When you’re living with a chronic condition, finding the right treatment makes a huge difference in your day-to-day life. Still, most medications, as beneficial as they can be, come with trade-offs—including potential side effects that take some getting used to. That’s something Selena Gomez has faced publicly for years.
The 30-year-old singer has lupus, an autoimmune condition that causes chronic inflammation in many parts of the body, like the skin, joints, heart, kidneys, lungs, and more. This leads to a spectrum of symptoms and possible complications, like persistent pain, overwhelming fatigue, skin rashes, frequent fevers, kidney damage, heart problems, and mental health disorders like depression, among others.
Though her health is nobody’s business, Gomez has been open about her condition and how it affects her physically and emotionally. “My lupus, my kidney transplant, chemotherapy, having a mental illness, going through very public heartbreaks—these were all things that honestly should have taken me down,” she told Elle in 2021. But she would think to herself: “‘You’re going to help people,’” she recalled. “That’s really what kept me going.
She’s still staying true to that sentiment. Recently, the Rare Beauty founder addressed the relentless, unsolicited comments she’s been receiving about her body—which, to be clear, is a topic no one should ever need to explain. During a livestream on TikTok, which was later posted on Twitter, Gomez said she tends “to hold a lot of water weight” when she’s taking a certain medication, though she didn’t specify the type.
“I just wanted to…encourage anyone out there who feels any sort of shame for exactly what they’re going through, and no one knows the real story,” she said.
There are various medications that can help treat lupus, and they all come with potential side effects that go beyond weight fluctuation.
Lupus impacts each person differently, so medication regimens are also “highly individualized,” Margo Bowman, PharmD, director of clinical pharmacy services at Corewell Health in Grand Rapids, Michigan, tells SELF.
Many people with lupus are on hydroxychloroquine, a disease-modifying anti-rheumatic drug (DMARD), which helps control inflammation and lower the risk of flare-ups, or periods when the disease is active and causing symptoms, Lynn Ludmer, MD, medical director of the department of rheumatology at Baltimore’s Mercy Medical Center, tells SELF. “It has been known to increase lifespan and decrease the risk of brain and kidney disease,” she says. “After that, it depends on the particular kind of lupus a person has and the right medication varies from person to person.”
Corticosteroids may also be used short-term to fight inflammation and control symptoms. “These medicines are very important to allow us to ‘put out the fire’ immediately,” Dr. Ludmer says. They’re pretty potent drugs, so experts try to prescribe them at “the lowest dose for the shortest amount of time,” she adds.
That’s because long-term use of corticosteroids is linked to a slew of potential side effects—and some degree of weight fluctuation is one that many people taking them experience, according to Johns Hopkins Medicine.