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AIDS Treatment Data Network
(ATDN) Weight loss and HIV

December 1, 1994
Treatment Review #15; December 1994

Weight loss associated with HIV infection is also known as wasting, because the rate at which a person can lose weight makes them look like they are wasting away. Wasting may be due to a number of reasons. These include: decreased nutritional intake; increased energy needs due to fever, infection, wound healing or rapid breathing; ineffective utilization of nutrients by the body and problems with absorption. Someone's desire and ability to eat can also change due to depression, lack of appetite, swallowing problems, altered taste due to disease or medications, feeling of fullness, nausea and vomiting.

Diarrhea is often a cause of wasting. Diarrhea can be caused by infection and/or dietary factors. Some people with AIDS have lactose (milk sugar) intolerance, others have fat intolerance. Taking too much Vitamin C may also cause diarrhea. Lactose-free diets may be helpful, as may decreased fat intake or avoidance of certain fats in the diet. Consulting with a dietician who works with people with HIV and AIDS can help determine which foods you may need to avoid, and which can help control symptoms. The Network can refer you to a nutritionist.

Putting weight back on is much harder than keeping it on, or increasing what you have. The goal of weight gain is the addition of lean tissue mass. While total body weight includes fat and water, lean tissue for muscles and vital organs is most important. Weight gain from fat and water is not as useful. Lean tissue is built through a combination of food that is high- calorie and rich in proteins and complex carbohydrates, and exercise, which converts food energy into muscle. Early intervention in treating wasting really means making every effort to prevent wasting. Regular exercise, along with a diet high in proteins and complex carbohydrates can help prevent weight loss. Preventing the infections that can cause diarrhea and lead to wasting is also very important. Some treatments are available and in studies for treating and hopefully reversing wasting. These are described below.