Like many other on here, I have experienced severe increase in itra-abdominal fat. I would like to have a ct scan or mri, but my doctor thinks it will be a waste since we know it is lipodystrophy. My question is, can I privately pay for a CT scan or mri without a dr's referral? Is one scan preferential to the other for showing the intra abdominal fat, and do i need contrast? how much does this cost? i know there is the new medicine egrifta, but i really don't want to start a medication that can cause blood sugar probems.

thanks

CT scans are useful to localize fat increases or decreases. Egrifta is a very expensive treatment for increased abdominal fat (> 30,000/year in US) that has to be given as a shot, average improvement is decrease of 1/2-1 inch of belt size, has some side effects in some patients (such as bone pain), and the benefit reverses when injections are stopped. Diet, exercise, changing meds around in some cases are worth considering in some patients. Treatment overall is very frustrating as is long term management of weight gain in the general population (though I would argue more complex and challenging in HIV+ persons). KH