Being overweight or obese is increasingly common among people with HIV, as it is among the general Canadian population. The reasons for this are unclear but may be related to the fact that people with HIV are living longer and better. Obesity—defined as a BMI over 30—comes with its own set of health risks including heart disease, diabetes, high blood pressure, gallbladder disease, fatty liver disease, loss of bladder control and some cancers . Years ago it was unheard of to recommend that a person with HIV lose weight but it is now clear that the health risks of obesity outweigh the risk of developing wasting in the future. Losing weight and keeping it off is difficult and takes dedication. There is no shortage of weight-loss diets and the best ones emphasize healthy, balanced eating that can be sustained over a long period. Many of the so-called fad diets work initially, but they are so restrictive that beforelong people go back to their old eating habits and regain all the weight they lost.

When considering a weight-loss diet that eliminates food groups or includes only a few foods, ask yourself if this will meet your needs to stay healthy. Rather than “going on a diet,” which tends to be short lived,try to see this as a long-term project for improved health. And think about including some exercise. In fact, the best predictor of long term success in weight loss is physical activity. Exercise builds lean body mass but most importantly uses energy, which means burning calories. Be sure to do something about unwanted or unexpected weight loss right away. If you are overweight or obese, losing even 5% of your weight will have health benefits.