Hello, I have been HIV+ for 19 years and over the last 2 years have put on 30 pounds. I am young only 35 years old and have 2 teenage children. I attend college full time and I am losing my hearing so I have to get my college degree done as soon as possible. My energy level is very low and I decided since it warmer and I am out of school for the summer I would start exercising. I have tried kickboxing and pilates so far. I get out of breath very easy, maybe after 3 minutes and it hurts my chest. I am taking combivir and sustiva. Most of the weight gain has been in my stomach and breasts. I went from a C cup to a DD in a short time. They cause me to slouch and I find it very unattractive. My question for you is, What is the best type of exercises to do. Should I start off slowly, since I have such a difficult time catching my breath. Could that be from being out of shape? I eat well, I don't over indulge. My only weakness is diet pepsi. I have cut back to 3 20oz a week, from 2 a day. I want to remain as healthy as I can. My doctor doesn't seem to think the weight gain is a problem, but I am not happy with it. Thanks

I think kickboxing and pilates are too hard to start (I would lose my breath also!) I love the elliptical trainers since they are low to no impact and you can really go after a great burn in 30 minutes (you can change the intensity as you go)without exhausting you. I would also combine this with weight training three times a week for one hour sessions.

What do you think has changed in the last two years? Have your meds changed? Have you become more sedentary? Are you eating more?

At least you are not drinking real pepsi full of sugar (although nutrasweet scares me in the long term). Try your very best to drink water instead (I know it is not easy after being hooked on the diet pepsi flavor)

Get your doctor to check your hormones (testosterone, DHEA, estrogen, progesterone, thyroid) to make sure you have no defficiencies. There is a great pharmacy that compounds customized hormone creams for women with a doctor's prescription called Women's Intenational Pharmacy ( visit http://www.womensinternational.com/ for more details)

You may also want to make sure you do not have a glucose tolerance problem. Talk to your doctor about a GTT (glucose tolerance test) Sustiva and protease inhibitors can affect the way insulin works in your body and influence the way your body stores fat. There are ways to improve insulin sensitivity with insulin sentizers like Glucophage, Avandia or Actos. Your doctor can describe the pros and cons if you do need them.

Serostim (growth hormone) has also been shown to be effective at burning fat, but it is not approved for lipodystrophy yet.

Anyway, as you can see, it is a complex issue that needs to be discussed with your doctor.