Atripla & Weight Gain

[screwysquearl]

Hi everyone:

Just found this forum and joined.
 I was just diagnosed with HIV and actually, AIDS toward the middle of April of this year. I was in the hospital for the remainder of April and most of May battling PCP. I didn't even know I was infected. I know now that I was co-infected with HIV and Hep B. I know this because prior to Hep B, I was neg. When I got acute Hep and was diagnosed with Hep B, I assumed (falsely) that they also screened me for HIV because I was high risk and they were going to treat my Hep B with Lumivadine (which is a no-no when you are HIV+ also).

Anyway, I have battled weight all of my life. I have been obese most of my life (5'7" and 220lbs). About three years ago, I started losing weight and losing it fast. Didn't think anything was wrong or bad because I had gone from working in an office to being a courier for FedEx. I was lifting a lot of packages and, literally, doing a lot of running (in and out of a truck 100 times per day) and thought it was from the physical activity. I got down to 135 lbs in about 6 mos. I was tone, my legs looked great, 27" waist. Was eating like a horse just to keep the weight on. Again, thought that my metabolism finally changed from one that was slow to one that was fast. My metabolism had changed alright.

Come to find out (when I was diagnosed in April). That my metabolism was revved because of the virus. It was literally on 24/7 trying to fight the virus. My IDD told me that once I started HAART (which, I couldn't until I was over the PCP), and got the virus under control, my metabolism would slow. Hmmm. Slow to what it was before? Nonexistent?

The PCP ravaged me. I went into the ER because I thought I was anemic. They did a blood panel and wanted to x-ray my heart because I was having near-synscope episodes, too. The ER doc came back and told me my heart was fine, but I had pneumonia. This shocked me because I didn't really have a cough nor respiratory issues you would associate with pneumonia. He said it was probably "walkers pneumonia." He said I was definitely anemic, but that my White Blood count was really low. He asked when was the last time I had an HIV test. I told him about 4 years ago when I was diagnosed with Hep B (which I cleared). Again, thought I was tested. He asked if they could do a test. I said, of course. I told him I was surprised because since the Hep B event, I have had NO sexual partners. Not even a hand-job (sorry to be graphic). The Hep B was my wake-up call. I even started working at FedEx because of the random drug-testing. I loved being a courier and it was great pay. It was my incentive to stay off of meth.

Side note; I actually stopped doing meth because it caused me to actually GAIN weight. Yes, my metabolism was THAT crappy.

Anyway, through out the week, my pneumonia got worse. The Avelox was doing nothing. By a week later, I could hardly breathe without pain and I had a fever of 104. The ER doc called me back exactly a week after I had seen him and wanted to know how I was doing (I think he already knew). He asked me to come into the ER again. He was quite laid back in his tone. Not alarming or anything. Went in and he told me that more than likely, I had PCP. He told me that I was HIV+. He told me that I had to be admitted into the hospital. I told him I had no insurance. He told me that this was not optional and we were not having a debate. I took that to mean what it meant and went in. I was in intensive care for about a week and then physical rehab for another. Was on O2 the entire time.

I went from 135 to 120.

My IDD told me that once the virus was under control, my metabolism would return to normal. I have been on Atripla for a month now. He was right. I am gaining weight rapidly. Am up to 138. I am VERY hungry all of the time. I am working FT in an office setting, again. I am concerned about becoming obese. I am worried about diabetes, again because of my predisposition for it (my father has it and all of the other "African-American" afflictions: congestive hear failure, High Blood pressure, High cholesterol...all of which went away when I was infected with HIV (does anyone see the irony in this?). I am concerned that all of this is going to return.

My diet is good. I have started going to the gym, I work out, sometimes twice/day 5 days per week. I have noticed that I am picking up the most weight in my mid-section. That is probably the most difficult area to control weight and is usually where we do carry weight.

I need to clarify one thing: Being over weight my entire life damaged me to the point of depression and suicide attempts. I have been slim for about 3 years, now. I still feel overweight because THAT is how I lived and was treated most of my life. Becoming slim or losing weight does not change that. It has made me very shy. It has been hard because people that would not have given me the time of day in the past are now interested in knowing me. That has damaged me to the point that I know I will probably die alone and without a partner. I am 37 years old. I apparently look like I am in my early 20s (I think being biracial contributes toward this illusion). Some (a lot, I have found) of the gay community can be very esoteric. I have always been attracted to older me (late 30s to 50s). Both physically and for companionship. They don't tend to judge a person physically, as much. Don't respect the one-night standers...

Anyway, I guess my point to this story had to do with some of the posts I saw about Atripla and weight gain. Atripla doesn't really CAUSE weight gain. It is more or less your metabolism going from hyper-drive to normal levels. When your metabolism is low, you face weight gain. The best way to combat low metabolism is to create a high one. Exercising does this. Exercise that speeds your heart rate and makes you hot. HIV does this, when the HIV is not there (as much), your metabolism has no reason to be on all of the time.

I say this with a smile on my face and absolutely DO NOT INTEND FOR IT TO INSULT OR OFFEND ANYONE:

"HIV: nature's best diet."

I have found that humor has helped me greatly over the past two months.

I am doing better (by the way, my CD4 count at diagnosis was 12 and my VL was 350,000). I get my new counts next week (it's been a month since being on HAART and almost 3 months since PCP/Crypto/MAC/Pulmonary Embolisms...that not really related to the HIV, but the DVT from all of the IVs and PIC lines I received (on Coumadin for that)). I actually feel better, now physically, than I have in a couple of years. I feel good, too because I finally know what is wrong with me and it can FINALLY be treated!! Chronic pain is one of the most depressing things...

I am working FT, I have a routine. I work out. I am meeting new friends (I just moved from Seattle to FL to be with my family again...I haven't really seen them in about 10 years). Almost dying has given me knew perspective (there was a point in ICU, when I did think I was going to die because I couldn't breathe and the pain was so great. I was very upset because I was alone and thought I would die alone and without my family by my side). It has made me seen what I have taken for granted. THAT haunts me. It is trifling that it takes something so tragic to make us realize that.

I offer support to others in any way I can. That is my pledge to this group. I am meeting new people online. I am learning a lot about my condition. I am VERY active in my treatment. When I don't get what I need from my IDD and GP, I raise holy f'ing hell. I think it is ONE of the reasons, I feel great, today.

Take care of yourselves and each other. Be considerate of those who are different or "not status quot or mainstream." We are good people and have feelings, too. We are also BEAUTIFUL PEOPLE! Who knew?

Earl Price, 37
Panama City, Fl (formally, Seattle, WA)

[vivyt]

Yes I have learned this. I abosolutely have to exercise and I didn't before. Of course I am stubbornly trying to avoid it but I am tired of my clothes not fittine...I guess I wll have to give in...LOL!

I'm glad you are feeling better. I too had PCP and had an extreme weight loss. I did not stay in the hospital. I refused. Once it was under control my body snapped back although it is not and will probably never be the same.

Hope things continue to go well!

[John2038]

Hi screwysquearl,

Just wanna want to say Welcome !
It's amazing to read stories like yours. You have been through a lot of things.

You have also mentioned that you are exercising 5d/wk and that really great !
There are no reasons, if you train+diet properly (and with the agreement of your ID doc) that you gain anything else than a better health and mind.

You are on meds, on Atripla. So probably a  lot of combos remains available to you
Better you continue thinking now how you gonna enjoy the life.

Keep Well !
John

[rick21007]

Hi Earl--welcome to the forums!  Glad to hear you are doing well and have your health back.

I contracted hiv and hep b about the same time you did.  Like you was initially diagnosed with hep and lost a lot of weight----looked like a concentration camp survivor.  Then got a nasty OI and only then was diagnosed with hiv--that was December 06. 

I only just started Atripla 6 weeks ago and am doing well on it.  My ID and I started discussing going on meds this spring and by May it seemed the right time.  I requested to be started on Atripla as it treats both the hiv and hep b.  Fortunately I have tolerated the Sustiva well.   My first labs at 5 weeks: hiv viral load went from 83,000 to 230 and hvb viral load from 200 million to 82,000.  CD4 up slightly from 368 to 372.  I feel great.  One thing I notice is that I don't have the chronic stomach issues that started when I had the acute hep. and my seasonal allergies are way better.

I work out at a gym 5 days a week also.  This makes a huge difference in how I handle stress, my confidence and how I feel about myself in general.  I take the Atripla first thing in the morning and it tends to make me a little spacey but I find working out really clears my head.  I also eat really healthy which for me is red meat and lots of vegetables.

rick

[rick21007]

PS---I lost a lot of muscle mass when I was so sick with hep b and I thought I was never going to get that back.  I noticed since going on the Atripla and working out that while I actually lost 5 lbs in the past month and went down a pants size I have gained noticeable muscle mass in my upper arms and shoulders. 

rick

[rondrond]

Hi Earl,

Welcome to the forums.
You'll find a lot of us with similar experiences.

You won't be alone.
ronnie

[David_CA]

Hi Earl and welcome to the forums.  With me, PCP was what got me thin and looking good!    Of course, I felt like crap and could barely walk across the yard.  When my Dr. got the x-rays of my lungs, he put them up on the light box and said "these white things are not balloons; these are your lungs."  He then handed me an envelope and told me that the local hospital was expecting me and had my room waiting.  I told him that I had things to do at work.  Like your Dr, he told me that not going was not an option!  That was Dec. '06, and I was diagnosed HIV+ in March '06.  I've also gained a lot of weight since then (+/- 15 lbs)... even more than I weighed when I was HIV-.  I think a lot of it, for me, was the Prednisone.  I literally could not eat enough to feel full when I was on that.  Regardless, I'm on Atripla now and, while not my heaviest, weigh a bit more than I'd like or should. 

I'm thinking that in time you'll overcome the overweight trauma you suffered earlier.  You mention being thin for three years and still feeling the same, but I think that in a few more you'll gradually move beyond that.  Take care.

David

[Lou-ah-vull]

Earl,

Once I started HAART, my weight dramatically increased as well. There is definitely truth to the idea that once your immune system is not locked into a losing battle with your body, your metabolism returns to normal and weight gain is a strong possibility.  I enrolled in a weight management program last October (after returning from AMG) and have dropped almost 26 pounds (6 inches off the waist and an ungodly amount of fat.)  I am still about 8 lbs over the ideal goal and am working now to reduce BMI (body mass index) to around 20 (currently around 23 which is normal.)

The key has been calorie management and regular cardio and weight training exercise.  When I slack off (which I do from time to time) I begin to gain again.  Thankfully I am in a maintenance program with a weekly class and i do not let it get out of hand.

Keep working on both exercise and calorie control and the odds are very good that you will not see dramatic weight gains.

I also have now been on Atripla since Feb 2007.  This drug has been lipid friendly for me and has enabled to concentrate on weight control.

Best of luck to you and keep posting!

Gary

[LordBerners]

Welcome Screwy,

I have tried to take Sustiva and Truvada twice now (same as Atripla), but only lasted around a week each time because I immediately lost all appetite and found food disgusting.  It sounds like this is not among your side effects.. I think you are fortunate, though I certainly understand your desire to stay slim.

I recently lost around 40 pounds due to tuberculosis, and now that I'm under treatment and feeling great I am gaining about a pound a week.  I'm hoping I can stop as I don't want to be 190 pounds again.

Interestingly, I have never noticed any direct metabolic or any other effect from the HIV - other than my one opportunistic infection (the TB), I don't think the HIV has shown any symptom, and that's with a viral load of 100,000.  I'm currently not on ARV but will probably have to try again very soon - am dreading it.

Anyway just a note that you're lucky to still enjoy food - I just couldn't bear that the joy of eating was totally destroyed for me when I was on the Sustiva.