Q and A

Question

Does HIV cause weight loss?

Can facial wasting and losing weight happen prior to starting treatment?

Can they simply be features of HIV (or stress) without being due to opportunistic infections?

Answer

Thank you for your questions.

General weight loss and facial wasting (fat loss) are very different things.

Before effective HIV treatment (ART), wasting and loss of appetite were very common among people living with HIV.

Some of the reasons that caused wasting were nausea, diarrhoea, poor absorption of food, fevers and loss of appetite. These symptoms are largely related to having a low CD4 count and not being on ART.

Information about body changes as a side effect are at these links for body fat changes (lipodystrophy) and fat loss (lipoatrophy).

Losing fat from the face is sometimes a feature of aging – ie it happens naturally as you get older. HIV doesn’t cause fat loss prior to treatment though, and is unlikley to cause it after treatment so long as you don’t use either d4T or AZT.

This answer was updated in January 2016 from a question first posted on 21 May 2008.

55 comments

  1. Nuel

    I have been on arv for eight months now and noticed a 5kg weight loss and don’t like that. Secondly, I was also placed on TB drugs without any symptoms or reactions. Should I continue to take the TB drugs or stop?

  2. Roy Trevelion

    Hi Lelo,
    General weight loss is not usually linked to HIV treatment (ART). If you are worried about losing weight please talk to your doctor about it. You can ask about tips for diet too. Here’s the i-Base guide to a balanced diet.

  3. Lelo

    I was diagnosed with HIV Feb this year and I have taking my meds but I have lost weight and it worries me! Should I be worried?

  4. Roy Trevelion

    Hi Naomi,
    What ARVs are you taking? Modern HIV treatment (ART) doesn’t cause fat loss. It’s a good idea to talk to your doctor about weight loss. Here is a guide to having a balanced diet. This can help to maintain what would be a healthy weight for you.

  5. naomi

    I av realized am lossing weight, for the last 2 months I have lost 5kgs, is it normal?

  6. Roy Trevelion

    Hi Roland,
    Are your ARVs working well? Having an undetectable viral load and a strong CD4 count can benefit your health. So a slight weight loss shouldn’t be a worry. But you can talk to your doctor about your diet and ways to put on weight.

  7. Roland

    l have been on ARVs for a year now
    Anytime i go back for check up i realise a slight weight loss

  8. Roy Trevelion

    Hi Lebogang,
    This link takes you to the section on Diet: a balanced diet and your health. It’s from the i-Base guide to quality of life. Many people ask about how to lose weight but the same idea of a balanced diet applies if you want to gain weight. Fruit and vegetables are also a good source of liquid. If you think you’re not drinking enough water perhaps you could try eating more soft fruit and vegetables.

  9. Lebogang

    Im on ARVs but not gaining weight and I was fit before any problem, I do eat but problem with water drinking

  10. Lisa Thorley

    Hi Nadi,

    This is something that you will need to talk to a doctor about. They will be able to examine you and advice what you need to do.

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