Unintentional weight loss and HIV

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.

An important first step is to identify any medical cause of the weight loss. 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.

Losing too much weight can be dangerous as it reduces the body’s ability to fight infection and recover. 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. Changes in your appearance because of weight loss can also be difficult to cope with.

If you are concerned about your nutritional requirements, cannot face eating during this period or are finding it difficult to keep food down, speak to a member of your healthcare team or a dietitian. They will not bully you into eating 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.

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.

Eating when you are ill

When you become ill you often lose your appetite. However, your energy requirements are often greater when you are sick. What you eat is likely to be very important to how you fight illness and the speed at which you recover.

• To help prepare for times when you are ill, make sure you always have food available in your home. Canned foods, long-life products and frozen 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, or having small frequent meals, may be easier than eating three main meals; it can also be less tiring to prepare and eat food in this way.
• It is a good idea to have snacks full of energy at hand for when you are unwell such as nuts, dried fruits and cheese and biscuits.
• Easy-to-swallow full-fat drinks and yoghurt may also 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.