Weight loss continues to be a difficult problem for people with HIV. Studies have shown that even a small amount of unwanted weight loss increases the chance of getting sick and dying. Whenever weight is lost, some comes from stored body fat and some from lean tissue. How much is lost from those two compartments depends on the underlying cause of the weight loss. When weight loss is due to not consuming enough calories—called starvation in medical terms—about 40% of the weight lost comes from lean mass and 60% from fat. When there is an infectious process with fever, the body develops a stress response to the infection and up to 80% of the weight lost will be from lean mass and only 20% from fat.

This is because the body is rapidly breaking down muscle to provide the ingredients needed to fight infection. This type of weight loss is more serious and more difficult to reverse.In HIV disease there are many factors that cause weight loss, but not consuming enough calories is generally the driving force. If you have any symptoms or side effects that make it hard to eat, talk with your doctor or dietitian right away. It is important to prevent weight loss and the downward spiral of malnutrition. See for ideas on how to deal with these and other issues. The primary strategy for treating weight loss is to increase macronutrient intake to the level needed to promote weight gain. This is achieved with a high-calorie, high-protein diet and a multivitamin mineral supplement.

Analyzing your body

  1.  Try to find a dietitian who can perform body composition analysis.
  2.  Measure your own waist at a point just above the belly button to see if you are at increased risk of heart disease. If you’re a man, your risk is increased if your waist is greater than 102 cm (40 inches). For women, the risk is higher when your waist is larger than 88 cm (35 inches).