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Lipodystrophy and WastingLipodystrophy and Wasting
           
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Definition of Wasting
Mar 28, 2004

I'm confused about what constitutes wasting...

At the time of my diagnosis late last year I'd lost about 20 pounds in the preceding 9 months. Now, keep in mind I'd been TRYING to lose weight by going to the gym more and cutting eggs/dairy out of my diet. (I've been vegetarian for almost seven years...)

Anyway, my PCP says that since I've never had an AIDS diagnosis my weight loss was NOT technically wasting, but my nutritionist says that it WAS wasting because any HIV-related weight loss is considered wasting.

Since starting treatment almost three months ago, I've put back about fifteen of those pounds. But also during this time, the eggs and dairy have been slowly creeping back into my diet here and there. (Im still largely vegan, but not entirely.) So, again, Im not sure if its diet or HIV at play here...

Can you shed any light on this?

Thanks, D

Response from Ms. Fields-Gardner

The CDC definition of wasting is based on weight loss of 10% from baseline weight. The definition shown on the CDC site states:

"HIV wasting syndrome: Findings of profound involuntary weight loss of greater than 10% of baseline body weight plus either chronic diarrhea (at least two loose stools per day for greater than or equal to 30 days), or chronic weakness and documented fever (for greater than or equal to 30 days, intermittent or constant) in the absence of a concurrent illness or condition other than HIV infection that could explain the findings (e.g., cancer, tuberculosis, cryptosporidiosis, or other specific enteritis)."

Thus, wasting is an AIDS-defining diagnosis. However, it sounds like your weight loss was related to an intentional change in your diet and not to HIV infection. Not everything you experience is a direct result of HIV infection.

Still a tricky issue that you may need to revisit with your dietitian and physician. Perhaps the question will be, did you lose the amount of weight you should have lost due to an intentional weight loss diet or was some weight lost due to the effects of chronic disease?

And, on the question of losing weight, I would encourage you to get a body composition evaluation done to make sure that the loss and gain of weight reflects intentional diet and not disease effects.


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