We recently reported that a 12-week internet weight loss program produced greater weight losses than education control in overweight/obese people living with HIV (PLWH) (4.4 kg vs 1.0 kg; p < 0.05). This manuscript presents the changes in diet, physical activity, behavioral strategies, and cardio-metabolic parameters. Participants (N = 40; 21 males, 19 females) were randomly assigned to an internet behavioral weight loss (WT LOSS) program or internet education control (CONTROL) and assessed before and after the 12-week program. Compared to CONTROL, the WT LOSS arm reported greater use of behavioral strategies, decreases in intake (− 681 kcal/day; p = 0.002), modest, non-significant, increases in daily steps (+ 1079 steps/day) and improvements on the Healthy Eating Index. There were no significant effects on cardio-metabolic parameters. The study suggests that a behavioral weight loss program increases the use of behavioral strategies and modestly improves dietary intake and physical activity in PLWH. Further studies with larger sample sizes and longer follow-up are needed.
Clinical Trials Registration: NCT02421406.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Mankal PK, Kotler DP. From wasting to obesity, changes in nutritional concerns in HIV/AIDS. Endocrinol Metab Clin North Am. 2014;43(3):647–63.
Amorosa V, Synnestvedt M, Gross R, et al. A tale of 2 epidemics: the intersection between obesity and HIV infection in Philadelphia. J Acquir Immune Defic Syndr. 2005;39(5):557–61.
Crum-Cianflone N, Tejidor R, Medina S, Barahona I, Ganesan A. Obesity among patients with HIV: the latest epidemic. AIDS Patient Care STDS. 2008;22(12):925–30.
Tate T, Willig AL, Willig JH, et al. HIV infection and obesity: where did all the wasting go? Antivir Ther. 2012;17(7):1281–9.
Thompson-Paul AM, Wei SC, Mattson CL, et al. Obesity among HIV-infected adults receiving medical care in the United States: data from Cross-Sectional Medical Monitoring Project and National Health and Nutrition Examination Survey. Medicine. 2015;94(27):e1081.
Koethe JR, Grome H, Jenkins CA, Kalams SA, Sterling TR. The metabolic and cardiovascular consequences of obesity in persons with HIV on long-term antiretroviral therapy. AIDS. 2016;30(1):83–91.
Koethe JR, Jenkins CA, Lau B, et al. rising obesity prevalence and weight gain among adults starting antiretroviral therapy in the United States and Canada. AIDS Res Hum Retrovir. 2016;32(1):50–8.
De Wit S, Sabin CA, Weber R, et al. Incidence and risk factors for new-onset diabetes in HIV-infected patients: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Diabetes Care. 2008;31(6):1224–9.
Butt AA, McGinnis K, Rodriguez-Barradas MC, et al. HIV infection and the risk of diabetes mellitus. AIDS. 2009;23(10):1227–34.
Capeau J, Bouteloup V, Katlama C, et al. Ten-year diabetes incidence in 1046 HIV-infected patients started on a combination antiretroviral treatment. AIDS. 2012;26(3):303–14.
Duran AC, Almeida LB, Segurado AA, Jaime PC. Diet quality of persons living with HIV/AIDS on highly active antiretroviral therapy. J Hum Nutr Diet. 2008;21(4):346–50.
Vancampfort D, Mugisha J, De Hert M, et al. Global physical activity levels among people living with HIV: a systematic review and meta-analysis. Disabil Rehabil. 2016;40:1–10.
Vancampfort D, Mugisha J, De Hert M, Probst M, Stubbs B. Sedentary behavior in people living with HIV: a systematic review and meta-analysis. J Phys Act Health. 2017;14(7):571–7.
Becofsky K, Wing EJ, McCaffery J, Bodreau M, Wing RR. A Randomized, controlled trial of a behavioral weight loss program for HIV-infected patients. Clin Infect Dis. 2017;65(1):154–7.
Thomas JG, Leahey TM, Wing RR. An automated internet behavioral weight-loss program by physician referral: a randomized controlled trial. Diabetes Care. 2015;38(1):9–15.
Pinto AM, Fava JL, Raynor HA, LaRose JG, Wing RR. Development and validation of the weight control strategies scale. Obesity (Silver Spring). 2013;21(12):2429–36.
Thompson F, Subar A. Dietary assessment methodology. In: Coulston A, Boushey C, Ferruzz M, editors. Nutrition in the prevention and treatment of disease. 3rd ed. London: Elsevier; 2013.
Krebs-Smith SM. Health Eating Index 2015. J Acad Nutr Diet. 2018;118:1622.
Papazoglou D, Augello G, Tagliaferri M, et al. Evaluation of a multisensor armband in estimating energy expenditure in obese individuals. Obesity. 2006;14(12):2217–23.
Jakicic JM, Marcus M, Gallagher KI, et al. Evaluation of the SenseWear Pro Armband to assess energy expenditure during exercise. Med Sci Sports Exerc. 2004;36(5):897–904.
Guenther PM, Casavale KO, Reedy J, et al. Update of the Healthy Eating Index: HEI-2010. J Acad Nutr Diet. 2013;113(4):569–80.
Ambrosini GL, Solis-Trapala I, Ahern AL, et al. Greater improvements in diet quality among overweight participants following a group-based commercial weight loss programme than those receiving support to lose weight in primary care. Nutr J. 2018;17(1):64.
O’Brien KM, Hutchesson MJ, Jensen M, Morgan P, Callister R, Collins CE. Participants in an online weight loss program can improve diet quality during weight loss: a randomized controlled trial. Nutr J. 2014;13(1):82.
Anderson C, Harrigan M, George SM, et al. Changes in diet quality in a randomized weight loss trial in breast cancer survivors: the lifestyle, exercise, and nutrition (LEAN) study. NPJ Breast Cancer. 2016;2:16026.
Webel AR, Moore SM. Randomized controlled trial of the systemCHANGE intervention on behaviors related to cardiovascular risk in HIV + adults. J Acquir Immune Defic Syndr. 2018;78(1):23–33.
Gomes NCC, et al. Effects of combined aerobic and resistance exercise on exercise capacity, muscle strength and quality of life in HIV-infected patients: a systematic review and meta-analysis. PLoS ONE. 2015;10(9):e0138066.
O’Brien KK, Tynan AM, Nixon SA, Glazier RH. Effectiveness of aerobic exercise for adults living with HIV: systematic review and meta-analysis using the Cochrane Collaboration protocol. BMC Infect Dis. 2016;16:182.
Fitch KV, Anderson EJ, Hubbard JL, et al. Effects of a lifestyle modification program in HIV-infected patients with the metabolic syndrome. AIDS. 2006;20(14):1843–50.
Shah KN, Majeed Z, Yoruk YB, et al. Enhancing physical function in HIV-infected older adults: a randomized controlled clinical trial. Health Psychol. 2016;35(6):563.
Tudor-Locke C, Craig CL, Aoyagi Y, et al. How many steps/day are enough? For older adults and special populations. Int J Behav Nutr Phys Act. 2011;8(1):80.
Creasy SA, Lang W, Tate DF, Davis KK, Jakicic JM. Pattern of daily steps is associated with weight loss: secondary analysis from the step-up randomized trial. Obesity. 2018;26(6):977–84.
Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102–38.
Engelson ES, Agin D, Kenya S, et al. Body composition and metabolic effects of a diet and exercise weight loss regimen on obese, HIV-infected women. Metabolism. 2006;55(10):1327–36.
Reeds DN, Pietka TA, Yarasheski KE, et al. HIV infection does not prevent the metabolic benefits of diet-induced weight loss in women with obesity. Obesity (Silver Spring). 2017;25(4):682–8.
We wish to thank Whitney Howie for her contribution to the dietary analyses. This project was supported by the Providence/Boston Center for AIDS Research (Grant Number P30 A1042853); the ACTG Clinical Research Site 2951 (The Miriam Hospital; Grant Number UM1AI069412); and the Cardiovascular Behavioral and Preventive Medicine Training Grant (Grant Number KB T32 HL076134).
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Wing, R.R., Becofsky, K., Wing, E.J. et al. Behavioral and Cardiovascular Effects of a Behavioral Weight Loss Program for People Living with HIV. AIDS Behav 24, 1032–1041 (2020). https://doi.org/10.1007/s10461-019-02503-x