Ten top tips: coping
with LIPO
Sick of sunken cheeks, non-existent buttocks and fat in all the wrong places?
Try our lipodystrophy makeover
Words Patrick James
Image Russell Plows
1 Consider switching
Lipo is no fun; we lose the fat under the skin, see our arms and legs thin
and we can develop unsightly paunches. Some women see their breasts double
in size, other people see their faces and necks swell or gain a ‘hump’
around the neck and shoulders. The jury is still out on what causes body fat
changes (lipodystropy) or fat loss (lipoatrophy). At first the finger of blame
pointed to the virus itself, then to protease inhibitors and, most recently,
research suggests nukes (especially thymidine analogues like AZT and d4T)
are most likely to lead to fat loss. Avoiding these drugs in your regimen
could halt the process and even begin to reverse severe fat loss. Don’t
suffer in silence; ask your doctor about drug alternatives.
2 Home cook and bulk up
Most of us are in the enviable position of being able to eat as much as we
like without putting on weight. But sometimes trying to gain weight when you
are thin is much harder than losing it, especially if you have a poor appetite
due to HIV drugs. If your appetite is sluggish, eat calorie and nutrition-rich
meals regularly throughout the day; don’t rely on one big evening meal.
Eat a diet rich in complex carbohydrates, including brown rice, pasta and
oats; proteins from meat, fish and nuts, as well as fresh fruit and veg. Avoid
a lot of dairy and microwaveable meals which are high in animal fat and low
in nutrients. Go for fresh ingredients and learn to pamper yourself with delicious
home-cooked food every day. If you’re casting around for a new lover,
make sure they’re at least as good in the kitchen as they are in the
bedroom.
3 Control diarrhoea
HIV, as well as antiretroviral drugs, is known to damage the gut wall and
this means only a small amount of nutrients are absorbed into the blood stream.
Unfortunately, a lot of goodness in our food passes straight through us without
touching the sides. Imodium and codeine phosphate can control diarrhoea, but
only as a temporary measure. Homemade soups and cooked fresh vegetables are
nutritious and bind the gut but complex carbohydrates (rice, bananas, bran
and pasta) are the best. Avoid too many spicy foods, raw salads, eggs and
dairy products as they seem to fly out the other end. Recent research highlights
the beneficial effects of garlic, cranberries and natural yoghurt to act as
natural antibiotics which slow down and strengthen the gut.
4 Work that body
Slowly building up a programme of resistance training with weights has now
been shown to partly reverse the ravages of lipodystropy and lipoatrophy.
Don’t rush into it though. Start by getting professional help from a
trainer at one of the Positive Health schemes run by organisations like the
YMCA, and slowly build it into your life, at least two or three times each
week. Don’t try and become a Muscle Mary. Remember, even Arnie’s
previous rock hard muscles have now turned to saggy flab since he’s
turned to political life. All in all, light regular exercise helps with weight
loss as well as improving relaxation and aiding sounder and deeper sleep.
5 Get a bit of extra help
People with lipodystrophy and increased blood fats, such as high triglycerides,
find eating fish rich in omega-3 oils such as sardines or mackerel, or getting
fish oil supplements from your doc, can lower your trigyclerides. Other supplements
including vitamin B and acetyl L-Carnitine have been shown to help nerve and
muscle tissue re-grow.
6 Quit the fags
Smoking wrecks your lungs, greatly increases the risk of heart disease and
cancer and puts you off your food. Most ex-smokers gain weight faster after
quitting and find that their sense of taste and smell returns quickly. Research
shows that people living with HIV smoke much more than the rest of the population
(maybe it’s the stress) but now might be the time to seriously consider
quitting for comfort, aesthetic and health reasons. Smokers build up unhealthy
fats in the blood, putting them at higher risk of strokes and men suffer diminished
levels of testosterone and a lowered sex drive.
7 Make fashion work for you
Back in the 1980s, male models used to have their wisdom teeth extracted to
draw in their cheeks to achieve a chiselled-cheekbone ‘Armani’
look. But many of us with lipodystrophy are sick to our back teeth of looking
like a skeleton. When it comes to fashion, vertical striped clothes are known
to be slimming and horizontal striped clothes are supposed to bulk you out.
The baggy-assed jean look, height of fashion this year, is a relief to those
of us who seem to have lost our gluts forever. But fashion is all about cycles
of sales and
pretty soon tight jeans will be back in. Try different things and avoid clothes
which accentuate the negative. If you’ve a skinny backside you can bulk
up with padded underpants made by Butt For You Inc (www.buttforyou.com).
8 Get a good chiropodist
People who’ve lost fatty padding on the soles of their feet can find
walking barefoot is similar to walking on broken glass. Hard skin, calluses
and corns build up quickly and can be very painful. A referral from your HIV
clinic or GP to a local chiropodist who you can see regularly should improve
comfort and put a spring in your step. Pains in the feet caused by lipoatrophy
and peripheral neuropathy can be greatly relieved by padded insoles fitted
into your shoes. Most hospitals have orthotic departments for people with
false limbs and braces that can make moulds of your feet and build tailor-made
insoles. Ask your HIV doctor about a referral. High street chemists stock
brands like Dr Scholl’s that make air-bubble insoles and much more for
sore feet. Designer trainers are not everyone’s must-have fashion item
but chiropodists recommend them for support and comfort. Other specialist
shoes from Ecco, Dr Martens and Caterpillar provide excellent padding and
are also proven to help. If you suffer from infections, spray your feet with
an anti-fungal after washing.
10 Reach for a referral
HIV clinics can now give referrals to dietitians, physiotherapists, community
nurses, health advisors, psychologists and even occupational therapists. So
talk through your physical and emotional issues around lipodystrophy with
your HIV consultant and make use of this support at your clinic.
Consider surgery As a final resort, if it’s all too much to take, there
is the alternative of surgery for sunken faces using synthetic remedies like
New-Fill. Many HIV clinics refer for these treatments on the NHS, so ask your
doctor if you’re serious about having them. Private health clinics do
advertise these services but they can cost several thousand pounds. The bottom
line in all of this is not to let HIV ruin your life, your looks or your self
confidence. After all, it’s only a tincey-wincey little virus. On a
lighter note, prolonged and deep kissing considerably strengthens facial muscles.
What better reason to find someone to
pucker up with?
