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Avoiding and managing weight loss

The improvements in health that accompany treatment with anti-HIV drugs include improvements in body weight.

However, weight loss can be a very serious issue for people with HIV, especially if they have a low CD4 cell count or are ill because of the virus. Unintentionally losing just 3% of your body weight can significantly increase your chances of becoming ill because of HIV.

When you become ill you often lose your appetite. However, your energy requirements are likely to be greater when you are sick. Losing too much weight can be dangerous as it reduces the body’s ability to fight infection and recover. Changes in your appearance because of weight loss can also be difficult to cope with.

If you are ill, or are recovering from illness, what you eat is likely to be very important to how you fight illness and the speed at which you recover. If you are concerned about your nutritional requirements during this period, speak to a member of your healthcare team as soon as possible as it is very easy to start missing out on essential nutrients.

Above all, don’t think that eating problems or unintentional weight loss are trivial. They are not, and it is always better to see someone early to prevent problems later.

Unintended weight loss should always be taken seriously. If you cannot face eating or if you are finding it difficult to keep food down, a dietitian will not bully you into eating your food. Rather, they will work with you to try to help you regain your appetite, recommend smaller, more nutritious meals, or look at other solutions.

Causes of weight loss

An important first step is to identify any medical cause of the problem. Loss of weight can be an important warning sign of the presence of an infection or other condition, and is often noticeable before other more specific symptoms become apparent. It is unusual for a person with HIV to lose weight if there is not an underlying medical problem, although lack of appetite, worry and depression can be causes.

It is important to try and minimise unhealthy weight loss during illness and to put weight back on as lean muscle mass if you lose it during an illness.

Tips on eating when you are ill

Always have food available in your home. Canned foods, long-life products and frozen, ready-made meals can be helpful when you are feeling unwell. If you are unable to afford food then seek help and advice from your local council, HIV treatment centre or an HIV support agency.

Snacking through the day may be easier than eating three main meals; it can also be less tiring to prepare and eat food in this way.

Easy-to-swallow full-fat drinks and yoghurt may provide a useful source of energy and calories.

Your clinic will be able to provide food supplements that contain a balance of the nutrients you need, which may help you boost your energy intake if you are very unwell.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.