Nutrition & Weight

Good nutrition and weight maintenance are extremely important for people living with HIV. The vitamins, nutrients and energy that nutritious foods provide can help stave off illness. Maintaining weight, and preventing the loss of muscle mass (called lean body mass), bolsters general health and the body's ability to fight disease.
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That said, malnutrition and weight loss are common problems associated with HIV disease. Malnutrition can result from a loss of appetite due to depression, fatigue, illness or drug side effects. Without an obvious loss in a person's weight, it can persist undetected.
Weight loss can be an obvious sign of malnutrition. It can begin and become severe anywhere in the course of HIV disease. Wasting is extreme weight loss -- an unexplained loss of 10% or more of a person's normal weight. Some people report wasting despite having very high CD4+ cell counts. However, the risk of wasting and serious malnutrition increases dramatically when CD4+ cell counts fall below 100.
There are many ways to manage your nutrition and weight. A comprehensive strategy for treating HIV should address these areas. Your weight should be monitored with the same watchful eye as your CD4+ cell counts and other lab results. It's critical to prevent, detect and reverse weight loss early. Specialists note that the difference between successfully treating an opportunistic infection and treatment failure can depend on a few pounds of weight.
There are many ways to prevent and treat weight loss. Using different approaches may be needed throughout HIV disease. A healthy person with no obvious signs of weight loss will probably develop a very different kind of strategy than someone with significant weight loss. Similarly, weight loss due to problems in the gut (gastrointestinal distress), diarrhea or other conditions may need different interventions than weight loss due only to drug side effects.
Finding a nutrition and weight maintenance program that fits both your lifestyle and nutritional needs is critical for success. The following are a few points to consider, which are further explained in this article.
Include nutrition and exercise as part of a comprehensive treatment strategy for HIV.
Rigorously diagnose and properly treat causes of weight loss.
Follow reasonable guidelines for "safer" food preparation.
When necessary, consider using supplements to replenish deficiencies.
Learn the pros and cons of various interventions.
Include nutrition and exercise as part of a comprehensive treatment strategy.
The importance of nutrition and maintaining lean body mass cannot be overstated. Good nutrition, combined with exercise, strengthens the body and mind. Together, they can provide a solid foundation to optimize the benefits of therapies to treat HIV and other infections.
Most doctors and people living with HIV do not recognize the early signs of weight loss. Ways to help prevent wasting and malnutrition include careful monitoring of weight, using lab tests to look for vitamin and hormone deficiencies and developing a nutrition and exercise program. Whenever possible, it is far better to correct nutritional problems before they become severe. This may mean intervening with improved diet, appetite stimulants or weight gain supplements.
Your strategy for coping with nutrition and exercise should be checked periodically, adapting it to your body's changing needs. Two people at the same stage of wasting may approach exercise and nutrition differently. Someone willing to follow a workout regimen and careful diet may rebound from wasting by simply adopting better eating habits. Someone who is less inclined to exercise and finds it more difficult to carefully follow a diet may need more invasive interventions, ranging from the use of appetite stimulants and supplements to total parenteral nutrition (TPN). Both people might successfully rebound from wasting, but each intervention reflects individual lifestyle factors and choices. There are pros and cons to each option. Get informed, weigh the risks and benefits, and develop a realistic plan to prevent or reverse wasting.
Many people experiencing weight loss or malnutrition feel frail and avoid strenuous activity. They also tend to feel depressed -- a condition linked to malnutrition. These feelings often get in the way of keeping up with good nutrition and exercise. This perpetuates a dangerous cycle. Even if you feel frail, your body is much more resilient than you may feel!