Some people living with HIV notice that their weight increases after they begin antiretroviral therapy (ART). This can be surprising, especially when their eating habits have not changed much. However, weight gain after starting treatment can happen for several reasons, and it does not automatically mean something is wrong. Here are five important things to understand.
1. The Body Begins Recovering
Before treatment, HIV can cause inflammation, reduce appetite and make the body use more energy than usual. This can lead to unintended weight loss. When treatment controls the virus and health improves, the body may begin restoring lost weight. This is sometimes called a return-to-health effect.
2. Appetite May Improve
Some people experience poor appetite, nausea or other symptoms before starting treatment. As their health improves, they may feel hungry more often and begin eating regular meals again. This can contribute to weight gain, particularly if their calorie intake increases.
3. Some HIV Medicines Can Contribute To Weight Gain
Research has found that certain antiretroviral medicines are associated with greater weight gain in some people than others. For example, medicines containing dolutegravir and some newer treatment combinations have been associated with weight changes. However, not everyone taking these medicines gains weight, and the reasons are still being studied.
4. Changes In Daily Activity Can Affect Weight
As people begin feeling healthier, their routines, appetite and activity levels may change. If someone consumes more calories than their body uses over time, weight can increase. Sleep, stress, age and other lifestyle factors can also influence body weight.
5. Other Health Conditions May Play A Role
Weight gain is not always caused by HIV treatment itself. Conditions such as thyroid problems, changes in metabolism and other medications can also contribute. Significant or rapid weight changes deserve attention, particularly when accompanied by swelling, breathlessness or other new symptoms.