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Life sciences · Journal article
Current Opinion in HIV and AIDS · September 2, 2026
A consensus or society position rather than new primary data.
This is a narrative review reframing obesity management in aging people with HIV from weight-centric to body-composition-and-function-centric approaches, highlighting sarcopenic obesity, muscle quality, and frailty as clinically relevant constructs. The authors synthesize emerging evidence that exercise with resistance training may preserve muscle and function, while warning that pharmacologic weight loss alone may compromise lean tissue. This represents a clinical and research priority statement rather than definitive evidence for a specific intervention.
Narrative review. Aging people with HIV (PWH) in the contemporary antiretroviral therapy era.
Weight gain in the antiretroviral therapy era often reflects increased visceral and ectopic adiposity rather than lean mass Sarcopenic obesity is characterized by coexistence of excess adiposity and impaired muscle mass or function, with implications for healthy aging in PWH Exercise-based interventions, particularly resistance training, demonstrate promise for preserving physical function, reducing frailty, and improving body composition
Pharmacologic weight loss may raise concerns regarding lean tissue preservation without concurrent focus on muscle health
Clinicians and researchers should shift from assessing obesity solely by weight to evaluating body composition, muscle quality, and functional status in aging PWH. Exercise-based interventions, particularly resistance training, should be prioritized; pharmacologic weight loss should be implemented cautiously and ideally alongside muscle-preserving strategies.
A narrative review synthesizing evidence on body composition, sarcopenic obesity, and frailty in aging people with HIV, offering a reframing of clinical and research priorities rather than reporting original empirical findings.
As stated by the source record.
Clinicians and researchers should shift from assessing obesity solely by weight to evaluating body composition, muscle quality, and functional status in aging PWH. Exercise-based interventions, particularly resistance training, should be prioritized; pharmacologic weight loss should be implemented cautiously and ideally alongside muscle-preserving strategies.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
PURPOSE OF REVIEW: As people with HIV (PWH) age, obesity is increasingly prevalent, yet body weight alone inadequately captures the functional and metabolic consequences of adverse body composition remodeling. This review examines emerging evidence supporting a shift from weight-centric approaches toward a framework centered on sarcopenic obesity, muscle quality, and frailty in aging PWH. RECENT FINDINGS: Weight gain in the contemporary antiretroviral therapy era often reflects increased visceral and ectopic adiposity. Sarcopenic obesity is a clinically relevant phenotype characterized by the coexistence of excess adiposity and impaired muscle mass or function, with important implications for healthy aging. Emerging evidence highlights myosteatosis and impaired muscle quality as potential mechanistic links between adiposity and functional decline. Exercise-based interventions, particularly those incorporating resistance training, demonstrate promise for preserving physical function, reducing frailty, and improving body composition. In contrast, pharmacologic weight loss may raise concerns regarding lean tissue preservation if implemented without a concurrent focus on muscle health. SUMMARY: Obesity in aging PWH should be reframed as a body composition and functional health problem rather than simply excess body weight. Clinical and research priorities should emphasize early identification of vulnerability, preservation of muscle health, and interventions that support long-term physical resilience and independence.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.