CORTISOL AND OBESITY HERE’S THE REAL question we are interested in: Does excess cortisol lead to weight gain? The ultimate test is this: Can I make somebody fat with prednisone? If so, that can prove a causal relationship, rather than a mere association. So does prednisone cause obesity? Absolutely! Weight gain is one of prednisone’s most common, well-known and dreaded side effects. This relationship is causal.