Feb 11, 2008
I'm a 36 y.o. HIV positive male of 14 years. I have both lipodystrophy/lipoatrophy. I'm close to 300 pounds. I've had 4 dorsocervical fat pad (buffalo hump)liposuctions. my legs have no fat, once so ever, just calf muscle to hold my body upright. I have a rather large suprapubic fat pad. (in the last 5 years has gotten bigger). My arms are still ok. Most of my body weight (75 %) is in my abdomen. I have switched meds, dieted, excercised, and still am gaining weight. My doc put me on serostim, I gained 17 pounds in 7 days on it, so I was taken off of it. My Doc seems to think my only option will be some kind of surgery to remove my visceral fat. Is there such a surgery? I have inquired, but can't seem to find any surgeon in the L.A. area that does this. Could you give me some advise on what to do and possibly a surgeon referral?
Response from Dr. Henry
Treatment options for well established lipodystrophy problems are quite limited. You don't mention which HIV meds you are on or have been on. Often the best option to to try and avoid worsening (sometimes might see reversal) fat distribution problems by switching off any HIV meds that could be contributing further to the problem. I am not aware of much experience/success with removal of visceral (intra-abdominal) fat for this problem. If any reader knows of any published data on that approach please post. Exercise and diet can help some patients improve fat increases but results are variable. KH
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