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Lipodystrophy and WastingLipodystrophy and Wasting
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weight loss immediately following diagnosis
Jul 29, 2002

Hello... I was diagnosed HIV+ about three weeks ago. My doctor and I agreed to watch and wait before starting a regimen of meds, so I'm maintaining my regular healthy diet and very active exercise schedule. My question: It looks like I've dropped four pounds in the last two weeks (I'm 5'8, 168 lbs. normally). Is any kind of immediate weight loss common in people who seroconvert? Or am I being paranoid? Thanks........

Response from Ms. Fields-Gardner

Staying generally healthy is a very good strategy to support whatever you decide to do about managing HIV infection. Weight varies more widely than 4 pounds over such a period of time and you might start by making sure that the change in the scale is really a weight loss. It helps, of course, to have a good scale. You should measure your weight at the same time of the day... preferably in no more clothing than your underwear just after going to the bathroom when you first wake up. That weight should remain pretty stable.

If you still find that you are 4 pounds down and especially if the trend is downward there could be a calorie imbalance. Usually, you eat enough calories to maintain weight, so you should check to see if you have changed your intake. Stress can change the way you eat and that will be the first thing to check.

Your calorie needs may have increased. This happens with an infection (including HIV infection) and you can start by eating more calories to compensate.

Keep a good eye on your weight (realizing that your goal is a stable weight within about 5 pounds or so over time). If you have any rapid weight losses that you cannot account for with reduced calories, tell your doctor and start investigating reasons why. Even then, eating well is important (feed and cold, feed a fever, feed everything enough!).

It is a good time to get baseline measures done so you know what is normal for you. Ask for a referral to an HIV-savvy dietitian who can measure and evaluate your dietary intake, body composition, and other important features of your body's health. Get regular check-ups on these items to keep track and respond to any adverse changes quickly.

Best wishes!

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