Understanding HIV-Related Excess Belly Fat
What Is HIV-Related Excess Belly Fat?
People with HIV may have fat that builds up in some places and goes away in others. This is called “lipodystrophy” (lie-poh-DIS-tro-fee).
Some people with HIV who have lipodystrophy can develop excess belly fat. This is a type of lipodystrophy called abdominal “lipohypertrophy” (lie-poh-hi-PER-tro-fee). The excess belly fat is called “visceral adipose tissue” (VAT).
VAT is:
- Hard fat that surrounds a person’s abdominal organs
- Chronic (meaning it lasts a long time)
- May not go away with diet and exercise alone
Who Is at Risk?
It’s important to remember that gaining this excess VAT is not typical. When most people without HIV gain weight in their belly, they usually gain some VAT, but they gain more ‘soft’ fat just under the surface of the skin.
People with HIV can gain excess VAT in their belly and may actually lose the soft fat in their belly and other parts of their body. Healthcare providers and scientists are not sure about how the excess VAT develops in people living with HIV.
There are a variety of factors that may increase the risk of someone who is HIV+ developing HIV-related abdominal lipohypertrophy, or excess belly fat, including:
- Age. People over the age of 40 have a higher chance of being diagnosed with HIV-related abdominal lipohypertrophy
- Length of infection. Those who have had HIV for more than three years are at an increased risk
- Markers of disease severity. If your lowest CD4 count is below 100, you may be at risk. This may be related to the effect HIV has on different types of cells in the body. HIV can change the way those cells normally work
- Use and duration of ART. Some types of antiretroviral therapy (ART), specifically protease inhibitors, are believed to play a role in HIV-related abdominal lipohypertrophy. Although not completely understood, the condition may be related to direct effects of the medications or to the viral suppression that happens as a result of taking the medications
- Ethnicity. Non-Caucasians are more likely to develop HIV-related abdominal lipohypertrophy
- Gender. Women are at a greater risk than men, although because there are more men with HIV in the US, there are likely more men with the condition. However, a woman with HIV may be more likely than a man to develop HIV-related abdominal lipohypertrophy
- Lifestyle factors. Smoking and/or having a higher body mass index (BMI) (higher than 26) have been shown to influence the condition. To learn more about BMI and calculate your own, visit the Centers for Disease Control and Prevention here
Identifying HIV-Related Excess Belly Fat (Abdominal Lipohypertrophy)
While the medical community has not yet standardized the way HIV-related abdominal lipohypertrophy is identified, there are a few common methods doctors use, including:
- Measurements of different body parts, including the size of your waist and hips
- Patient questionnaires
- Physical exams
- Assessment of the type of body fat
If you think you may have HIV-related abdominal lipohypertrophy, you should talk to your doctor. Use the Doctor Discussion Guide to help start the conversation.