Question
What can I do about my buffalo hump?
11 July 2012. Related: Access to treatment, All topics, Side effects, South Africa.
I started taking ARVs in 2004. I was on stavudine and I developed buffalo hump and the distribution of fats is abnormal. My
doctor changed me to Atripla. The distribution of fats is not remedied.
I now feel abnormal and have a low-self esteem and I’m too fat.
How can I remedy the situation. I’m embarrassed.
Please help me also curb my appetite, because I eat too much.
Answer
Thanks for posting a question and allowing us to post the answer online.
Buffalo hump, apart from not having a great name, is one of the side effects that some people were unlucky to get using earlier treatment. It is less common now, but I’m sure hearing this doesn’t make you feel any better.
It is sad that you are feeling this way now, because you have clearly been so lucky in getting access to treatment. You also must have been so committed in taking the meds for them to have worked for so many years. These experiences make you an amazing woman and mean that you will have the strength to find a way through this. You shouldn’t let anyone make you feel embarrassed about how you feel or how you look.
Because you are also feeling depressed, your doctor should know about this in case there is something s/he can help with. This includes checking whether efavirenz (one of the drugs in Atripla) is causing the depression or making it worse. Efavirenz can affect your moods including making depression worse.
You mentioned wanting help with eating and that you feel you over eat, but this is something to talk about to your doctor too. Lots of people who have put on weight when on HIV treatment, think this is just about diet, so they cut back on eating everything. This is just as unlikely to help as over-eating. If you want to change things, this is likely to take time and happen slowly and getting advice from a health adviser or dietician might help. You have plenty of time to make these changes.
The following links below are for more information about different aspects of your question.
Although these studies are useful, you are clearly having a rough time right now. As well as talking to your doctor, it might help to find other people in a similar situation so you can support each other.
I wondered whether you were involved with Treatment Action Campaign (TAC) as they have a lot of branches in South Africa.
Please let me know if I can help with other information.
Further information
Information on efavirenz side effects.
Information on fat accumulation and lipodystrophy and possible treatments is at this link.
In the UK some people have liposuction for fat pads on the shoulder or neck. This is pretty successful in at least half the cases, but in some people the fat returns again. It is also a serious surgery that is free here, but may not be easy to access in other countries. Still, it would be worth asking your doctor about this.
This is a link to a study about liposuction in HIV.
However, some researcher in the USA ran a large study that report that shoulder fat was common – in 10% or HIV negative Americans. The reported this to be one of many symptoms associated with increased weight and being over weight.
If you have put on weight generally, in the long term, making changes to a more active life with a healthier diet, might help reduce the shoulder fat as well as other fat.
This is probably a slow process. You could set small goals that are easier to achieve. It involves eating a balanced diet and becoming more active. This study reported that diet and exercise can reduce symptoms.
These links include information about a balanced diet and leading a more active life.
Hi Zoliswa,
When you say worse, what do you mean?
I am using Atroiza, instead of getting better it becomes worse. Its stressing me out.
Hi Zoliswa,
The above post provides you with a lot of info, as to does the following link.
http://i-base.info/guides/side/fat-accumulation
It explains how the fat accumulation could be possibly treated.
What meds are you on? How long have you been taking them? Is this something that you’ve talked to your doctor about?
I’m growing the buffalo hump and its growing big. What is worse is that I am a community health worker. People keep on asking what is behind my shoulders, I wish I could get help.
Hi Cynthia,
I’m glad to hear that your daughter inspires you to stay strong. Because you are in South Africa I suggest contacting the Treatment Action Campaign to find out whether there is a way to access treatment for lipodystrophy in South Africa. I hope this is helpful, please let me know if we can help futher.
Hi! Thank you for listening. It helps to know that there is someone out the who’s willing just hear me. I live in South Africa. I have a 4 year old daughter whom is the only thing that keeps me going
Hi Cynthia,
I am so sorry to hear about how unhappy these body changes have made you. This is one of the most difficult side effects to deal with and can be very upsetting. Do you have any support to help you deal with this?
I’m sorry to hear that your medical aid won’t cover the costs of surgery. Can I ask which country you live in?
Have you tried any of the other potential treatments for these changes in fat distribution? There’s information about this in our guide to side effects. Also, have you tried changing treatment to see if this improves these symptoms?
Hi my name is cynthia, I am a 32 year old lady who used to live positively with the HI Virus. I started taking anti retroviral treatment in 2007, and I developed lipodystrophy in 2010.
I am a short person and I have developed a buffalo hump, very big breasts, very big tummy and the thinning in my legs and lost fat in my buttocks.
I have lost hope in getting help because my Medical Aid won’t pay for plastic surgery and I won’t be able to pay for it out of my pocket. My request is that we convince medical schemes to pay for these kinds of procedures because Lipodystrophy could be the cause of many deaths in people living with the virus.
I was 23 years when I first found out about my status and I was a very positive person but ever since I developed this thing really I’ve never felt this bad and suicidal in my life. I just hate everything about the way I look
Hi
Check this link for info on fat loss and this link for info on fat gain.
Both side effects are rare for people starting treatment with currently recommended drugs.
Fat loss is nearly entirely linked to two old drugs – d4T (stavudine) and AZT (zidovdine).
If you are not using these drugs then fat loss is very unlikely.
Shoulder fat was mainly linked to earlier protease inhibitors.
Because of the higher awareness of body changes as a side effect, your doctor should monitor you for changes and change treatment in the unlikely event that anything happens.
Most people put on a little weight when starting treatment though, but this is healthy and expected. It is probably related to having a better appetite and your energy not being taken up by untreated viral load.
Could you perhaps specify what current meds are known to cause lipodystrophy? I mean both gain (eg. buffalo hump) and loss of body fat (facial wasting). I ask this in order to avoid any potential med that may trigger this in the near future when I have to start treatment.
Thankyou