Energy balance

In HIV-associated wasting, weight loss is primarily driven by reduced energy intake rather than elevated total energy expenditure.

For HIV patients experiencing wasting, the primary driver is often reduced food intake, not an abnormally high metabolic rate. Interventions should prioritize increasing caloric intake and managing factors causing anorexia (like infection or medication side effects) rather than assuming the patient is 'burning too many calories' through hypermetabolism.