Your healthcare provider is the only one who can diagnose you with HIV-associated wasting. Several factors have been identified as possible contributors. This is not intended to be a complete list and should not replace the advice of a healthcare professional.


Metabolism is how the body turns food into energy. If you’re HIV positive, your body may draw energy from lean body mass.1 When you lose lean body mass, you are losing muscle, organ tissue, blood cells, and water—all of which may result in decreased physical endurance.5


Individuals with HIV-associated wasting may have growth hormone (GH) resistance, which involves a decrease or absence of the effects of growth hormone in the body. GH resistance may contribute to loss of LBM.

The loss of lean body mass, including muscle, can occur when your body resists, and has trouble using, the growth hormone that it makes naturally—or when your body is not making enough of the growth hormone it needs.1,6


Testosterone is a hormone that is primarily produced by the testicles in males and to a lesser extent, by ovaries in females. It is important for maintaining muscle mass, bone growth, adequate level of red blood cells, and sexual function. Low levels of testosterone may result in significant loss of lean body mass.3,8


Inflammation is a natural biological response to infection, stress, trauma, and cell injury that helps control tissue damage.9 Inflammation can continue to occur despite control of HIV—and can change your metabolism, resulting in breaking down muscle tissue and causing a decrease in appetite.10 Ongoing inflammation due to a persistent threat such as HIV can lead to many problems throughout the body.


When you’re living with HIV, many factors can affect your ability to consume an adequate amount of calories and nutrients. These factors may include:2

  • Feeling depressed
  • Feeling tired
  • Oral sores
  • Nausea
  • Vomiting
  • Constipation
  • Gastrointestinal tract disorders
  • HIV medications that may lower your desire to eat or change your sense of taste and smell


Having trouble swallowing can decrease food intake, leading to loss of weight. Causes of painful or difficult swallowing may include:2,7

  • Masses in the esophagus (the tube that connects the throat with the stomach)
  • Dental disease or loose-fitting dentures
  • Infections
  • Acid reflux (stomach acid flowing back into the esophagus)


Some infections can make food difficult to swallow and may cause a loss of appetite. When you find it uncomfortable to eat, you may miss meals. Infections may cause changes in metabolism and increase your caloric needs. This increase in energy needs and decrease in nutrient intake may result in unintentional weight loss.3,7,16


Diarrhea can be caused by several factors, including bacterial and viral infections, irritable bowel syndrome, intestinal disease, food intolerances, and reactions to medication. Diarrhea may result in abdominal pain, dehydration, and weight loss. As with any symptoms, if you have concerns, talk with your healthcare provider.11-14

All of these issues can contribute to loss of weight, loss of LBM, and a decrease in physical endurance. Only your healthcare provider can evaluate your symptoms and decide what may be causing them. If you have concerns about these conditions or unintentional weight loss, your healthcare provider can help.

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