Malabsorption of food

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Altered metabolism

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Food and drug interactions

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Androgen deficiency

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No cooking facilities

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Limited income

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Reliance on community food programs

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With the onset of malnutrition, the client loses weight and experiences several body composition

changes. Starvation results in loss of body fat and muscle. Wasting syndrome produces a loss of

a serious percentage of body weight, with accompanying diarrhea and fever, and has been

considered a defining symptom of AIDS since 1987. The degree of loss of lean body mass can

indicate the length of time that the client has left to live.

Lipodystrophy syndrome

Lipodystrophy syndrome occurs in early end-stage AIDS and produces altered body composition

and various hormonal and physiological changes. The cause of the syndrome and its relationship

with HIV and protease inhibitors are unknown. Because of the disfiguring nature of some

symptoms, lipodystrophy can be particularly distressing for women. Symptoms include

Redistribution of body fat

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Increase in waist size

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Thinning of the arms and legs

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Increased facial wrinkling

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Weakness and muscle wasting

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Gastrointestinal symptoms

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Increased triglycerides and cholesterol

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Decreased testosterone levels

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Hypertension

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Diabetes

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To determine body composition changes, provider staff should recommend that clients be

measured on a bioelectrical impedance analysis machine. This noninvasive machine sends a

weak electrical current through electrodes placed on the client's hands and feet to measure fluid

volume, blood cell mass, extracellular mass, and level of body fat. Repeated every 3 to 6 months,

this procedure can provide an accurate gauge of the client's biophysiological status.

Providers can treat weight loss and malnutrition by prescribing a nutritious, balanced diet with

plenty of fluids and a daily multivitamin, if needed. Protein and calorie supplements are

recommended if the client is losing weight. The client should avoid toxic substances such as

alcohol, tobacco, and recreational drugs and should practice a daily routine of moderate exercise.

Pharmaceutical interventions that may be required include appetite stimulants, thalidomide, and

growth hormones.

Treatment staff should also discuss integrative therapies with the client. These can include herbs,