7 Things Selena Gomez’s Battle With Lupus Has Taught Us About the Autoimmune Disease

For almost a decade now, Selena Gomez has been using her stardom to help educate the public about lupus. Lupus is a sometimes debilitating chronic condition that Selena was diagnosed with in 2013. Later, she disclosed her diagnosis to the public in a 2015 Billboard article.

The pop music sensation has made it her mission to raise public awareness about lupus. She’s been candid about her journey along the way, discussing her lupus symptoms and treatment and her struggles adapting to life with this diagnosis. Here are seven challenges Gomez has faced — and what she’s shared in hopes of helping others.

1. Kidney Transplant Is a Common Complication

Gomez told the audience at the Lupus Research Alliance annual gala in November of that year that the transplant was tied to a complication called lupus nephritis, a kidney disease associated with lupus, according to People. “After undergoing so many tests to monitor my kidneys, my doctors told me I have lupus nephritis, one of those complications from lupus,” Gomez told the audience. “They said I would be needing a kidney transplant.”

“We always recommend patients with lupus are seen regularly by a rheumatologist, because often they won’t have any signs or symptoms the kidneys are being affected until later on, when there’s more and more damage,” says Dr. Katsaros.

2. Lupus Can Take a Mental Toll

“There are studies that show an association between bipolar disease and lupus, which means an individual can have both conditions,” says Rosalind Ramsey-Goldman, MD, the John P. Gallagher Research Professor of Rheumatology at Northwestern University Feinberg School of Medicine in Chicago. “This does not mean that one condition causes the other.”

3. Lupus Can Lead to Weight Fluctuations and Body Image Issues

Many people with lupus struggle with fluctuating body weight. “Weight loss can occur during a flare, especially if the person has anorexia or gastrointestinal symptoms from the disease itself or medications,” says Ramsey-Goldman. “But the most common problem is weight gain that results from lupus medications like steroids,” she adds. “Steroids can cause changes in the face that make it appear fuller and rounder than normal, as well as increase the circumference of one’s waist and limbs,” Ramsey-Goldman advises.

Ramsey-Goldman explains that weight gain can also occur if someone with lupus has organ inflammation, especially if the kidneys are involved and they experience trouble expelling fluid from the body, which she advises “can cause swelling in the legs, and if severe, the entire body.” She adds that these weight changes can impact people’s body image, especially in younger people with lupus. “They can experience negative comments from their peers,” she says, “and in some cases, [it] may lead to decisions to not take lifesaving medications.”

As a celebrity with 423 million followers on Instagram alone, changes in Gomez’s appearance don’t go unnoticed. She regularly faces cruel comments from internet trolls about her weight. In an episode of the Apple TV+ docuseries, Dear …, Gomez told viewers, “My weight would constantly fluctuate because I would be on certain medications. And obviously, people just ran with it. It was like they couldn’t wait to find a thing to bring me down. I was being shamed for gaining weight because of my lupus.”

Her swift retorts to body-shaming incidents have been publicized in the media. But even when Gomez would respond with posts and images promoting body positivity and use such moments to teach her followers something about her condition, she says that sometimes she would also be “crying her eyes out.”

In February 2023, the BBC, Self, and the Los Angeles Times all reported on a TikTok livestream in which Gomez spoke about lupus, body shame, and how she "holds a lot of water weight" because of her medications. She also offered encouraging words to anyone feeling shame because of “what they’re going through,” saying: “I just want people to know that you’re beautiful and you’re wonderful, and yeah, we have days where maybe we feel like shit, but I would much rather be healthy and take care of myself. My medications are important, and I believe they’re what helps me.”

4. Lupus Can Affect Fertility and Pregnancy

“Fertility can be a challenge,” says Ramsey-Goldman, “because of the consequences of the disease or the treatment needed to control the disease.” And when lupus is active, she says, “it’s not a good time to conceive because there can be risks to both the mother and fetus.”

Gomez says she’s been advised to avoid pregnancy since her condition could put her life and a baby’s life at risk. In a September 2024 interview with Vanity Fair, she said, “I haven’t ever said this … but I unfortunately can’t carry my own children. I have a lot of medical issues that would put my life and the baby’s in jeopardy. That was something I had to grieve for a while.”

Ramsey-Goldman recommends counseling to assess pregnancy intentions early in the disease course. “With counseling, a person with lupus can have a successful pregnancy,” she says. “The main goal is to control disease, prevent damage to organs, and if pregnancy is desired in the future, use guideline-recommended medications, deemed safe for use during pregnancy.” She adds that it’s also possible for women who’ve had kidney transplants to work with a multidisciplinary team “to manage a pregnancy safely for both mother and child.”

As for Gomez, she told Vanity Fair that she is thankful that there are other ways to create a family. "I find it a blessing that there are wonderful people willing to do surrogacy or adoption, which are both huge possibilities for me," she said. “I’m excited for what that journey will look like, but it’ll look a little different,” said Gomez. “At the end of the day, I don’t care. It’ll be mine. It’ll be my baby.”

5. Stroke Is a Potential Lupus Complication, Too

Gomez took a break from the spotlight back in the winter of 2014 and entered a rehab program in Arizona to help her deal with the disease, she told Billboard. “I was diagnosed with lupus, and I’ve been through chemotherapy. That’s what my break was really about. I could’ve had a stroke,” she said.

6. Lupus Treatment Can Involve Chemotherapy

In the Billboard article, Gomez revealed that she’d undergone chemotherapy to treat her lupus, though she had a hard time opening up to fans about it at the time. “I wanted so badly to say, ‘You guys have no idea. I’m in chemotherapy,’” she said. “I locked myself away until I was confident and comfortable again.”

Not everyone with lupus will need chemotherapy, but people with serious cases of lupus may be prescribed a chemotherapy medication — such as cyclophosphamide, methotrexate (Rheumatrex, Trexall), or rituximab (Rituxan) — which suppresses the immune system.

7. A Healthy Lifestyle Can Help Limit Lupus Flares

In her May 2024 Today interview with Kotb, Gomez touched on the topic of wellness and lifestyle with lupus. "Having to take steps to make yourself healthy takes a lot of work," she said.

Katsaros says diet is an important part of managing lupus and that avoiding cholesterol and high amounts of fat and sugar can reduce inflammation and minimize symptoms.

Gomez shared more about what it’s like to live with lupus and how she copes in a 2021 Elle interview. “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 said, adding that what kept her going was thinking about how she would channel it into doing good. “‘You’re going to help people,’” she told herself.

The Takeaway

• Lupus can cause serious damage to the kidneys and may require a kidney transplant.
• Lupus and its treatments can have a negative impact on mental health and cause weight fluctuations that lead to body image issues.
• A healthy pregnancy is possible, but there are risks and potential complications; pregnancy counseling can help.
• Regular exercise, a healthy diet, sleeping well, and avoiding smoking and ultraviolet sunlight can reduce lupus flares.