Hi. I would like to start by saying thank you so much for all the time you Doctors spend on this web site. Ok, here is my question: I just started on hiv meds with a cd4 of 60 and a viral load around the million mark I just got through a really tough bout with lymphoma and chop therapy. I am weighing in at 114 lbs with a height of 5'6". I have so much stomach pain and nausea that food is really the last think I can think of right now. Can you give me some advice on how to get my appetite going? I do not want lose anymore weight. My meds are sustiva/epivir. Thank You so much.

The fact that you are motivated to work on the nutrition issues such as weight maintenance and gain is a very good thing! It sounds like the stomach pain and nausea are really getting in the way of getting enough food. There are several strategies you can try and it may take persistence to get things going.

Nausea and abdominal cramping or pain can be associated with both of your medications. Some dietary strategies include lower fat, and small (but frequent) meals. Calorie-containing supplements can help and you might consider some with higher calorie levels (remember that these liquid or bar supplements are meant to sip or nibble at when you have problems with nausea). You should also make sure that you are well-hydrated (abdominal pain is sometimes a symptom of dehydration) by drinking plenty of fluids. In your case, calorie-containing fluids might be a good choice to support weight maintenance and gain. For more complete strategies, get a referral to a dietitian who can help to evaluate and recommend strategies for you and your doctor to consider.

Talk with your doctor about how severe your symptoms and whether you feel them after eating or at other times. He/she might recommend antinausea or other medications to ease the problems. If the problem is long-term and you have lost a good amount of weight from your baseline, you may also want to be evaluated for hormonal changes.

Your goal is to restore your comfortable weight. General levels of weight can be calculated based on your height. If you are a man, 140-145 pounds might be a good level with a medium frame. If you are a woman, around 130 pounds would be a good weight for a medium frame. It is not always easy to gain back lost weight, so be persistent!