Hello,

Before I begin, thank you for the service you provide. I'm learning so much by reading questions and answers!

I was diagnosed HIV+ in July and am in my fourth month of combination therapy (Sustiva/Trizivir). Had pretty severe nausea for the first month (that occasionally creeps up if I don't take med w/ food or if I drink alcohol (consequently, I have cut alcohol consumption)) and appetite loss continues to be a struggle (though it seems to be getting better). Since being diagnosed (probably due to stress, side effects of meds, and increase in smoking) I've lost 25 lbs. (I'm a 5'7" male and now weigh 125 lbs.). I'm working hard at the appetite issue and slowly, but surely, am gaining weight (though it's pretty slow going). My question: Before being diagnosed, I jogged and exercised regularly; since July, however, I have been scared to do anything that would exacerbate the spiralling weight loss. Now that my appetite seems to be coming back, what kind of cardiovascular exercise would you recommend for someone worried about burning too many calories? (By the way, lab work is a-ok for the time being... cd4 count's about 600 and vl undetectable.)

Thanks again...

Starting with your question, while it is true that you need to favorably balance calories intake with calorie output to maintain and gain weight, some exercise is essential to putting that weight were you want it and to make it optimally function. Appetite can be benefited by exercise and quitting smoking. Whenever possible, preventing weight loss is a better thing to do than to try to regain ground. When you lose weight, you not only put fat at a compromise, but also your muscle and bone tissue.

If you are a medium frame then you should gain to around 150 pounds, your optimal weight. But, if you are usually a muscular person, you may need a bit more weight. Start with some exercise to help you to maintain and gain muscle (resistance style). Follow-up with some moderate cardiovascular exercise. And, quit smoking!!

Considering that you have had some stuggles in the past, it might be worth getting a referral to a physical therapist for an evaluation and exercise prescription. That way you can take into account any limitations and tailor your workouts to what you would like to accomplish.

Also, check out a couple of websites for some information: www.hivfitness.org and click on the training program link on the left side of the page. There are also a couple of handouts on exercise that will be available on www.TCEConsult.org at the beginning of 2002.

As a final note, next time a symptom is severe enough to limit your food intake, put some strategies in place pronto!!