He bought clothes just to cover it up. He was constantly monitoring his posture, hoping to minimize its appearance. But he wasn’t able to hide it for long. Someone approached Andy Ansell in his church, pointed at his protruding midsection, and asked, “Are you trying to put on weight?”

HIV-positive for more than two decades, the 42-year-old Minneapolis resident was no stranger to the effects of lipodystrophy -- a side effect in which fat is redistributed throughout the body -- which is caused by certain antiretroviral medications and by the virus itself, not to mention the effects of aging seen in HIVers as pharmaceutical advances are allowing them to live longer.

Ansell had experienced the appearance of pronounced veins on his legs and arms for years. Then, a long convalescence after a cycling accident two years ago left him out of shape and overweight. Twenty extra pounds on his 5-foot-4 frame sank right to his midsection, giving him the distended look that some call “Crix belly,” so called after one of the medications that can be major culprits for “lipo” side effects.

“I was like, I’m healthy, but I still have that outward, visible appearance of somebody that has HIV,” he says. “While there’s nothing wrong with that, it still makes you feel -- no matter how healthy you are -- like there’s something wrong with you.”

Ansell’s doctor told him that no magic pill or procedure could do away with his unwanted belly. The best hope lay in diet and exercise, although there would be no guarantees. At the time, Ansell’s commitment to physical fitness was sporadic. Meals were also “hit or miss,” he says, with sugar playing a large role in his diet. He decided to make a change.

Ansell switched to eating small meals every three hours. He began to avoid packaged, processed foods and to eat lots of fruits and vegetables, lean protein sources, and whole grains.

“It’s not that it’s a diet,” he says of the tack he took. “It’s really more of a lifestyle change.”

He also hits the gym like it’s going out of style. This includes cardio workouts five days a week on a stationary bicycle and free weights three times a week as well as yoga and abdominal classes. Within six weeks he began to notice the changes to his body.

“I first noticed it,” he says, “because my clothes started fitting differently. My pants started to fit again! That was pretty significant. I started to feel -- I hate saying this because it makes it sound like being positive is ‘not normal,’ but I started to feel normal.”

After three months the changes to Ansell’s body were dramatic. And today, he’s down to 145 pounds and proudly sporting a six-pack.

“I feel great!” he says. “While I’m not ashamed to have HIV, it pisses me off when HIV impacts my life in a negative way. And the body changes were always a reminder of that. Now I really feel like -- I don’t want to say victorious, but it really is an experience of ‘Screw you, HIV! I know you’re in there, but you’re not going to take more from me than you’ve already taken.’”

When researchers at the University of Texas at Austin conducted a review of studies concerning HIV and physical activity, they found that HIVers consistently cite exercise as their most important coping mechanism for dealing with both the virus and side effects of antiretrovirals. So the UT team hoped to prove that exercise can improve quality of life among HIVers. And indeed it can, they found. Not only is some sort of physical fitness routine safe for most people living with the virus, but even moderate exercise has been consistently shown to increase muscular strength and endurance, build muscle, shed fat, and increase overall physical functioning in people living with the virus.

“We see our mission as to preach the gospel that people need to be physically active,” says Gregory A. Hand, Ph.D., MPH, the associate dean of academic affairs for the Arnold School of Public Health at the University of South Carolina and an expert on the importance of exercise for HIVers. “They need to watch their diet, and they need to be trying to do healthy lifestyle activities that can affect people with HIV as well as healthy individuals. There’s no reason why being infected with HIV should affect your lifestyle in terms of trying to do healthy activities.”

Tags: Health