Weight loss and anorexia

Weight loss is a major problem in AIDS and directly influences survival. The causes of weight loss are complex and several factors may coexist in individual patients. Anorexia may occur secondary to drug therapy, opportunistic infection, taste disturbance, or oral discomfort, resulting in inadequate food intake. Malabsorption of fat, lactose, vitamin B12, and bile salts has been demonstrated.

Simple dietary measures such as encouraging smaller, more frequent, meals may be helpful and a wide variety of nutritional supplements are available. Appetite stimulants such as megestrol acetate may be beneficial but weight gain is usually modest. Recombinant human growth hormone, although expensive, may partially reverse HIV-associated weight loss. In patients unable to tolerate oral feeding, enteral and parenteral feeding are alternative forms of nutrition but their efficacy and place in management are still being evaluated. Enteral nutrition offers a safer and cheaper alternative to total parenteral nutrition which is perhaps most useful in patients with severe diarrhoea, nausea, and vomiting, in whom fluid balance and control of symptoms has been difficult.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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