side-effects of hormone therapy (https://m.youtube.com/watch).

Yes, weight management will be more of a challenge on ADT — maybe much more. Your body will metabolise food less efficiently, and you'll feel less like exercising, especially at first. There's a good chance you'll also develop more breast tissue (men already have some, but it isn't as prominent).

For food, avoid fad diets and just eat moderate portions with a lot of variety. Your grandparents' generation's rule to cover 1/2 of your plate with vegetables, 1/4 with a starch like potatoes or brown rice, and 1/4 with a high-protein source still works fine. Calcium and vitamin D supplements are strongly recommended in many credible sources to reduce bone-density loss.

For exercise, the important thing is to keep moving: if you used to run 10K, try walking 5K. If you used to walk 5K and can't now, walk 2K. If you used to bench press 100lb, try 50lb, or 40lb, or whatever, but just keep moving (except when you need a full recovery day; those will happen). Eventually, if you stick with it, things can start to improve. Compared to the treatments for many other kinds of cancer, ADT for prostate cancer isn't really all that bad.

I found that for me, the weight gain is dependent on me. I get on the scale every morning and eat based on what I weigh. I always eat breakfast, but I will skip lunch if I’m a little heavy.

I am 6’4” and like to weigh 189. I’ve been able to stay at that weight for about 25 years. Right now, I’m about 2 pounds above it, Driving me nuts, trying to lose those 2 pounds. On ADT for 8 years and never had a weight gain issue. If you get the munchies, find yourself something with almost no calories that you can eat.

I never had a belly before ADT but taking ADT causes your muscles to deteriorate and one of the main muscles it hits is the stomach muscle so that’s where the belly comes from, Not from eating more, it’s from losing muscular control.

If you are also on abiraterone, the prednisone you take with it may be a contributing factor. I gained 11 lbs. in the past year, most of it in my stomach and male boobs…

The message it’s loud and clear the ball it’s my court thanks for all the suggestions 🙂

Zzotte

Welcome ZZ. A bummer about your diagnosis, but my take is if we are fortunate to live long enough it will catch most of us. It is a challenge we can win. A good move to join this group. I have received nothing but positive and accurate information from the participants. My case is similar to yours. Diagnosed 2 years ago at 74 with stage 4 (after 8 months of missed diagnosis). 6 rounds of chemo and abiraterone and Lupron since. Side effects, yes, but the treatment is successful to date (clean scans the past 18 months) so I will take the trade off. I have been always physically active, 29 years in the military helped with that. Weight lifting, running and cycling. I gained about 8 pounds during the chemo (what appetitive loss??), then lost 18 with exercise and a sensible diet. I like to eat but fortunately have a wife who “helps” me with the diet. A good bit of the weight loss was muscle, that’s part of the ADT game. Keep up the exercise and be happy that you still can. Don’t expect the same weights on the bar that you had 10 years ago. (I use the machines so that I do not chase my old free weight numbers.) Do something every day. I find it helpful to exercise mid-afternoon when my “fatigue slumps” usually occur. And dogs are God’s gift. I have a Golden Retriever who gives me “that look” if it seems I am about to skip our daily walk. Again, this is a win-able challenge. Do your own research, do not hesitate to question your physicians (they are human). Keep up the exercise, even if you may not feel like it, watch the diet, and treasure your loved ones who are in support. Every new day is an adventure, let's see what it brings. GB

Saying a prayer for you Brother. Onward and upward!

I'm 73, 68" and 206, up from 191 during treatment. With Testosterone 0, metabolism slows and calorie consumption has to drop or weight rises. That, combined with stress eating and struggling while moving toward plant-based sugarless diet, are causing my weight gain. Weight/resistance exercises seem to be key in reducing muscle loss, and exercise helps combat fatigue.