May 30, 2007
I realize so much is still unknown on the topic of lipodystrophy and lipohypertrophy so I'm asking for a little speculation here...
Lipodystrophy seems the more "problematic" from a causation, and especially treatment standpoint, so I'm not going to focus on that one right now.
I'm recently diagnosed and recently started treatment (MK-0518/Sustiva, with Truvada [clinical trial]).
My main concern right now is lipohypertrophy. I say this because I already started with a considerable "beer belly". I'm basically this skinny guy with the huge belly(soft fat, not hard fat). Since my diagnosis I've been working very hard on this. I've lost 30lbs and the belly is shrinking, but I can still pinch about 2 inches of fat near my belly button, so I still have more work to go.
My thinking is that I want to be as aggressive as possible in getting in good shape and good health PRIOR to adding the new issues of chronic infection and treatment.
Is there anything besides diet and exercise (which I'm doing) that you would recommend that I ask my Dr about to help me achieve better body shape?
Response from Dr. Young
Thank you for your post and for your generous participation in clinical studies.
There's a lot to know about lipodystrophy. One key thing is that the typical fat that you can "pinch" generally isn't lipo-- lipodystrophy is really two syndromes; one is lipoatrophy (fat loss), the other is fat accumulation. The former involves the loss subcutaneous (skin) fat-- the fat you can pinch. Loss of subcutaneous fat results in prominent facial bones and veins in the arms and legs, for example. Fat accumulation generally involves non-subcutaneous fat stores- within the abdomen, or breast.
It would sound to me that the fat you can pinch is the usual fat accumulation that trouble many people (HIV+ and HIV-).
TheBody has a useful Lipodystrophy Resource Center. I hope that this is helpful to you.
Best of health, BY
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