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Lipodystrophy and WastingLipodystrophy and Wasting
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Began a weight loss program.
Oct 22, 2001

I just joined Weight Watchers as I am approx. 50 pounds over weight. I found out I was hiv+ 3 years ago, I'm on meds, Valtrex, Paxil, Viramune and Combivir. My viral load is undetectable and my tcell varies between 500 and 900. I am healthy other than some mild side effects and of course the hiv. I'm wondering, will I be promoting wasting by losing weight? Weight Watchers lets me eat what I want as long as I stay within a certain amount of points. It just promotes good portion control. I like the program and would like to continue it until I get to a healthy weight. Please advise if this is a good idea. Thank you in advance.

Response from Ms. Fields-Gardner

Weight loss and weight control are sometimes sticky issues when HIV-infected. Weight Watchers can be an excellent program for the things you mentioned: learning about portion control, dietary balance, and healthy weight goals.

The addition I would recommend is a body composition evaluation to find out what that 50 pounds extra represents. In this case, I would recommend both a BIA (bioelectrical impedance analysis) and a set of anthropometric measures (including circumferences of the arm, chest area, abdomen, thigh, and calf along with fatfolds -- usually done with "calipers" by a person trained in technique -- of the triceps, abdominal area, and thigh).

Your body composition evaluation will tell you more about whether or not that 50 pounds is a normal diet-induced gain or a consequence of your body's changes with disease, medications, and aging (among other factors).

If your extra weight is normal gain, then you can afford to diet if you do so sensibly. For a diet-induced weight loss, you are likely to lose around 60% of the weight as fat and 40% as lean. Exercise will help you to hold onto lean weight (particularly muscle) and emphasize fat losses. The concern with dieting is the additional losses of muscle or extremes in fat losses under the skin (subcutaneous fat). You can monitor to make sure that this doesn't happen by having regular body composition check-ups.

If your additional weight looks like the result of changes in metabolism or includes some "lipodystrophy syndromes" style changes, you may want to be a bit more careful and spend some time with your doctor to discuss appropriate ways to address those problems.

Whatever you decide to do, good eating habits (including portion control and the rest) and a good regular exercise program will support both types of goals: healthy weight maintenance and support to normalize altered body fat deposits.

bad vitimins??
Shingles and HIV

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