PLWH if you want to live longer start with right medicine
The obesity related metabolic diseases should be the primary concern when patients are initiated on the weight loss drugs. Poor/cheap calorigenic food high in carbohydrates and fat are the most common causes of obesity and obesity related health problems.
This study was performed on rats nevertheless their findings suggest a significant correlation between obesogenic low protein high calorie food combined with anti viral HIV drugs and increased metabolic syndrome related mortality. However Tesamorelin reversed the metabolic issues when co-administrated with cARTs. So PLWH who often gain weight in the first few years ofter they have been treated with antivirals should avoid low protein high calorie diets which is easier said than done failing the dietary approach they should get started on Tesamorelin to avoid deadly metabolic disease. It might look good to conveniently shed few pounds by taking obesity drugs but you will live longer if you get started on Tesamorelin.
"This study showed that the low protein high calorie diet was obesogenic. These obesogenic activities were as great as /exceeded that of the classical cafeteria diet (normal protein high calorie diet) in addition this lowprotein high calorie diet interacted with both IICR and classical cART drug regimen to reproduce cART associated metabolic dysregulations. These dysregulations were however reversed by co-treatment with tesamorelin indicating the possible involvement of the growth hormone system dysfunction in its pathophysiology.
The finding from this study therefore may provide a potential pathophysiologic explanation for the observed increased mortality rate seen in sub-Saharan Africa when cART is initiated in patients with nutritional insufficiency."
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0298752