Will Truvada Make Me Gain Or Lose Weight?

Before getting prescribed Truvada as PrEP, an HIV prevention strategy that when taken as prescribed makes it virtually impossible to contract HIV, we always have a slew of questions. Most of them have to do with whether or not the drug will change or limit our lifestyles. 

According to NationalEatingDisorders.org, queer folks are disproportionately impacted with eating disorders, many of which are manifested through heightened workout routines at the gym or an extensive amount of health and body concerns in our daily tasks.

For some, the rumor that Truvada creates weird fat gains or shifts without our consent prevents us from doing more research. But I’m here to tell you... there’s nothing to worry about. 

As reported by NAM AIDSMap, an international HIV information resource, PrEP doesn’t raise lipids or alter body fat. However, the study did show that Truvada is associated with a slightly lowered cholesterol level and suppression of body fat gain, though both are likely short-term. 

Numerous studies have shown Truvada to be a safe and well-tolerated drug (one even compared it to aspirin). According to Gilead, about one in 10 people in studies reported they had nausea, stomach pain, or weight loss when they first started taking PrEP. Most of the time, these side effects improved or went away after taking PrEP for a few weeks.

In the study, published in Clinical Infectious Diseases, Truvada did not affect lean body mass.

All participants in the study (those taking Truvada and those taking a placebo) experienced slight weight gain, but those who received Truvada saw less fat gain. That ultimately goes away eventually. Additionally, Truvada was not associated with lipodystrophy, the abnormal distribution of body fat that is definitively linked with a few antiretroviral drugs that are much older than Truvada and are no longer commonly used to treat HIV.

“These data provide additional reassurance,” the study authors concluded, “on the modest, apparently benign and possibly transient metabolic effects of [Truvada] as PrEP."

However, the authors added that because the study population was young (a median age of 25) and followed only for a year or two, longer-term follow-up of older individuals is warranted.