Research
Hormonal
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) such as semaglutide and tirzepatide are effective for weight loss in people with HIV, with tirzepatide showing the largest mean percent change in weight.
If lifestyle changes are not enough to manage weight gain from HIV medication, ask your doctor about GLP-1 RAs like semaglutide or tirzepatide. These drugs are highly effective for weight loss and can help reduce fat deposits. They are used alongside diet and exercise.
GoodSupportsHIGH confidence
Of these, tirzepatide was recently approved and results in a mean percent change in weight of -20.9% compared to placebo (-3.1%; p<0.001)... The study demonstrated that semaglutide was effective in reducing weight and total fat in central and peripheral deposits.
Why this rating
Based on FDA-approved agents and specific trials (ACTG 5371) in PWH.
Source
Beyond the Numbers: Weight Gain Risk Factors, Implications, and Interventions among Individuals with HIV
Yesha Patel et al. · Journal of AIDS and HIV Treatment · 2024
DOI 10.33696/aids.6.047
narrative_reviewCited 3×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Switching from Tenofovir Alafenamide (TAF) to Tenofovir Disoproxil Fumarate (TDF) in women with HIV results in significant weight loss, indicating TDF has weight-suppressive effects.Good
- Integrase Strand Transfer Inhibitors (INSTIs), specifically Dolutegravir (DTG) and Bictegravir (BIC), are associated with significant weight gain compared to older antiretrovirals like Efavirenz (EFV) or Protease Inhibitors.Good
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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