Question

Will switching treatment help me lose weight?

29 January 2024. Related: All topics, Changing treatment, Side effects.

Hi,

I have been on Biktarvy since 2020 and doing well. Undetectable after a few weeks of treatment. My CD4 count started pretty low and is now plateauing around 380.

My main is issue is that I have gained about 40 pounds in 4 years. I exercise several times per week and eat relatively well. No matter what I do though, weight is very hard to shed.

My doctor suggested switching from Biktarvy to Dovato and see if it makes a difference. Any insight on switching regimen—in particular regarding weight management?

Thanks.

Answer

Answer: Josh Peasegood

Hi, how are you doing?

I am sorry to hear about the difficulty you have been having with your weight.

Both Biktarvy and Dovato are associated with weight gain but rarely as much as yourself.

Switching between Biktarvy and Dovato for this reason would likely not yield positive results as they can both contribute to the same problem.

Has your doctor offered to investigate for other possible causes of weight gain? While your treatment can contribute, Biktary on average leads to weight gain of around 9lbs over 2 years. There has been no evidence to show that weight gain continues after this point and given that you have gained 40lbs over 4 years it is possible that there are other factors.

Both Biktarvy and Dovato use integrase inhibitors. These have been shown to increase weight by increasing appetite. Have you tracked what you have eaten and tried to adjust your diet accordingly? I recognise that this can be difficult, especially with an increase appetite but it is important to assess the root cause of weight gain e.g., if it is treatment, tracking your diet should help to lose weight.

Josh.