We’ve known for some time that many people living with HIV gain weight after starting our life-saving HIV antiretroviral medication. While this has been something that people living with HIV have told us (anecdotal reports), it is only recently that clinical studies and researchers are beginning to confirm this observation although we still are not sure why some people are more susceptible to gaining weight.
Overall, the average adult living with HIV or not, will put on approximately ½ to 1 kilogram of weight each year. This small weight gain is in part due to our lifestyle factors, what we eat, when we eat, how much we eat which is different from person to person; our personal genetics, body type, how quickly we digest our food or use our energy which is also different from person to person; as well as the usual ageing process.
What we know, is that people living with HIV on antiretroviral medication gain weight faster than people without HIV. This weight gain is more common in women living with HIV, black people living with HIV, and people who have a low CD4 count and high viral load at the time of starting their HIV treatments.
Researchers are recognising that the very medication that does the best job in suppressing our viral load (integrase inhibitors also called INSTIs) with fewer side effects, is linked to this weight gain. Dolutegravir (DTG) is a very common second-generation integrase inhibitor that’s an ingredient in many of our most effective HIV antiretrovirals. HIV antiretrovirals that contain tenofovir alafenamide (TAF) have also come under scrutiny for the link with weight gain. HIV medications that include both DTG and TAF demonstrate a greater weight gain. The reasons for this are currently unknown. To find out if your medication contains DTG or TAF or perhaps both DTG and TAF, ask your HIV prescriber next time you’re renewing your prescription.
There’s also little evidence to show that switching your antiretroviral medication to another one will impact this situation. Changing medication does not mean that you will automatically loose weight. The occurrence of weight or the amount of weight gain, is different from medication to medication, as well as from person to person, depending on our personal genetics, body type and individual lifestyles. What might seem to work for one person does not seem to work the same way for someone else in the same way.
So what can we do until there are new medical interventions that can affect this weight gain linked to HIV medications?
Besides the standard responses you may have already heard about lifestyle changes, diet and exercise, it can be useful to have a regular self-reflections on those things you can modify or change in your diet.
Consider the small daily activities and movement that can have useful impacts on slowly losing any undesirable weight gain.
Can you take the stairs for one flight instead of riding the lift all the way?
Can you ‘exercise snack’ for 20 seconds while you’re brushing your teeth, waiting for the kettle to boil or the microwave to finish?
Having an ongoing holistic discussion with your HIV doctors about your options can be an important way to stay up-to-date with any recent clinical studies, research or evidence about HIV antiretrovirals and weight gain.
You’re also welcome to get in touch with our peers also living with HIV to share your strategies and celebrate any wins you have to reduce any unwanted weight, by calling Positive Life NSW on (02) 8357 8386, 1800 245 677 (freecall) or contact@positivelife.org.au.
