You may remember photos from the early days of the AIDS epidemic. They showed emaciated young people, all skin and bones and looking very ill. Thankfully, those images, burned into many people’s minds, are now somewhat out of date.

Ever since the mid-’90s, when powerful combinations of drugs became the standard way to treat and suppress HIV, most HIV-positive Americans have been living longer, healthier lives. What was once called “the slim disease” has now become a condition that can commonly be managed (with work) for years. In 
fact, sometime during the past decade, researchers noticed that HIV-positive people were as likely as other Americans to be overweight.

But that doesn’t mean HIV can’t still rob positive people of pounds crucial to good health. If left untreated (for instance, in people who don’t know they have HIV because they haven’t been tested), HIV will progress to AIDS. At that point, with the immune system severely damaged, AIDS-related wasting kicks in and people lose necessary body weight and muscle.

Even some people with well-controlled HIV may unintentionally lose body mass. They may have a different sort of wasting (lipoatrophy), which diminishes their body’s fat in the face, buttocks, arms, legs—even feet.

Researchers continue looking for ways to reverse such fat loss. Meanwhile, HIV-positive people keep finding ways to replace facial fat, pad bony butts and camouflage their shrunken legs and arms.

For more on fat loss, search “lipoatrophy” at poz.com.