Nutrition and weight maintenance

November 2004     View PDF     En español

Diagnose and treat the causes

It’s extremely important for you and your doctor to rigorously diagnose and treat the cause(s) of weight loss. HIV and related conditions can cause weight loss, fatigue, muscle loss and chronic diarrhea. The gut is a major site of early HIV infection, where the virus first establishes itself in the body. Many bacterial, viral, fungal and parasitic infections of the gut grow unchecked once the immune system is weakened. These can contribute to weight loss.

Some doctors test repeatedly to identify the cause(s) of diarrhea and weight loss. Others only treat the symptoms. It’s important to do both. Aggressive diagnosis should be accompanied by aggressive treatment.

That said, diagnosing and treating unexplained weight loss and diarrhea can be difficult since multiple causes often occur at the same time. For instance, with testing, a parasite may be identified as a cause of diarrhea, but treating it may only reduce and not resolve the problem. This might be because the parasite was “masking” another infection. More testing and treatment may be needed to deal with the underlying problem(s).

Also, sometimes wasting is due to malabsorption, when the tissue and cells lining the gut have lost the ability to transfer nutrients. Knowing when this is the case helps in selecting the right treatment. Finding the cause(s) of weight loss and diarrhea is always critical to finding the right solution. Treating only symptoms, without knowing the underlying causes, can sometimes do more harm than good.