Loose weight?

[gorka]

I am recently poz (last 6 months) and my numbers are good.  I am overweight and was wondering if its OK to loose weight given that I may encounter problems down the road.  Neither Dr or the nurse encouraged me to do so when I asked which I thought was weird but curios what folks here recommend.  I am concerned with HART effects on cardiovascular health and thought I should try to loose some weight to counterbalance that but kind of confused with their response.  Thank you for the feedback

[Jim Allen]

Hi

Look if you want to start going to the gym or do sports etc.  nothing is stopping you from doing that just don't over do it.

https://www.poz.com/basics/hiv-basics/hiv-exercise

Jim

[gorka]

Thanks for the feedback and the link Jim 

[CaveyUK]

I am recently poz (last 6 months) and my numbers are good.  I am overweight and was wondering if its OK to loose weight given that I may encounter problems down the road.  Neither Dr or the nurse encouraged me to do so when I asked which I thought was weird but curios what folks here recommend.  I am concerned with HART effects on cardiovascular health and thought I should try to loose some weight to counterbalance that but kind of confused with their response.  Thank you for the feedback

Losing weight if you are overweight is always good, regardless of status.

The doc/nurse may not have focused in on this because of your recent diagnosis and the most important thing is dealing with the main thing in front of them.

For what it's worth, I am overweight too and need to lose weight. Shortly after diagnosis I asked the doctor specifically about this and she said that it is something I would need to deal with, but suggested that I don't make any sweeping changes to diet at that point (ie. starting meds). I suspect this was to ensure that I had a period of getting used to the treatment first, as drastically changing diet or exercise regime can present 'side effects' which could be confused as being to do with the meds.

Given you are on meds, doing well and have decent numbers though - you should look to get as fit as you can, just like anyone

[gorka]

HI Cavey

I am not on meds yet still waiting for genotyping test.  But my numbers are good nonetheless probably because I am recently infected.  Thanks for giving your input.  I should have started weight loss before given that some folks report here weight gain when taking meds. 

[zach]

When you say your team didn't encourage it, I read that as meaning it simply wasn't brought up. Am I right? I would be willing to bet if you asked, they would be supportive of the idea.

Losing weight in a healthy way is great. Fad diets, weight loss drugs, and the like... no that isn't good. All in your approach.

Gaining weight on HIV meds isn't guaranteed by any means at all. I have a feeling you read that somewhere on the internet, years old information about medications that are rarely used anymore.

[gorka]

Hi Zach

I specifically asked both the nurse and Dr (separately) and neither really encouraged it but didnt say I should not do it either.  Maybe they are waiting to see how I respond to meds.   There are some more recent threads on here also that discuss weight gain from Triumeq so that concerned me given that is one of the drugs I will be potentially taking.

[CaveyUK]

It is by no means guaranteed but it seems that weight gain during the first months of ART is seen quite commonly - anecdotally at least.

This isn't likely due to a side-effect of the meds as much as your body no longer having to consume energy fighting a fast-replicating virus.

Funnily enough, I was reading today something from an well respected HIV specialist in the UK which talked about this very thing. His advice was to slightly up exercise or reduce calories when starting ART to offset any risk of weight gain (if this is a concern).

That of course, was not mentioned to me by my doctor who suggested I make no immediate dietary changes, but as I was fairly large to start with perhaps it was seen as a bit of a moot point.

Based on all that then, I would say - if starting ART - then a moderate increase in cardiovascular exercise and a slight drop in calories would probably make sense, but probably don't do a dramatic switch to your diet or push yourself too hard in the early days.

If you are not starting ART then getting into physical shape will be a good idea, regardless. One thing I regret, in hindsight, is not doing more to get in physical shape prior to my diagnosis and starting meds.

[BT65]

Hi, I'm a long term survivor (almost 30 years positive). In the early days I went through the wasting syndrome, then bounced back.  (It was a long process though).  Then when the combination therapy started in '96 I gained quite a bit of weight.  I don't believe that happens much anymore with the newer meds though really it can happen regardless of meds. 

I have never been obese, other than when I was pregnant, lol.  But I did gain quite a bit of weight in a 10 year period.  Earlier this year I lost almost 30 lbs and it has definitely helped physically.  I have bad knees and even a little bit of extra weight caused me more pain issues.  I simply started eating healthier and started exercising more.  I knew enough not to do anything drastically because I've tried that before and it did not stick.

I still exercise and still eat healthier. I just remind myself of how much better I feel when I do.  I agree with Zach that fad diets, diet pills, etc, are not a good idea.  Just try to concentrate on living healthier and think about the benefits. 

Betty

[CaveyUK]

Then when the combination therapy started in '96 I gained quite a bit of weight.  I don't believe that happens much anymore with the newer meds

I think weight gain after starting ART is quite common.

I don't think it is directly to do with the meds though, but rather - without the body having to fight a losing war against a virus, the metabolism slows down a bit. This is clearly a good thing, but a side effect of that is that consuming the same calories as before can lead to weight gain. Thats certainly been the case with me - quite dramatically so.

I wish in a way that I had dieted before diagnosis as I would have probably found it easy to lose the weight. I suspect it will be far harder now

[gorka]

I actually lost a few pounds since starting meds 15 days ago so go figure.  Noticed though that my fat is kind of becoming soft vs being hard before.  Doubt meds have anything to do with it so time to hit the gym to firm up a little 

[BT65]

I know, too, that aging can cause weight gain.  Metabolism slows down as we age, and as more people with HIV are aging, weight gain is bound to happen regardless of meds or no meds.  Exercise is important but also difficult to get started and stay active in.  I seem to start and stop, every time with good intentions. 

I also have diabetes and exercising helps that a lot. Last week I didn't exercise as often because I was on vacation (that was my excuse lol), but I have been at it regularly lately.  When I lost weight earlier this year, I lost about 20 lbs very quickly so some of my skin seems flabby.  So I have been including resistance exercises along with riding my recumbent bike, to try to tone some of the skin up. 

I do know that since getting older it takes much longer to get into shape, where when I was young I don't remember ever being flabby. I also weighed much less when I was young also, and my metabolism was much higher.  So, I believe combinations of things definitely effect weight gain, exercise, etc.  Good luck to everyone who is going to try to control diet and exercise.  We should have a support forum for those subjects lol.

Betty

[elf]

It's not only an aging thing.

HAART are know to cause metabolic changes, just like antipsychotics are.
Iatrogenic (drug-induced) weight gain is difficult to ''treat'' as compared to ''normal'' weight gain (developed by overeating).


If antihypertensives or antibiotics caused all of these, they would be banned from use.
But, for HIV+ people (or for people with psychosis) everything is fine.  Like we don't pay taxes as well.

We deserve better meds too.

[mecch]

It's not only an aging thing.

HAART are know to cause metabolic changes, just like antipsychotics are.
Iatrogenic (drug-induced) weight gain is difficult to ''treat'' as compared to ''normal'' weight gain (developed by overeating).


If antihypertensives or antibiotics caused all of these, they would be banned from use.
But, for HIV+ people (or for people with psychosis) everything is fine.  Like we don't pay taxes as well.

We deserve better meds too.

Most people use antibiotics for a brief treatment.  I don't know how they could cause weight gain.  Let's assume there was an antibiotic treatment of say a year, or years, and it was associated with weight gain. EVERY DOCTOR would evaluate the benefits versus the downsides and make the call.  I bet it would be for the antibiotic treatment.

Why must you offer such flimsy and false equivalencies? 

Many antibiotic treatments and antihypertensives are LIFE SAVING.  So the trade off in some other effect would be worth it.

The same is true for HIV Treatment. 

Also, I haven't heard a lot of buzz in the last 5 years about most of the newish combos causing weight gain. Do you have a link to such research?

"But, for HIV+ people (or for people with psychosis) everything is fine.  Like we don't pay taxes as well."

I can even begin to unpack all the assumptions you built into the line above.

[mecch]

I am recently poz (last 6 months) and my numbers are good.  I am overweight and was wondering if its OK to loose weight given that I may encounter problems down the road.  Neither Dr or the nurse encouraged me to do so when I asked which I thought was weird but curios what folks here recommend.  I am concerned with HART effects on cardiovascular health and thought I should try to loose some weight to counterbalance that but kind of confused with their response.  Thank you for the feedback

Gorka, it's a pity you didnt get a chance to have a conversation about this with your doctor and get some sort of useful response.  Does this happen often?  Maybe make a list of questions and show it to the doctor and bargain how many questions can be answered each time.

Exercise and eating well is one way to lose weight and
1) I have never heard of a doctor advising an overweight HIV+ person, these days, to NOT lose weight
and
2) exercise and eating well is a great thing for anyone to pursue, HIV+ or HIV negative, so why not just concentrate on that, and you will probably loose weight, and you can ask the question next visit, anyway.

[CaveyUK]

Exercise and eating well is one way to lose weight and
1) I have never heard of a doctor advising an overweight HIV+ person, these days, to NOT lose weight
and

Mine did. Sort-of

At diagnosis, I talked with the doctor about lifestyle changes and how I should diet to lose weight. She said that in her opinion, I should hold off making any significant lifestyle changes until I was stable on the meds. The rationale seemed to be that changing other things at the same time could lead to confusion as to whether something was a side effect of the drugs, or a result of a radically changing diet or exercise programme.

Of course, once settled on the meds and it's a different story, and my doctor is encouraging the various lifestyle changes I was bleating on about at diagnosis (quitting smoking, more exercise, diet etc)

[harleymc]

One of the major problems with dieting is loss of muscle along with the fat.

Fat is easy to regain. Muscle is a lot harder to regain.
So while we do calorie restriction, we still need resistance work and adequate protein to protect our muscle mass.