The Challenges of HIV and Obesity

Understanding How It Impacts Your Disease and What You Can Do

For years, HIV was associated with weight loss and wasting, but now are dealing with an ever-growing challenge among patients with HIV: obesity.

A study conducted by the U.S. military looked at 660 HIV-positive patients treated at a naval hospital. Not one of the study participants met the definition of wasting, once a hallmark of HIV infection. Instead, 63% met the clinical criteria for obesity, effectively the same rate seen in the general U.S. population.

With people with HIV now living longer than ever, weight has become more of a problem than ever. Often times it has been attributed to the compartmentalization of HIV, meaning that the patient (and sometimes even the healthcare provider) treats HIV in isolation, ensuring the CD4 count is up and the viral load is down while ignoring all other health-related issues, including exercise, diet, and smoking.

Most treaters today understand that it's time to shift the focus to better prevent the development of heart disease, diabetes, high blood pressure, and weight-associated illnesses.

Women Running
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Losing Weight When You Are HIV-Positive

HIV positive people who need to lose weight should follow the same general weight loss recommendations as the rest of the population. You should always eat a balanced meal that does not exceed your caloric needs. You need to exercise and avoid junk food.

Sure, we know all of these things, but how do we actually start?

Keep a Food Diary

The best place to begin a weight loss program is to keep a food diary. Knowing what you are eating, how much you are eating, and when and where you are eating can help you adjust your diet and eating habits.

Each time you eat, be it a snack or a full meal, write down what you have eaten, how much, and under what circumstances. For instance, if you eat a bowl of chili at a party, write down how much chili you ate, the ingredients, and the circumstances surrounding you eating the chili. For instance:

  • Was it your dinner? Or just an impulsive snack?
  • Were you hungry? 
  • How were you feeling emotionally? Before eating? After eating?
  • Were you given the meal and ate simply so you wouldn't insult your host?

Enter as much detail as you can into your diary and as soon as possible after eating. 

Don't Diet, Simply Watch What You Eat

Like anyone with a weight problem, adjusting what and how much you eat is the first step to weight loss. An all-too-common problem is that we try fad diets and quick loss diets that may work in the short term but do nothing to keep the weight off. An effective diet is simply one that teaches you healthy eating habits that can serve you a lifetime.

Equally important is the need to identify exactly why you eat. Ultimately people eat for many reasons besides just hunger. It's important to think about what triggers your eating outside of mealtimes. With the help of your food diary, you can start figuring out when and why you are eating in order to identify and control those impulses.


Combining regular exercise with a healthy diet will not only help you lose weight but also improve your cardiac, respiratory, and muscular health as well. Experts say that as little as 30 minutes of exercise three times a week will improve your health and help you lose weight.

The bottom line is this: if you watch your calories and fat intake, maintain portion control, exercise, and avoid the triggers that lead to impulse eating, you will lose the weight. If unable to do this on your own, don't despair. Simply speak to your healthcare provider or a licensed dietician. You don't need any special "HIV diet," just the same tool others use to lose weight and live a healthier lifestyle.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Mark Cichocki, RN
Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years.