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Lipodystrophy and WastingLipodystrophy and Wasting
           
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losing weight
May 2, 2002

I am hiv+, female, currently not on any meds, and am working on a diet program with my physician to shed some lbs just for general health. In a science class I was taking we were told that genetics determines your # of fat cells, so this does not change, they can only get bigger or smaller. However, in a health class I am taking, we learned about hyperplastic vs hypertrophic obesity. They said that overweight children who are growing can increase their # of fat cells which can lead to obesity. I am confused, I was an overweight child and am wondering if I will have a hard time trying to lose some weight because of hyperplastic obesity, or do your # of fat cells really always stay the same?

Response from Ms. Fields-Gardner

That is the theory. And, it is said, weight is regained more easily in hyperplastic obesity. In adults, it is usually a hypertrophy of fat that yields weight gain while hyperplasia (growth in numbers) of fat cells are more common in children. However, both types are controlled through the number of calories and the amount of fat you consume.

Things become even more complex when you throw in chronic disease (such as HIV infection). When you lose weight, you will lose both lean and fat and you will need to make sure you have a buffer of lean that you can afford to lose in the process. Because of this, you will first want to be evaluated for body composition. You should also be monitored during your weight loss to make sure that your health is not damaged in the process. Ask for referral to a dietitian who is familiar with both HIV infection and obesity to assist you.

Best wishes on this!


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