Daniel Lee, M. D.Assistant Clinical Professor of Medicine
UCSD Medical Center
Owen Clinic
Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date. I have been on HIV meds since 1999. At that point I was diagnosed with AIDS. I was started on Combivir and Sustiva. I am now on Trizivir and Sustiva. I also take oral Testosterone gel. I had initially lost weight, but subsiquently as the meds took effect and I regained my health, I developed a protruding stomach and gained weight. I have not had any luck, through diets, exercise, yoga, healthy eating, staying very faithful to my meds in reducing the weight gain and the stomach size. I am not fat in other areas. Muscle mass has increased in my arms and legs. I also take lopid and lipitor for chloresterol and triglicerides. The testosterone was initially given because of a decrease in testosterone and an increase in androgen and enlargement of breasts.
My question: Are there any new medicines, regimines, surgeries, such as liposurgeries, to take care of the stomach fat. I am very self-conscious about it. Thank you for any help you might give.
Daniel Lee, M. D.
Assistant Clinical Professor of Medicine
UCSD Medical Center
Owen Clinic
It sounds as if you have lipodystrophy with fat accumulation in the abdomen. The exact causes and treatments are not known, but many things have been tried. Protease inhibitors have been cited as a cause, but not everyone receiving a PI gets lipodystrophy. One PI, Reyataz, appears to be very good in regards to lipids and probably lipodystrophy. One can also check to see if you have insulin resistance (ask your doctor). If so, you may benefit from metformin, which has been shown to improve fat accumulation in the abdomen if you have insulin resistance. Serostim, or human growth hormone, may also help, but it is not approved for lipodystrophy, just for wasting. Liposuction may work if you have a lot of subcutaneous fat, but often times, lipodystrophy is characterized by visceral fat (deeper fat surrounding the intestines, other organs) accumulation. I would recommend looking for more detail on the internet. Good luck.
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