i have been on medication almost 7 years now.i start my treatment with kaletra, zerit,epivir.after 5 years,i was haven some side effect,i luse weight on my buttok,leg. and i gain a lot of fat around my stomack,my chest,and my face.i complained for my doctor and he change my medication in 2005 with norvir,reyataz,zerit and epivir. steel i face the same problem again he change zerit & epivir with truvada since 2006 i'm taking norvir,reyataz,truvada. but the problem steel it's the same even wrost.everyday i'm gaining weight above my stomack.i'm ashemed of my self to mix with people in public.i can't wear skirt my leg is to slim. when i tell my doktor he told me to choose the medication i'll like to take.for me is difficult to choose because i'm not a specialist.i don't know how can i get my woman shape back. please help me what to do?including the type of food that i have to eat and avoied? God Bless U

Well, at least now you are off Zerit and taking a combination that is a lot more "metabolically" friendly. It is very difficult to have fat return in the legs after severe lipoatrophy. All we have left is to exercise with weights and machines more so that our extremities gain lean body mass so that they do not look as skinny.

We have very little data about best ways to deal with fat accumulation in HIV besides small studies on exercise (good results), metformin ( conflicting but mostly promising results), growth hormone (good results but the FDA did not allow its approval for lipodystrophy), testosterone (decreases waist size but only by burning subcutaneous fat, Oxandrolone- Oxandrin ( small study that shows decreases in visceral and subcutaneous fat but decreases in HDl cholesterol), and some emerging data on the benefits of soluble fiber in visceral fat reduction. We do not have any data on low carb diets and HIV related visceral fat reduction, but I have heard many people say they have worked for them. You may want to read books like Sugar Busters or the South Beach diet to learn more.

As always, have your doctors check your thyroid function and other hormones to ensure that everything is ok.

I hope this helps some and let us know how things go!

Nelson