Maintaining a healthy weight after being diagnosed with human immunodeficiency virus (HIV) can be difficult. Some people find that they gain weight as a side effect of HIV medications, while others unintentionally lose weight, putting them at risk of becoming sick.

Unexpected and significant weight gain or loss can have several impacts on your overall well-being. One myHIVteam member wrote, “Being 50 pounds heavier is making me so fatigued and causes joint pain.” Another member said, “I hate when people point out my weight loss. It does something to me mentally.”

If you are concerned about gaining or losing weight, there are some ways you can manage your weight with HIV. Talk to your doctor about whether the following approaches may help you reach and maintain a healthy weight.

1. Changing Treatments

In some cases, weight gain after HIV diagnosis occurs because of the antiretroviral therapy (ART) medications that are part of the care regimen for nearly every person with HIV.

People with HIV who take these treatments might gain weight up to three times faster than those who are HIV-negative. Medical researchers are not entirely sure why certain ART medications cause weight gain. However, research indicates that it may be connected to HIV-related immune system changes.

Additionally, people whose immune systems were more active when starting ART have been found to gain more weight while on antiretroviral drugs than those who had less active immune systems at the start of HIV treatment. This was found to be true even when ART was successful in lowering immune system activity.

There is not a lot of research available about which weight loss methods work best for HIV-positive people who gain weight because of antiretroviral medications. There is no clear evidence so far that changing HIV medication will result in weight loss. However, if weight gain on ART is rapid or negatively affects your quality of life, you can talk with your doctor about changing treatments.

Certain medications seem to cause more weight gain than others. Additionally, some people gain more weight on one treatment than they do on another. Always talk to your doctor before making any changes to your treatment regimen.

2. Exercise

In some cases, post-diagnosis weight gain simply corrects unintended weight loss that occurred before diagnosis. Untreated, HIV can lead to a lost appetite, fevers, nausea, fat and muscle loss, or opportunistic infections. Opportunistic infections occur more frequently and are more severe in people with weakened immune systems, which can cause significant weight loss. If you’ve gained weight after an HIV diagnosis — whether or not it’s caused by ART — you might benefit by incorporating exercise into your daily routine.

Physical activity can help people with HIV not only lose weight but also experience additional benefits, like reducing stress, improving sleep, and lowering the risk of developing heart disease and high blood pressure. Talk to your doctor about whether an exercise regimen is a good idea for you. In many cases, your health care team may advise you to do the same types of exercise you enjoyed before your HIV diagnosis.

One myHIVteam member wrote, “Played tennis for an hour and 45 minutes this morning with my buddy, then went back in the afternoon for another 90 minutes with my other buddy. I’d be on a court all day if possible!” Another said, “I’ve been exercising a little more to see if that helps with the weight gain.”

If you’re underweight, your doctor might recommend adding weights and strength training to your routine so you build muscle mass and avoid future weight loss.

3. Healthy Eating

Having HIV doesn’t usually mean that you need to make drastic changes in your diet. That said, people with HIV can benefit from the role good nutrition plays in keeping the immune system healthy and maintaining a balanced body weight.

According to NAM, a U.K.-based HIV educational organization, a balanced, healthy diet for people living with HIV includes a variety of whole foods:

• Starchy foods, such as bread, rice, and potatoes, provide carbohydrates to nourish your body with energy, fiber, and minerals.
• Fresh fruit and vegetables contain fiber, minerals, and vitamins.
• Low-fat dairy products, including milk, yogurt, and cheese, provide key vitamins and minerals — such as calcium.
• Lean proteins found in beans, nuts, fish, eggs, and poultry also provide vitamins and minerals.

Work with your health care team, or ask for a referral to a registered dietitian, to help you create a balanced diet and ensure you get all the nutrients your body needs. Whether you’re trying to gain or lose weight, you may need to adjust your calorie intake or change the ratio of proteins to carbohydrates you’re consuming.

A health care professional will measure your body weight and calculate your body mass index (BMI) and ask you questions about your current food intake. They can then devise a plan that will help you reach your body composition and weight goals.

Find Your Team

On myHIVteam, the social network for people with HIV and their loved ones, more than 36,000 people come together to ask questions, give advice, and share their stories with others who understand life with HIV. Here, members talk about a wide range of personal experiences and concerns. Body weight with HIV is a commonly discussed topic.

Have you started treatment for HIV and struggled with weight gain or loss? Have certain changes in your diet, exercise, or treatment regimens helped? Join myHIVteam today, and let other members know by leaving a comment below or starting a conversation on the site.