Glucocorticoids (GCs) are widely used to effectively treat inflammatory disease, however GCs have a number of recognised side effects. It has been shown that patients and clinicians view these side effects differently, with clinicians most concerned with serious side effects such as osteoporosis and diabetes. Consequently these side effects are well researched with clinical guidelines and recommendations. A side effect shown to be of particular concern to patients is weight gain, however this topic has not been well researched and consequently clinicians find it difficult to provide patients with accurate information about the potential of weight gain. The aim of this review is to provide an overview of GC use specifically in rheumatic disease, patient views on GC therapy and GC-induced weight gain. We will discuss the evidence including the extent and the impact of weight gain on the patient, and highlight areas that warrant further investigation.