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Weight gain can be a somewhat unexpected result of treatment for HIV. Add that to the complicated feelings you may already have about being positive, and you could find yourself struggling with your body image. 

It’s a common feeling. Many people with HIV say they’re bothered by changes to their bodies – some to the point of becoming depressed. But there are things you can do to protect your health and feel better about your body. 



Why Am I Gaining Weight?

Dramatic weight loss used to be a telltale sign of HIV infection. But that has largely changed because of early treatment with antiretroviral drugs. 

  • To an extent, putting on weight is a good thing. Your body burns a lot of calories when it’s fighting an infection, so gaining weight shows the virus is being controlled. 
  • Antiretroviral treatment has also changed HIV from an almost certainly fatal illness to a manageable condition. Now that you can expect to live as long as everyone else, you run the same risk of gaining weight as you get older. 

But weight gain can also be a side effect of HIV treatment. 

  • People who took the older generation of combined antiretroviral drugs tended to either gain or lose fat in certain parts of their body. They would get very thin in their face, arms, and legs with a large belly – a look that some felt made it obvious they were being treated for HIV. 
  • You’re likely to gain weight on the newer antiretrovirals, too. Doctors just aren’t sure why. 

Many people become overweight or even obese in the first few years of HIV treatment. That can lead to other health problems, like heart disease, liver disease, and diabetes. Obesity tends to be more of a risk if you’re female, nonwhite, or have a low income. 

What Can I Do to Change it?

Talk to your doctor or case manager about your weight gain. If it’s related to a medication you’re taking, you may be able to switch. But that probably won’t reverse any changes to your shape that have already happened.

Eating healthy food and exercising can lower your overall amount of body fat and build muscle, which can change the way you look. It can also boost your immune system to help your body fight infection and prevent some complications from HIV.

How Can I Feel Better About My Body?

Your body image is tied to the voice inside your head. You can feel better about how you look if you train that voice to be kinder.

  • Focus on who you are as a person, not what you look like. Keep a list of your accomplishments and qualities you like about yourself and read it when you start feeling insecure.
  • When you have a negative thought about your weight, stop. Replace it with something positive and encouraging.
  • Think of your body as an instrument, not a decoration. Remind yourself of all the amazing things it does for you every day. 
  • Try to see a bit of extra weight as a sign of progress. Your treatment is helping you live a longer, healthier life. 

While you’re learning to think differently about your body, you can try some other positive steps to help boost your self-esteem:

  • Wear clothes that fit well, in colors that make you feel good.
  • Try to stop comparing yourself to others. Be critical of ads that promote unrealistic beauty standards. If things you see on social media send you into a spiral, take a break. 
  • Spend time with positive, supportive people who aren’t obsessed with their looks.
  • Find a cause you care about and volunteer. Getting outside yourself to help others can benefit you, too. 
  • Exercise and good nutrition can help you feel better. HIV puts you at risk for vitamin D deficiency, so a healthy diet is especially important. And regular exercise is proven to boost your mood. Fun physical activity like dancing can make you feel strong and capable.
  • Be nice to your body. Learn ways to relax and let go of stress, like deep breathing, mindfulness, or yoga. Treat yourself to a bubble bath or a walk in the woods.

Where Can I Get Help?

When you live with HIV, depression is a real concern. You should stay on alert for signs of trouble. A poor body image makes you more likely to become depressed. And some HIV medications can raise your risk. 

  • If your negative feelings interfere with your life or don’t let up, talk with your doctor or case manager. They may be able to refer you to a therapist or get you medication that can help. Make sure whoever you talk to knows what HIV drugs you’re taking, along with other meds and supplements. 
  • It can also help to talk with people who are going through the same things you are. Your local HIV clinic may have support groups, or you can find one online. You may feel better to know that other people have similar concerns about their weight and find out what they’ve done about it. 
  • And don’t count out the people closest to you. Even if they don’t know exactly how you feel, your family and friends can be excellent sources of support and encouragement. People with HIV who have a strong social network are less likely to be depressed.

Show Sources

Photo Credit: Artem Varnitsin / EyeEm / Getty Images


Journal of the International AIDS Society: “Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy.”

HIV Medicine: “Lipoatrophy among HIV-infected patients is associated with higher levels of depression than lipohypertrophy.”

Frontiers in Endocrinology: “The Impact of Weight Gain During HIV Treatment on Risk of Pre-diabetes, Diabetes Mellitus, Cardiovascular Disease, and Mortality.”

Nature: “HIV and antiretroviral therapy-related fat alterations.”

CATIE: “Body Weight and Body Shape Changes,” “Emotional Wellness.”

NAM: “Weight gain and HIV treatment.”

Current HIV/AIDS Reports: “Obesity And Weight Gain In Persons With HIV.”

CDC: “Healthy Living With HIV.”

European AIDS Treatment Group: “Strategies for managing weight gain in HIV patients.”

National Eating Disorders Association: “10 Steps To Positive Body Image.” “Mental Health.” “Body Image.”