GLP-1s and HIV: Thoughts?

ThinLizzie

ThinLizzie

Well-known member
Hi everyone! Super interesting presentation from Dr. Suman Shrinivasa about using GLP-1 receptor agonists (GLP-1 RAs) for weight and metabolic health, especially for people with HIV. She's at Harvard Medical School and seems like a big deal in this area. Basically, these drugs (like semaglutide, liraglutide) were originally for type 2 diabetes but also help with weight loss by suppressing appetite and slowing down digestion. Apparently, HIV meds can cause weight gain, so this could be helpful. Thoughts?
 
She mentioned that GLP-1 RAs can lower A1C levels and even reduce cardiovascular mortality. The STEP trial showed semaglutide was way better than liraglutide for weight loss (16% vs 6%).
 
For HIV patients, studies showed about 5 kg weight loss and a 2-point BMI reduction with GLP-1 RAs. Some trials even suggested they might work *better* in HIV-positive folks with diabetes. Also, good news for the liver, potentially reducing triglyceride content and inflammation!
 
The downside? Some lean mass loss, which could be a problem for older HIV patients and frailty. GI side effects are common (nausea, etc.). And getting insurance to cover it can be a pain, especially for weight loss purposes. Anyone have experience with this themselves?
 
Yeah, I've been on semaglutide for about 8 months now. Lost a good chunk of weight, but definitely noticed some muscle loss. I've been trying to up my protein intake and do more strength training to counter it. It's a balancing act for sure.
 
The lean mass loss is a concern. I've read that resistance exercise can help mitigate it. It's also important to ensure adequate protein intake, especially leucine. The SELECT trial showed a reduction in visceral fat, which is a huge benefit for metabolic health. But we need more data on the long-term effects on muscle function, particularly in vulnerable populations.
 
As a nurse practitioner, I've been monitoring patients on GLP-1s closely. The GI side effects are definitely the most common complaint, but they often subside over time as the body adjusts. Starting with a low dose and titrating up slowly is key. Also, it's crucial to educate patients about the importance of staying hydrated and eating smaller, more frequent meals to minimize nausea.
 
Okay, this is all really interesting! I've been trying to lose weight for ages, and I hadn't considered GLP-1s. But I am kinda scared of the side effects. Nausea sounds awful. Is it really that bad?
 
Pat_75, most are injections, but semaglutide has an oral form, though it's only approved for diabetes right now. You need a prescription from a doctor.
 
I'm curious about the food noise thing. Does it REALLY curb cravings? I'm a total food addict, so that's the biggest thing for me.
 
Food_xo, for me, it's been a game changer. The constant thoughts about food are SO much quieter. It's like a mental weight has been lifted. I still get hungry, but it's manageable, not this desperate NEED to eat everything in sight.
 
I've read anecdotal reports of people with ME/CFS experiencing improved energy levels while on GLP-1s, possibly due to reduced inflammation. Has anyone else experienced this?
 
Lucky_Fixed34 said:
I've read anecdotal reports of people with ME/CFS experiencing improved energy levels while on GLP-1s, possibly due to reduced inflammation. Has anyone else experienced this?
Click to expand...
That's interesting! I've seen a few patients report similar experiences. It could be related to improved insulin sensitivity and glucose metabolism, which can impact energy levels. More research is definitely needed in this area.
 
Okay, so I found this database someone made of GLP-1 side effects from Reddit. It's kinda scary, but also helpful to see what people are experiencing and what helps them cope. It's all anecdotal, of course, but still...
 
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