Understanding Weight Gain After Starting HIV Treatment

Recent research shows that approximately one in six individuals beginning HIV treatment experience a weight gain of at least 10% within one to two years. This increase in weight is more prevalent among women, Black individuals, and those in poor health prior to starting treatment.

The weight gain is often linked to specific antiretroviral drugs, particularly integrase inhibitors and tenofovir alafenamide. While the exact reasons remain uncertain, several theories have been suggested.

Importantly, this treatment-related weight gain may raise the risk of developing conditions such as diabetes and cardiovascular disease.

Initiating antiretroviral therapy (ART) improves overall health by suppressing HIV and strengthening the immune system.

Historically, severe weight loss was a common symptom of HIV, but the introduction of effective ART has led to noticeable weight recovery, particularly in those with advanced HIV.

This phenomenon, known as the “return to health” effect, is still observed in patients who begin treatment after significant weight loss.

However, not everyone gains weight, and the amount varies from person to person, highlighting the complex nature of this side effect.