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Zambia: Challenges of Obesity, HIV/Aids
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The Times of Zambia (Ndola)
COLUMN
7 July 2008
Posted to the web 7 July 2008
Margaret Mangani
AMONG the stereotype it was commonly known as the sliming disease. AIDS was associated with involuntary sliming due to the on-set of opportunistic infections until in the recent past when a new scenario has emerged with those who are on anti retroviral therapy (ART) developing obesity.
In the past few years even if you were naturally slim you stood the chance of being mistaken for someone who was suffering from AIDS.
Unless you had a reason why you had chosen to maintain such a body stature then you could easily be mistaken for one who was infected.
Perhaps in the lay man's thinking, that was the yard stick for measuring who was infected or not before medical experts ruled out that method as being inaccurate.
Of course unless one went for counselling and testing you could not tell by simply looking. It was more of a myth than a fact.
But being obese comes with its own complications of one developing hypertension or even diabetes or cardiac ailments and what's more, with a person who is already HIV positive, this can prove to be a more complicated health condition to manage.
While appreciating that for ARVs to work effectively they must be complimented by a good diet, perhaps obesity, a condition which is commonly associated with the elite and with people who are not infected by the HIV virus, comes about due to absorption of certain micronutrients more than is required by the body.
Most people who are taking ARVS are gaining more weight and by sight this could largely be attributed to bad diet choices coupled with lack of exercise and thus one ends up being obese.
Though statistics are not available yet to measure the gravity of the problem, there is visible evidence to suggest this new health trend concern.
Scientists and researchers have to play their role in investigating and coming up with an answer to ascertain exactly what happens to the body composition otherwise everything would be left to speculation.
A nutrition specialist for people living with HIV/ AIDS, Beatrice Kawana, confirmed this development when she made a presentation during an advocacy and awareness workshop on body composition and its role in the management of HIV/AIDS and other diseases due to lifestyle.
Ms Kawana said it was gratifying to see a worn out person putting on weight but lately ART sites have observed that clients have developed more weight than is ideal and this has led to obesity.
"We have observed that some clients are going beyond the normal ideal weight and no research has been carried out yet to ascertain what exactly happens to the body," she said.
While the Nutrition Commission in Zambia is tasked with the role of giving guidelines on good eating habits that could contribute to a healthy living, Ms Kawana admitted that there have been some lapses in some areas largely because her organisation is faced with numerous challenges.
It would not be wrong to state that the commission has not been able to meet some of the people's expectations.
"We have been accused of not being aggressive. Yes I can admit that it's because we are faced with a lot of handicaps but we do try to provide nutrition guidelines to people living positively with HIV/AIDS," she said.
The problem of obesity in people who are on ART is not a new phenomena in Zambia as it has been cited elsewhere in the world as early as 2005.
For instance a study carried out in the United States found that more than 60 per cent of a group of HIV positive clients met the criteria to be classified as overweight or obese.
Nancy Crum Cianflone, MD of the Tri - Service AIDS Clinical Consortium of San Diego told participants of the Infectious Diseases Society of America meeting.
In contrast, none of the clients met the strictest standards for wasting and only three per cent met looser standers it was observed.
Medical advances have resulted in more HIV patients living longer than their counterparts two decades ago, causing them to be prone to the same habits as uninfected Americans - poor eating choices and lack of exercise.
Dr Crum-Cianflone credits the advent of highly active anti-retroviral therapy with the transition from wasting to excess weight.
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"This is a clear demonstration that HIV medications have really revolutionised the treatment of patients," she said.
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