Question
Should I stop ART if I have put on so much weight?
1 July 2023. Related: All topics, Side effects, Starting treatment, Support.
I have discovered that I’m HIV positive this year around March 2023, the treatment is giving me a lot of weight, I’m gaining too much and I think I should stop taking treatment.
Answer
Hi there
Thanks for sharing your experience and for saying how you feel. This is somethiing that other people have reported too, so you are not the only one to report this.
Please do not stop ART – but do talk to your doctor. The details below shows why some options might be better than others.
What does your doctor has said about this?
Did you clinic weigh you when you started and have they been weighing you – and measuring your waist and hips etc too? Knowing your normal weight and height is really important.
You change in weight needs to be recorded in your clinic notes. If you have put on more than 5-10% of your body weight over six months, the doctor needs to take this serioously.
Talking to your doctor is important. Also for the clinic to recognise that this is causing you a problem. This is so you can talk about options.
Stopping treatment is not a good thing to do. Certainly not for most people.
Some HIV meds can cause weight gain and some cause weight loss. For example, integrase inhibitors like dolutegravir and bictegravir are linked to weight gain in some people. Efavirenz (EFV) and tenofovir disoproxil (TD) can casue weight loss in some people.
Becasue this isn’t in everyone, the individual monitoring is important.
This means that changing treatment ‘might’ help – although no studies have proved this yet.
What is happening to you as an individual is more important that average results reported from different studies.
This includes your HIV history – ie your CD4 and viral load when you started treatment and the response since.
For example, starting with a very low CD4 or high viral load is linked to outting on more weight in the first six months of ART.
If you started wiuth a very high CD4 counts, for example higher than 500, it might be possible to stop ART and monitor you. Please note that treatment guidelines do NOT yet recommend doing this, but it might be an option for a few people.
Also which meds and for how long. It also involves knowing your age, and your normal weight and height, and waist/hip measurement. If you know your genetic parents or siblings, were they a similar shape and size at your age?
Without this information it is difficult to comment about your choices right now.
Diet and exercise are likely to be important.
This needs specialist advice – it won’t help to crash diet – you still need to eat properly. Being more active each day might help – nothing crazy – but maybe walking more if this is safe where you live.
Finally, if changing treatment is not possible, or if this doesn’t work, then meds in development might help.
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