What might be an early sign of corticosteroid side effects in a patient?

Weight gain is an early sign of corticosteroid side effects in a patient. Corticosteroids are known to cause alterations in metabolism, which can lead to increased appetite and subsequent weight gain. These medications often cause fluid retention and changes in fat distribution, which may be noticeable relatively soon after therapy begins. This side effect can be particularly concerning as it may signify the potential for more serious complications, such as metabolic syndrome or cardiovascular issues, if the corticosteroid therapy continues over a long period.

In contrast, the other options reflect positive changes that are generally not associated with corticosteroid side effects. Increased energy levels and improved sleep quality are not typical responses to corticosteroids, which can often lead to fatigue or sleep disturbances in some individuals. Similarly, an improved appetite, while it might sound beneficial, is also linked to the appetite-increasing effects of corticosteroids, which typically precede notable weight gain rather than being an early indication of adverse effects themselves.