HIV and Your Diet: Countering Weight Loss

Medically Reviewed by Michael W. Smith, MD on April 14, 2021
3 min read

Most people with HIV don't need a special diet. But if you're feeling sick and having symptoms like nausea, diarrhea, or weight loss, you may need some changes to what and how you eat.

Losing too much weight can be serious. Without good nutrition, you may get sicker.

"Good nutrition is very important for people with HIV," says Brad Hare, MD, director of the HIV/AIDS clinic at San Francisco General Hospital. Without a healthy diet, your body will have a harder time recovering and fighting off infections.

Unwanted weight loss related to HIV is less common than it once was, but it still happens. HIV itself -- as well as related problems and treatments -- can cause it. It's more common in people with untreated or severe disease, an infection, or a high viral load, which is a high concentration of the virus in the blood.

When you have HIV, things that can cause you to lose weight include:

  1. The HIV virus itself.
  2. HIV drugs, which dull your appetite, make food taste bad, or make it harder for your body to absorb nutrients.
  3. Symptoms like nausea and mouth sores can make eating unpleasant.
  4. Diarrhea and other digestive problems can make it harder to take in nutrients from foods.
  5. Exhaustion can slow you down, keep you from grocery shopping, and limit your ability to prepare healthy meals.
  6. If you have advanced disease, high levels of HIV virus in your blood, or other infections, you may need more calories.

Talk to your doctor or a nutritionist who specializes in working with people who have HIV about how to get the nutrients you need. Possible solutions include:

  1. More calories. If your doctor decides that you're just not getting enough calories, increase them. A dietitian or nutritionist can advise you on the best ways to do this -- for example, nutritional supplement drinks or energy bars.
  2. Smaller meals. Big meals are more likely to make you feel sick. So instead of three meals a day, try more smaller meals or frequent snacks.
  3. Milder foods. If nausea or diarrhea is a problem, shifting to milder foods can help, says Kimberly Dong, RD, a dietitian at Tufts University School of Medicine. "Avoid anything that's spicy or acidic, like citrus fruits,” she says. Cut back on greasy, fatty foods, and avoid alcohol and caffeine.
  4. Softer foods. If you have infected gums or teeth, eating can hurt. "Switch to soft and bland foods," Dong says.
  5. Medication. Treatments like medications and hormone therapy may also help with your appetite and nausea.
  6. More fiber. If diarrhea is a problem, Dong says adding fiber and drinking more water can help.
  7. Exercise. Doing some gentle exercise could help boost your appetite. Using weights or resistance exercises to build muscles can help you stay strong.
  8. Good company. Making meals pleasant can help you eat more. Eat with friends and family whenever you can.
  9. Getting assistance. If exhaustion is a problem, lean on friends and family. "See if you can get family to help you cook and shop," Dong says. Ask them to prepare dishes like lasagna and casseroles that are easy to freeze and heat up when needed.