Hello,

I used to take Combivir and Sustiva before switching to Atripla, and since changing have seen a gradual weight gain of around 14lbs (in 8 months) however other than my muscles looking more toned (legs and arms) the only place the weight seems to be going is around my stomach...

... Now this is to the point where i naturally look slim, but some days look like my stomach is swollen and fat - is this common with a more fat friendly regime and how can i work on my stomach so its flat as i fear that the rate i am going people will see my stomach 10 seconds before the rest of me and it can be quite depressing...

I dont drink alcohol, eat well, and do light exercise such as walking so dont know why its happening...

Studies have generally shown that there is less fat loss with Atripla compared to Combivir + efavirenz. What is not clear is whether Atripla is associated with more intra-abdominal fat gain. Studies and clinical experience has not consistently noted the phenomenon that you describe though it may vary from patient to patient. The amount of stomach fat gain from Atripla has generally been very modest with occasional outliers. A nutrition/exercise assessment as well as thorough history and physical examinaton are important to assess factors involved. Sometimes an Xray (such as abdominal CT) can help sort out the anatomy and indeed whether there is a significant increase in intraabdominal fat. KH