What is Hard Belly

Not all fat is the same. Typically, when people gain weight, they add a layer of fat just under the skin. This is regular fat, or subcutaneous fat. It is a soft, doughy kind of fat and is easier to pinch.

However, some people with HIV can develop a different kind of fat that is hard, feels much firmer, and is difficult to pinch. This fat usually develops deeper within the abdomen. It is known by many different names, such as hard belly, excess abdominal fat, or visceral adipose tissue.

But no matter what it’s called, hard belly is not regular fat; it requires a different type of conversation with your healthcare provider and may require a different approach to treatment.

 


Hard belly is:

  • Fat that surrounds a person’s abdominal organs

  • A normal tissue that is harmful in excess amounts

  • Fat that may not be reduced with diet and exercise alone

People with HIV could be at risk for hard belly (excess visceral abdominal fat). There are a variety of factors that may increase the risk of someone developing hard belly, including:

  • Age
  • Genetics
  • Higher body mass index
  • Female gender
  • Taking HIV medication (and how long)
  • Length of time since HIV diagnosis

The following are common ways your healthcare provider may determine if you have hard belly:

  • Feeling the stomach for firmness
  • Measurement of the waist and hips
  • Calculating waist-to-hip ratio
  • Assessment of the type of body fat
  • Medical history and HIV therapy regimen

Hard Belly can be difficult to live with. It feels harder than regular fat and can contribute to other health concerns. Multiple studies show that excess hard abdominal fat (hard belly) in people with HIV may affect life expectancy. Hard belly has been associated with a variety of health conditions, including high blood pressure, cholesterol issues, diabetes, and heart disease.

Keep in mind that reducing hard belly may not decrease the risk of these and other health issues.

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If either your waist circumference exceeds 37.4 inches for men, 37 inches for women, or your waist-hip ratio exceeds 0.94 for men, 0.88 for women, you should have a discussion with your healthcare provider and ask what treatment is right for you.


Your Belly Discussion Guide

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