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Lipodystrophy, Body Changes and HIV/AIDS

May 2012

Table of Contents


What Is Lipodystrophy?

Lipodystrophy means abnormal fat changes. It is used to describe a number of changes in body fat that are experienced by many people living with HIV (HIV+). Lipodystrophy can also include changes in fat and sugar levels in the blood of HIV+ people.

Although there is no official definition of lipodystrophy in HIV, it is generally broken down into two categories:

HIV+ people can experience both body shape changes and metabolic complications. This is sometimes called lipodystrophy syndrome.


Body Shape Changes

Changes in the shape of your body can be caused by fat loss, fat build up, or fat redistribution.

Fat loss may happen in the:

Fat build up may happen in the:

Some studies show that lipodystrophy affects men and women differently. Women are more likely to see fat gain in their breasts and stomachs while men are more likely to see fat loss in their legs, arms, buttocks, or faces. However, many men and women suffer from both symptoms. It is not clear why there might be differences based on sex. It may have something to do with hormones or with how men and women burn fat differently.

Lipodystrophy can dramatically change your appearance. These changes can leave some people with feelings of poor self-image and low self-esteem. Some people may want to stop taking their HIV drugs. Others may put off HIV treatment due to fear of experiencing lipodystrophy symptoms. It is important that you talk to your health care provider if you are feeling this way so that you take the necessary steps to improve your health.


Metabolic Complications

Changes in fat (lipids) and sugar (glucose) in your blood are called metabolic complications and include:

Metabolic changes cannot be seen with the naked eye; they can only be confirmed through blood tests. Without treatment, they can cause serious long-term health problems.

It is important that you and your health care provider make sure you get regular lab tests to check for metabolic complications. Call your health care provider right away if you are experiencing symptoms of lactic acidosis.

See TWP sheets on hyperlipidemia, diabetes and lactic acidosis for more information.


What Causes Lipodystrophy?

Scientists have many theories about what causes lipodystrophy and research in this area is ongoing. However, the exact causes of lipodystrophy are still unknown. There may be different causes for different symptoms.

Not everyone taking HIV drugs develops body shape changes or problems with fat or sugar levels in the blood. Researchers have been looking for other factors that may cause lipodystrophy. The following appear to be risk factors:


Can Lipodystrophy Be Treated?

At this time, there is no simple treatment for lipodystrophy. However, there are a number of approaches that are being used to treat some of the symptoms.

Fat Loss

Fat Gain

Increased Lipids

Increased Glucose Levels, Insulin Resistance, and Diabetes

All Symptoms of Lipodystrophy

Reducing the amount of saturated fats you eat may help reduce cholesterol levels. Saturated fats are found in animal products. Reducing the amount of fats and carbohydrates you eat may help reduce triglyceride levels. Some health care providers also recommend more fiber in the diet to help control insulin resistance and help decrease stomach fat.

While there is no definite proof that these methods will improve lipodystrophy, there is no down side to eating right and exercising. It is a good idea to speak with a nutritionist or dietician about the steps you can take to improve your diet and level of physical activity.


Caring for Yourself

If you are experiencing lipodystrophy it is especially important to take care of your body. Keep all of your appointments with your health care provider, get regular lab tests, and tell your provider about any changes in the way you feel or in your body shape. Recording body measurements and weight on a regular basis, whether or not you are taking HIV medications, may give you valuable information down the road.

Some of these body shape changes and metabolic problems have been linked with heart disease and strokes in HIV+ people, so make sure you are checked regularly. Other factors, such as high blood pressure, may also contribute to the risk of heart attacks and strokes and need to be treated. You can also support your body, and especially your heart, with a healthy diet, regular physical activity, and stopping smoking.

Even though the physical changes of lipodystrophy can cause emotional distress, no researcher has suggested that people with lipodystrophy should stop taking their HIV drugs. If you are concerned about your appearance, talk to your health care provider about treatment options. There are many things that you can do to stay healthy and feel good about your body.




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