I'm eating plenty, but am still losing weight! What's going on?
Another cause of weight loss and wasting is malabsorption, a problem that is not uncommon among people with HIV. Foods that are swallowed require a great deal of processing by the gastrointestinal system (the gut) so that they can effectively be broken down into their most basic forms - either protein (amino acids), fat (triglycerides and cholesterol), or sugar (glucose) - and adequately absorbed by the intestine.
Drug side effects, such as diarrhea and vomiting, can prevent food from staying in the gut long enough to be properly digested and absorbed.
Diarrhea and vomiting may also be signs of an underlying infection or complication. Infections such as cryptosporidiosis and microsporidiosis can both cause diarrhea and drastically impair the intestine's ability to absorb essential nutrients. Other infections and complications of the gut include CMV, lymphoma, and KS, all of which can impair digestive function and absorption without causing overt symptoms (e.g., severe diarrhea). There have been numerous reports of people on anti-HIV therapy who are experiencing significant improvements in their overall immune status.
As a result, they are much less likely to develop opportunistic infections (OIs), like those just mentioned. And if an OI can be prevented, the risk of weight loss or wasting is decreased dramatically.
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