Question

What can I do about my abdominal fat?

7 April 2010. Related: All topics, Side effects.

I am HIV positive and I have extreme abdominal fat due to either HIV medication or related to my diabetes. My question is, is there anything that can be done or any medicine that counteracts this problem?

Many of the doctors that I have spoken with are afraid of the human growth hormone and I would like to know what is your take on this matter?

Answer

Answer: Charlotte Walker

Thank you very much for your question.

Fat accumulation remains a significant problem in HIV positive people on HIV medication. It can be a distressing thing to live with both physically and emotionally. However, there are a few things that you can try.

You did not say which medications you were currently taking but anecdotal reports have suggested that switching to atazanavir helps reduce shoulder or abdominal fats. There has been no formal research to quantify this yet.

Recombinant Human Growth Hormone (rHGH) has been used to treat some cases of fat accumulation in HIV positive people. However, most doctors are not happy prescribing it due to the side effects. rHGH has been shown to stimulate the growth of tumours and can cause increased risk of cardiovascular problems related to insulin resistance. This is especially dangerous in diabetics. The problem with rHGH is that once you stop taking it the fat comes back so it is not a permanent solution.

There is some good news though. A new drug called Tesamorelin is in the pipeline. It is a Growth Hormone Releasing Factor (GHRF) which works in a similar way as rHGH but with less side-effects. It is currently up for approval by the FDA and it is hoped it will be released by 2011.

One of the major health-related problems associated with abdominal fat is additional strain on the heart and lungs. If this is a problem in your case then it may be worth speaking to your doctor about trying a very low dose of rHGH until Tesamorelin becomes available. A dose of 1mg per day has been shown to have some effect on reducing fat without causing significant side effects. However, the study that showed this was in people who had already taken a higher dose of rHGH. It is unclear from this study if taking a higher then a lower dose of rHGH will interfere with your diabetes. It is important to discuss this with your doctor before you decide to start treatment. For more information on this study please follow this link.

For more information on Tesamorelin please follow the links here, here and here.