Weight Watchers

In the 1980s and early ‘90s, long before antiretroviral treatments, extreme weight loss — wasting syndrome — became a visible indicator of a person living with HIV, leaving the hauntingly gaunt, skeletal look etched in the public mind as the easily recognizable face of AIDS. 

After the widespread use of HIV antiretrovirals became the norm in the United States, wasting syndrome began to diminish and became a less common occurrence. While it is less visible, weight loss continues to exist in people living with HIV and evidence shows it’s still an important HIV comorbidity with dangerous implications. Approximately 10 percent of people living with HIV experience HIV-related weight loss, despite the use of antiretrovirals. A study conducted in 2002 — after the advent of ARVs — found that with weight loss of 10 percent or more, there was a four to six-fold increase in death compared to those with a stable weight.  More recently, AIDS Map reports, “unintentionally losing 5 percent of your body weight in a six-month period is an indicator that you could become seriously ill because of HIV.”

Numerous factors can cause or contribute to weight loss among people with HIV. Other comorbidities such as cardiovascular, respiratory, and kidney diseases may be a factor for some. Others can experience weight loss from HIV enteropathy (unexplained and prolonged diarrhea); a loss of appetite due to isolation, depression, or the use of multiple medications; or a reduced food intake due to economic disparity, food insecurity, oral infections, or difficulty eating. 

HIV itself can cause weight loss as the virus can increase the body’s metabolism.This speeds up the rate at which nutrients are used. HIV can also have an effect on the lining of the gut, which can lead to malabsorption, making it harder to for the body to absorb nutrients. 

The use of antiretrovirals is actually the most prominent way  to treat or correct HIV-related weight loss. Next comes eating healthier and consuming enough protein and nutrients. This is one of the cornerstones of maintaining good health, but it often remains overlooked.  Nutrition, particularly for those with medical conditions, can greatly affect both physical and mental wellbeing. Adequate nutrition is especially important for people living with HIV as the virus causes inflammation and damage to the digestive system that can leave them vulnerable to malnutrition and related illnesses.  Many HIV-positive people experience deficiencies in protein, selenium, and vitamin D. 

To resolve these deficiencies, doctors and nutritionists may prescribe a protein-based nutritional supplement to boost protein and caloric intake. Unfortunately, the supplements most often prescribed to treat weight loss are little more than sugar water with a multi-vitamin. Nutrition is not taught in medical schools, and data on protein supplements (and supplements in general) is limited. As a result, physicians often prescribe the products they are most familiar with, which aren’t necessarily the ones that are most effective. Too often, familiarity is built on in-office visits from pharmaceutical reps working for companies with large enough budgets to facilitate these visits. 

Doing your own research is great way to find out which supplements are right for you. Before talking with your doctor about adding a specific protein to your diet you’ll want to evaluate factors like the ingredients, how much protein each serving provides and how many calories are in each serving.  

The top three ingredients in the two most commonly used protein supplements are sugar, corn syrup, and water: the same key ingredients as many soft drinks. When looking for a protein supplement, look for those without corn syrup. Also look for ones that have less sugar and little or no sodium. These are usually better for you. Comparing protein and calories among various products will help you determine which supplements will provide the most benefit. For example, the top two supplements have approximately 240 calories in each serving and between 10-12 grams of protein. Meanwhile, a supplement called Enu, made by Trovita Health Science, contains double the calories at 480 per serving and double the protein at 25 grams per serving.  In addition, Enu contains no sugar or corn syrup. The top two protein supplements contain 150 and 200 milligrams of sodium verses 100 milligrams of sodium in Enu. Clearly Enu is a far superior weight gain supplement than the leading supplements, although many doctors prescribe these less healthy alternatives.

HIV-related weight loss can be physically and mentally devastating to a person living with HIV. Although science has come a long way in improving the quality and quantity of life for HIV-positive people, weight loss is an area that doesn’t gain the attention or research it deserves. 

Talk to your doctor and a nutritionist and ask them to help you devise a well-balanced meal plan that will assist you with adding healthy weight. Research weight gain supplements and familiarize yourself with those that will provide the calories and protein that you need instead of relying on brand recognition, which may not be the best option for restoring your weight to a healthy level. Information is your best defense against poor health. The more you know, the greater your ability will be to contribute to your own healthy lifestyle and quality of life.