Sep 26, 2012
How do I get rid of this huge bell im normally 150 lbs slim frame 5ft 7 im on atripla now for 5 or 6 years now I got to the gym with no results help me I don't want to look pregnant
Response from Dr. Henry
Increased fat (lipohypertrophy) is less common with more modern HIV regimens but does occur and can be frustrating to manage. Increased fat is a major problem in the US population at large (without HIV) so it has been a challenge to focus on what contribution to fat gain is made by specific HIV medications. There has not been a large study that has shown that switching from Atripla to another regimen can reduce abdominal fat though there are some regimens that may be more fat neutral there is no firm recommendation available. Diet and exercise remain the cornerstone of managment but those fall short for many patients.Growth hormone and growth hormone releasing factor have been approved for management of increased intrabdominal fat (studies show typically a 1/2 to 1 inch decrease in belt size--modest a best) at high cost (>$25,000/year), meds have to be injected regularly, have some side effects, and the benefit wanes when treatment is stopped. Genetics can play a strong role (either fat distribution in general without HIV as a factor--looking at similarly aged relatives can provide clues there) or in how fat is handled while on certain HIV medications (there may be a genetic predisposition in some patients for fat gain or loss). Fat loss has been a problem even more clearly linked to HIV and certain HIV meds (fat problems termed lipodystrophy) and also has been difficult to manage other than switching off offending meds (in case of fat loss specific meds have been more clearly linked to the proble-such as stavudine or zidovudine).KH
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