 
Looking for Lipo
by David Evans
If you see something, say something. Without official tests to diagnose lipo, talking with your doc is the best bet—along with taking a snapshot or two.
Diagnosing lipoatrophy can be tricky business, for your doc as well as for you. You can lose a lot of fat before the image you see in the mirror each day changes noticeably. There are tools that can detect minute differences—such as MRI and laser scans—but they’re rarely avail--able or affordable outside a research setting. Sophisticated scoring systems that rely on dozens of measurements have also been developed, but there’s a lot to be said for the most basic tool we have: visual inspection of our bodies.
Even without high-tech help, you and your doc have options available to you. You can have your doctor “inspect” you during every clinic visit, and then you can discuss any changes he or she sees. Alternately, take a self-portrait photo or Polaroid every three or four months and compare the images with your doc. You and your doc can also use a flexible tapeline to measure the circumference of key body points (like your legs and arms); record the measurements in a journal, or your medical file, to track trends.
Dr. Hsu says he looks for obvious signs of fat loss in key places; signs of lipoatrophy include deepening folds on the sides of the nose and protruding veins in the arms and legs.
To increase the chance that you and your doctor will notice fat loss as soon as it begins to happen, some patient-advocacy organizations suggest the tips below. You can do them with your doctor’s help, if he or she is willing, or on your own. Begin before starting HIV treatment and continue every three months.
PICTURE THIS
Here are some tools to look for changes to your body:
Use calipers to measure the thickness of a fold of your skin on your arms and legs.
Measure around your neck, upper arms, mid thighs and hips with a non-stretchy tape measure.
Take pictures of your body (sans clothing) and face. Things to look for include:
- how prominent the veins and muscles are in your forearms, legs and hands
- how prominent the fold of skin is that runs from the corner of your mouth up to your nostril on each side of your face
- how full your face and butt cheeks look
- how your clothing fits, particularly how much your butt fills out the seat of your pants
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