Question
Will exercise help with fat accumulation?
11 April 2012. Related: All topics, Side effects.
For the past year or so I have felt quite bloated. I was diagnosed with a hiatus hernia and have medication to control that. However, I still have an uncomfortable feeling in my stomach which feels like its pressing against my ribs. I explained the feeling to my doctor of just having too much stomach for my body. Doesn’t hurt, just feels uncomfortable like it shouldn’t be there. The doctor explained that this could be a result of fat accumulation. I have read a bit about this on your web, as well as others. My treatment combination is Truvada/Darunavir/Ritonavir.
They have taken extra blood to check my thyroid and also check for diabetes to rule these out. I haven’t heard anything (bloods over 2 weeks ago) so I assume they’re fine. I don’t usually get my results until my next appointment (every 3 months) – they just phone me if there is something not right!
I go to the gym about 4 times a week and do cardio and resistance training. Cardio is at least 45 mins per session (keeping my heart rate at around 140). I have a pretty good diet.
My question is, is there anything else I can do to help shift this fat accumulation? Doctor says my diet and exercise will help. Will the fat reduce over time, if I keep watching my diet and keep up with the exercise?
Doc said we can discuss treatment optionsat my next appointment in June, however, apart from this feeling I get on well with my meds so not really wanting to change. For info, CD4 is about 800 and VL undetectable.
Answer
I’m sorry to hear that you have these different symptoms but the bloating may or may not be related to your HIV treatment.
Changes in body fat can be a side effect called lipodystrophy. Does the information at this link describe your symptoms?
We still don’t know what causes fat accumulation and this makes it difficult to treat. This can be very frustrating. If you have fat accumulation, diet and exercise are the most likely way to try and reverse the symptoms.
Fat accumulation has been linked to protease inhibitors, including darunavir/ritonavir but also to other drug classes including NNRTIs and nukes. There is mixed evidence as to whether or not changing treatment will help with lipodystrophy. Removing darunavir/ritonavir from your may or may not make a difference.
The link above also has some information about a potential treatment for fat accumulation called tesamorelin. This has been approved in the US but a decision has not been made yet for Europe. This is an injectible treatment which can reduce central fat but not everyone responds to the treatment.
Human growth hormone (rHGH) is sometimes used in the UK if the fat accumulation is severe, but this is not an easy treatment. Although lower doses are less effective, this is probably better in order to avoid the worst side effects.
Comment