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 Obesity A Problem Among People With HIV
by
The Associated Press
Posted: October 4, 2007 - 6:30 am ET
(Los Angeles, California) Early in the AIDS
epidemic, people infected with the virus often lost a dangerous amount of
weight, at times looking gaunt and ghostly. Today, they are facing the opposite
problem. Many who have HIV, but not full-blown AIDS, are struggling with
obesity, which has overtaken "wasting syndrome" as the top concern.
AIDS researchers and advocacy groups say the
waistlines of HIV patients are growing right along with the girths of uninfected
Americans as the disease shifts from a death sentence to a chronic condition.
Exact numbers are hard to pin down. But new
research suggests that nearly two-thirds of the HIV population may be overweight
or obese, mirroring the U.S. population.
Doctors say there's a growing need to screen
people with the AIDS virus for obesity, which raises the risk of diabetes, high
blood pressure and cholesterol problems.
"We used to worry that they would lose
weight and become wasted," said Dr. Nancy Crum-Cianflone of TriService AIDS
Clinical Consortium in San Diego. "Maybe we should redirect our concerns to
making sure they are maintaining a healthy, normal weight."
About a million people in the United States are
living with HIV or AIDS, federal statistics show. At the height of the epidemic,
many had wasting syndrome, the uncontrollable loss of 10 percent of body weight
along with other symptoms like fever or diarrhea.
A turning point in the AIDS crisis came with
advances in modern medicine. Powerful drugs that keep the virus at bay also
boost the body's immune system. The result is that more HIV patients are living
longer than their counterparts two decades ago, and may be prone to poor eating
habits and lack of exercise.
Some experts offer psychological explanations.
Since the hallmark of HIV has been weight loss, some patients may be piling on
the pounds to avoid looking abnormally thin.
"It's very clear now that HIV is no longer a
wasting disease in America," said Dr. John T. Brooks, an epidemiologist in
AIDs prevention at the Centers for Disease Control and Prevention. Brooks did
not participate in the study.
Crum-Cianflone became interested in the problem
after noticing her patients were steadily getting fat and decided to study how
common obesity was in the HIV population.
She and her colleagues pored through medical
records of 663 patients with HIV at Navy hospitals in San Diego and Bethesda,
Md. Researchers analyzed medication records, duration of HIV infection and
whether patients had a history of diabetes or high blood pressure.
Sixty-three percent in the study were overweight
or obese. Only 3 percent were underweight and none were considered to be
"wasted." Among those with full-blown AIDS, about 30 percent were
overweight or obese.
The numbers are particularly striking because
most of those studied were in the military (some were military spouses) and tend
to be in better shape than the rest of the population. Previous research had
suggested about 40 percent of HIV patients are overweight.
Researchers did not find a connection between the
AIDS drugs and excess weight. When patients gained weight, they tended to put on
an average of 13 pounds over a decade. Those who became infected younger, those
who had the virus for a longer time, or those who had high blood pressure were
more likely to get fat.
Results were to be presented Thursday at an
infectious disease meeting in San Diego.
"These folks are in more ways than not
becoming like everyone else. If they're overeating, they're going to get
fat," said Dr. Michael Saag, director of the AIDS Center at the University
of Alabama at Birmingham, who had no role in the study.
"It would be very sad to survive HIV and die
of something else that was preventable," said Brooks of the CDC.
At AIDS Project Los Angeles, pudgy HIV patients
outnumber the very thin.
"Many of our clients don't even know what
wasting is. They never knew that look," said Janelle L'Heureux, a
nutritionist with the AIDS service group.
The problem is more evident in those who are
poor, because they more often eat junk food and don't have money to join a gym.
To help obese HIV patients, the group offers classes on how to read nutrition
labels and cook healthy meals.
Jack Gebhardt, 56, of Los Angeles, said he
started packing on the pounds after he quit smoking shortly before he was
diagnosed with HIV 12 years ago. After working out three times a week, Gebhardt,
who is 5-feet-8, went from 217 to 172 pounds.
A diabetic who is on disability, Gebhardt
currently cannot afford a gym membership and has seen his weight creep back up
to 182.
"I'd still like to lose a lot more
weight," he said.
©365Gay.com 2007
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