Dr. David L. Katz
Photo: Mackenzie Stroh
Q: I have a condition that requires me to take corticosteroids, which seem to have increased my appetite overall and for sweets in particular. Any advice on how to cut the cravings and decrease my appetite?
— LaDora Bradford, Vancouver, Washington

A: Corticosteroids are based on the adrenal hormone cortisol. The medication works wonders in reducing inflammation, which is why it's so widely prescribed. But chronically elevated levels of cortisol—from medication, or from stress, which drives up this hormone—can increase appetite and trigger weight gain. If stopping the medication isn't an option, check with your doctor to be sure you're taking the lowest effective dose. (Long-term use of corticosteroids can also leave you at increased risk of osteoporosis.) After taking this step, try dietary strategies to minimize the undesirable effects of the drug.

Scientific literature suggests that the flavor of sweet has addictive properties, meaning the more we eat, the more we crave. The best way to blunt this is to cut off the supply. That doesn't necessarily mean giving up dessert; much of the sweet stuff in your diet is coming from other sources.

There is sugar in the form of high-fructose corn syrup added to many foods we wouldn't ordinarily think of as sweet: bread, crackers, chips, salad dressing, and pasta sauce, to name a few. Check the ingredients in these foods, and avoid the ones that contain high-fructose corn syrup, dextrose, invert sugar, honey, corn syrup, molasses, and, of course, sugar.

I don't recommend turning to artificial sweeteners, either. They may be calorie-free, but they can still spur a sweet tooth. The diet soda you drink now may be the reason you have an irresistible craving for a sugary treat later on. Water is the preferred drink on most occasions.

If you bake or cook, experiment with ingredients so that you can reduce sugar. Based on a lot of trials in the Katz family kitchen, my wife, Catherine, and I don't think it's necessary to add the salt that dessert recipes call for, and skipping the salt will mean you can add less sugar. Next try replacing some of the sugar with fat-free powdered milk. Lactose—milk sugar—provides the bulk and consistency of the regular stuff but reduces total sweetness and calories, while adding protein and calcium. Start out by substituting a fraction of powdered milk for sugar, and then slowly increase the ratio as your sweet threshold subsides.

Once your taste buds get a break from sweetness, they'll be much more sensitive to the taste and easier to satisfy.
As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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