# Obesity and Weight Management in HIV: Epidemiology, Complications, and Emerging Treatments

## TL;DR

People with HIV on modern treatment often face obesity, which increases health risks, and new treatments like surgery and medical therapies may help manage weight.

## Contribution

This paper reviews the epidemiology, complications, and recent treatment advances for obesity in people living with HIV.

## Key findings

- Obesity in PLWH is linked to increased cardiometabolic risks and poor health outcomes.
- Surgical and medical interventions are more effective than lifestyle changes for weight loss in PLWH.
- Further research is needed to determine optimal obesity management strategies for PLWH.

## Abstract

People living with HIV (PLWH) on contemporary antiretroviral therapy experience high rates of overweight/obesity, which predisposes to cardiometabolic disease and multiple other conditions with negative health consequences in this aging population. We aim to summarize the epidemiology and pathophysiology of obesity in PLWH and review recent advances in the therapeutic management of obesity.

The prevalence of overweight/obesity in PLWH mirrors long-standing trends in the general population. Obesity and weight gain have a complex, multifactorial pathogenesis and directly mediate detrimental metabolic changes that are common in PLWH. While lifestyle changes are important, surgical weight loss and recent advances in medical therapeutics are more effective at reducing obesity and obesity-related complications.

Obesity in PLWH substantially increases the risk for cardiometabolic complications and poor health outcomes. Surgical and medical weight loss interventions are effective treatments to reduce obesity and obesity-related complications, though further research in PLWH is needed to define optimal management.