Improving your body shape

Muscle wasting was a significant problem for PLHIV before the HAART era and maintaining protein reserves and some body fat is useful at times of illness, when appetite and energy may be low. If you are interested in gaining weight and building muscle then see our section on fitness goals.

Although new HIV medications in the late 90’s massively improved health and life expectancy and reduced the level of HIV-related muscle wasting, some of the earlier drugs (NRTIs such as D4T, DDI, DDC) caused lipodystrophy. This metabolic syndrome can cause fat loss from the arms, legs, buttocks and face and in some cases the redistribution of fat to other areas (stomach, breasts, upper back and neck). It can also increase levels of fats (lipids/cholesterol/triglycerides) in the blood stream, which increase the risk of cardiovascular problems. Thankfully, with newer and better formulations of ARVs, lipodystrophy is much rarer today, but what can be done to prevent or reverse it if you have been affected?

First of all, if you are still taking any of the older drugs, changing medications should stop things getting any worse. Although some studies have shown that Human Growth Hormone can be effective in reducing abdominal fat, its high cost and frequent severe side effects mean that it is not likely to be prescribed through the NHS. Other than this, exercise is the only intervention that has been shown to reverse the progress of lipodystrophy in relation to general body shape. However this does not apply to facial wasting, which needs to be treated with Newfill injections.

Studies show that a combination of cardiovascular exercise and resistance (weight) training was the only thing which helped reduce the appearance of fat around the stomach area in men. Whilst it may not be possible to get rid of all the fat that has accumulated (depending on how severe the lipodystrophy might be), reducing some of the fat and building muscle in the areas where it has been lost (arms, legs, buttocks) can reduce the severity of the condition and improve your body proportions and appearance.

As exercise is an extremely effective way of reducing bad blood fats and increasing the good fats, not only will it combat the outward signs of lipodystrophy, but it will also improve the inner fat issues which, although invisible, are the greater health concern in the long term. Doctors often prescribe drugs to reduce cholesterol and triglyceride levels, and whilst these are effective, they can have their own side effects and are yet more pills to take. Exercise on the other hand will do the same job and provide you with a health investment for the future in terms of cardiovascular risk factors, improved appetite, sleep, bone density, mood and self esteem.

If there’s a better answer than this, it has yet to be found!