Viseral Fat and HIV

[TheRoof]

One of the issues HIV gives me more than anything else is fat tissue. (All though superficiality is another issue all together  )

Here is my experience with fat. (The bolded are the most important. You can skip to the bold you don't feel like reading)
I am a few weeks away from getting on HIV medication. (After 4 years of having this virus)  I asked the doc about "lipodystrophy" and he said that it is a slow process. It accumulates over time. I am 22 years old. I have some maybe 45 years left on this planet. - I am sure it is inevitable.

Before the virus I could eat anything. I was active, having a six-pack and looking extremely lean was never difficult for me. In fact I was chubby as a kid, then lost the weight and had a visible six pack and very cut.
At the current moment I am still slim, with muscle tone but it's simply not like it used to be. Which I don't care. The problem is I gained a "belly" and "hip-fat" I am an extreme healthy eater. No junk food, alcohol, or anything fun. It's mostly clean foods like white chicken, spinach, vegetables, and fruits. (On top of vitamins and protein isolate)  I started weight training and truly pushing my limits. 2 years ago. I am stronger, faster, more muscular and probably "feeling" healthier than before the virus. (Of course I know medication is important)  I am 6'1 and 165. I haven't "gained" any fat, but I have had fat redistribution happen. ( I am concerned of the side-effects my fatigue exponentially increased) I was "healthy" all around. Now my shoulders are bony, my arms are bony, chest bony in the middle, face fat loss, and my collar bones are visible. (My CD4's are in the 600's)








I have learned that its impossible to remove visceral fat unless you do liposuction. If fat cells increase, you cannot deplete fat cells. You can only shrink them. (Which  is why some people are skinny fat. Which I guess I am becoming)
(If you notice how some people diet, get skinny and then blow up again when they start eating like a normal human being. This is due to the fact that their fat cells simply shrunk, but they have not disappeared.
This is why people lose weight, and gain it back again. Very easily.)


To bring the main point.
I was wondering has anyone had any success with visceral fat loss? (All though saying it's impossible by the medical community unless through medical intervention is saying something. It is quite depressing) If so, what would you have to share? It feels like my fat (or what I had) simply redistributed all to my stomach, and lower back.


Growth Hormone for HIV Patients
http://www.hivandhepatitis.com/recent/2010/0402_2010_c.html

Visceral (Belly Fat)
http://www.youtube.com/watch?v=9MrVCPAsHfw&feature=related

http://www.youtube.com/watch?v=9MrVCPAsHfw&feature=related

[TheRoof]

To anyone who is interested in a more simple answer this is what the medical article said about human growth hormone for HIV-infected individuals.

"Growth hormone releasing factor that stimulates the pituitary gland in the brain to secrete more growth hormone....these changes are achieved without significant side effects of glucose."

[elf]

Visceral (as well as adipose tissue) fat can be minimized.
When I was HIV-, I jogged 10 miles every other day.
Now, I have to jog 10 miles every single day (or half marathon every other day).
Eating healthy is just not enough.

PS
You said you were chubby as a kid, this means you have a greater number of fat tissue cells than average, so you have natural tendency to gain fat more easily. (Well, like me. I got 40 lbs in my 1st year of taking meds, and it has taken me 2 years to lose them,,,and HAART affects your lipid metabolism, so it is more difficult to lose weight...Suddenly jogging 10 miles was not enough, I had to run more, and faster, half marathon is a new friend of mine now). I'm on cyclical ketogenic diet, with low carbs  and a lot of fat fish, olive oil and nuts. It may seem a paradox, but cutting carbs and fruits made me lose weight. You should eat fruits in moderation, and only fruits low in fructose: berries, peaches and apricots.

[Buckmark]

One of the issues HIV gives me more than anything else is fat tissue. (All though superficiality is another issue all together  )

Here is my experience with fat. (The bolded are the most important. You can skip to the bold you don't feel like reading)
I am a few weeks away from getting on HIV medication. (After 4 years of having this virus)  I asked the doc about "lipodystrophy" and he said that it is a slow process. It accumulates over time. I am 22 years old. I have some maybe 45 years left on this planet. - I am sure it is inevitable.

Before the virus I could eat anything. I was active, having a six-pack and looking extremely lean was never difficult for me. In fact I was chubby as a kid, then lost the weight and had a visible six pack and very cut.
At the current moment I am still slim, with muscle tone but it's simply not like it used to be. Which I don't care. The problem is I gained a "belly" and "hip-fat" I am an extreme healthy eater. No junk food, alcohol, or anything fun. It's mostly clean foods like white chicken, spinach, vegetables, and fruits. (On top of vitamins and protein isolate)  I started weight training and truly pushing my limits. 2 years ago. I am stronger, faster, more muscular and probably "feeling" healthier than before the virus. (Of course I know medication is important)  I am 6'1 and 165. I haven't "gained" any fat, but I have had fat redistribution happen. ( I am concerned of the side-effects my fatigue exponentially increased) I was "healthy" all around. Now my shoulders are bony, my arms are bony, chest bony in the middle, face fat loss, and my collar bones are visible. (My CD4's are in the 600's)








I have learned that its impossible to remove visceral fat unless you do liposuction. If fat cells increase, you cannot deplete fat cells. You can only shrink them. (Which  is why some people are skinny fat. Which I guess I am becoming)
(If you notice how some people diet, get skinny and then blow up again when they start eating like a normal human being. This is due to the fact that their fat cells simply shrunk, but they have not disappeared.
This is why people lose weight, and gain it back again. Very easily.)


To bring the main point.
I was wondering has anyone had any success with visceral fat loss? (All though saying it's impossible by the medical community unless through medical intervention is saying something. It is quite depressing) If so, what would you have to share? It feels like my fat (or what I had) simply redistributed all to my stomach, and lower back.


Growth Hormone for HIV Patients
http://www.hivandhepatitis.com/recent/2010/0402_2010_c.html

Visceral (Belly Fat)
http://www.youtube.com/watch?v=9MrVCPAsHfw&feature=related

http://www.youtube.com/watch?v=9MrVCPAsHfw&feature=related

I don't think you can blame your visceral fat on HIV.  Lipodystrophy is most strongly associated with HIV medications.  It is not, as you say above, inevitable.  Bodies do change as they get older, even without HIV and HIV meds.  But you're 22, so I don't think that is coming into play yet, yung'un.  The truth is, a lot of us don't have the body we would like, due to a variety of factors:  diet, exercise, and genetics.  You have to do what you can.

As for the visceral fat, Egrifta is a medication approved for the reduction of visceral fat.  I'm not sure how effective it is, nor would you be approved for it without a significant documentation of your history, mostly likely including which HIV meds you took.  That discussion would be between you and your doctor.

Regards,

Henry

[mecch]

You are NOT on HIV medication yet.  I never heard of active HIV infection causing body fat redistribution....  Has anyone?  I thought if anything fighting HIV 24/7 keeps the fires burning, and untreated HIV+ people lose body fat.   Maybe I'm wrong...

[eric48]

I have learned that its impossible to remove visceral fat unless you do liposuction.

Hi,

this is not my understanding of things... My understanding is that because that fat is attached to your organs and between cells, liposuction is not effective.

If it were, and since liposuction is such a well standardized procedure, visceral fat would not be seen as a problem.

Hope this helps Eric

[newbieguy]

I have discovered in the last few months that I am getting a small tummy, whereas the rest of my body is very lean and pretty fit, I do curls and pullups, and I try and watch what I eat, I don't drink much soda..I was always slim, but since I started treatment and got healthy, I have the belly which annoys me slightly.  I am right now about 170 pounds. I am 30 years old. I am not sure if it is due to the meds (Atripla) or just a natural thing. I'm happy with the rest of me, I just wanna lose the belly lol. Maybe situps will help? Not sure if it is partly diet-related? I eat a lot of cold cuts, lean meat sandwiches, and I try and eat fruit when I can. I am in grad school so I often don't have the time I need to shop for the healthiest foods out there. Any ideas why I am getting the belly bump? And what I can do to lose it?

[TheRoof]

You are NOT on HIV medication yet.  I never heard of active HIV infection causing body fat redistribution....  Has anyone?  I thought if anything fighting HIV 24/7 keeps the fires burning, and untreated HIV+ people lose body fat.   Maybe I'm wrong...

I went to my doctor today, him and I talked about lipodystrophy. He said that viseral fat is developed from protease inhibitors. Because it acts as an antagonist for the same molecule that targets the fatty metabolism when on HIV medications.

You are right. -- it's not viseral.
He also said, Fat redistribution does happen quoting him "Fat redistribution occurs with viral loads in the GI/Gut (Which tends to be the highest as well as the thalmus." He also said that fat does not  actually disappear the fat cells shrink and eats away at muscle tissue as the body prefers skeletal muscle over adiptose tissue for fuel. Which is why he said a clean-protein diet is important.

I asked him, why would the viral load stay on hips and stomach.(adiptose tissue)? He basically repeated himself  "Viral Load in the HIV patient is in the gut. That area gets inflamed 24/7. Areas of consistent inflammation get covered by adiptose tissue. When wasting happens the fat cells are still there, they shrink but do not move. Protease Inhibitors attack the same part of the metabolism that processes sugar and fatty acids.

He did not tell me why that happens, but I assume it's to protect the organs? All though -- that carries a lot of cardiovascular risk.
So I thought that was interesting.

[TheRoof]

I have discovered in the last few months that I am getting a small tummy, whereas the rest of my body is very lean and pretty fit, I do curls and pullups, and I try and watch what I eat, I don't drink much soda..I was always slim, but since I started treatment and got healthy, I have the belly which annoys me slightly.  I am right now about 170 pounds. I am 30 years old. I am not sure if it is due to the meds (Atripla) or just a natural thing. I'm happy with the rest of me, I just wanna lose the belly lol. Maybe situps will help? Not sure if it is partly diet-related? I eat a lot of cold cuts, lean meat sandwiches, and I try and eat fruit when I can. I am in grad school so I often don't have the time I need to shop for the healthiest foods out there. Any ideas why I am getting the belly bump? And what I can do to lose it?

My Friend who is HIV Positive who is on medications said he did "The Warrior Diet" for 4 months. & He had a lot of improvements. -- It an extreme diet though.

[dowellndoubtnot]

I am curious about this topic as well. My bf was recently diagnosed with HIV, and probably contracted it about 4 or 5 months ago. He is not on any meds yet, but he has gained some weight also in his tummy region, and seems to be bloated in the tummy area more often than usual.

COuld this be related to HIV? Or could it just be the stress that is changing his eating patterns or something.

[mecch]

TheRoof - thanks for that very interesting information.  New to me.  Thanks.
Also, that doc sounds like a keeper!

[elf]

protein-only diet is not recommendable, because
1. you need healthy fats (like olive oil, nuts, flaxseed) too, to use all that protein
2. if you eat healthy fats, you will help your beta-oxidation enzymes (that burn fat) work more efficiently

If you want to lose weight, or get rid of the adipose tissue...cardio is your friend...jogging, running, swimming...

He also said that fat does not  actually disappear the fat cells shrink and eats away at muscle tissue as the body prefers skeletal muscle over adiptose tissue for fuel.

This is not true at all.
The body does not prefer skeletal muscle over adipose tissue.
If this were true, all obese people would be dead due to autophagy.

In my case: cardio as well as cyclic ketogenic diet made me lose fat, and gain muscle.

[elf]

Front Endocrinol (Lausanne). 2012;3:12. Epub 2012 Jan 30.
Fluvoxamine attenuated endoplasmic reticulum stress-induced leptin resistance.
Hosoi T, Miyahara T, Kayano T, Yokoyama S, Ozawa K.
Source

Department of Pharmacotherapy, Graduate School of Biomedical Sciences, Hiroshima University Minami-ku, Hiroshima, Japan.
Abstract

Increasing evidence indicates that endoplasmic reticulum stress (ER stress) is involved in the development of metabolic syndrome. However, pharmacological treatments targeting ER stress are not well understood. In the present study, we found that fluvoxamine, a selective serotonin reuptake inhibitor used for depression, can attenuate ER stress-induced "leptin resistance," i.e., insensitivity to the anti-obesity hormone leptin. Treatment with tunicamycin, an ER stress-inducing reagent, caused cell death which was significantly inhibited by fluvoxamine. Leptin activates JAK2-STAT3 signaling. ER stress caused an impairment of leptin-induced STAT3 phosphorylation which was reversed by fluvoxamine. Fluvoxamine would be a novel leptin-sensitizing drug, which targets ER stress.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3355886/?tool=pubmed

[RedBear]

Hey there, good question.  My experience with visceral fat started after I had a bout of PCP.  I weighed 165 lbs. then which was a perfect weight for me as I'm only 5'6".  Once I started meds one night I had horrible stomach pain and the next morning I thought I was just bloated.  However that bloated feeling never went away.  A couple of months later, my innie became an outie.  I went to the doctor appt. and found I had now weighed 198 lbs.  I yoyo'd for a while but after 4 yrs. I was over it.  During this time I had little energy, it was all I could do to walk my dogs.  After going to the MHC and being diagnosed with depression, the doctor prescribed me meds.  The combination of budproprion and citralopram, it was like a cloud lifted.  I made up my mind to get back to my pre-diagnosis weight.  Started in Jan. of this year. I walk the dogs everyday, do 200 sit ups and some crunches as well as a variety of low impact weights and dancing around the house.  Changed my diet to less processed foods, more fruits and veggies, very little sugar and breads.  It wasn't easy at first but as of today I weigh 170 lbs, just 5 more lbs. to lose.  My next appt with the doctor is in 2 weeks and hope I lose that last 5 lbs, but won't beat myself up if I don't.  I've come a long way and have a doable diet and exercise regime that I can maintain.  Feel better too.  So hang in there and watch your diet and exercise.  You're young enough that they may have better melds that don't cause the Meds soon.  Good luck!

[Mishma]

I dropped 20 pounds switching to an integrase inhibitor from  the protease inhibitors which I had been taking, like alot of you, since HAART was first introduced. I posted a review in Research News on this subject.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371609/pdf/nihms381084.pdf
Management of the metabolic effects of HIV and HIV drugs