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Understanding HARD BELLY (excess visceral abdominal fat)

(and why it’s different from regular fat)

real patient real patient

If you are living with HIV, one issue that may be challenging is lipodystrophy. Lipodystrophy refers to changes in body fat that include buildup or loss of fat in certain areas of the body. HARD BELLY results when the buildup of extra hard fat in the abdominal (belly) area pushes up against the abdominal wall and stretches the muscles until they become taut.

HARD BELLY fat is not like regular fat

Regular fat:

  • Surrounds organs
  • May be associated with fat accumulation in organs
  • Feels harder and firmer than regular fat.


  • Surrounds organs
  • May be associated with fat accumulation in organs
  • Feels harder and firmer than regular fat
  • May be hard to reduce with diet and exercise alone

HARD BELLY may be associated with serious health issues*:

  • High cholesterol
  • Cardiovascular disease
  • Acid reflux
  • Diabetes, insulin resistance
  • Sleep apnea
  • Liver fat
Please talk to your healthcare provider for more information or if you have any concerns about health issues you are experiencing.

*EGRIFTA SV™ is not approved to reduce the health consequences of HARD BELLY (excess visceral abdominal fat).

Who is at risk for developing HARD BELLY?

A number of factors may increase the risk of developing HARD BELLY, including:

  • Older age
  • Living with HIV
  • How long you have been living with HIV
  • Certain types of anti-retroviral therapy (ART)
  • How long you have been on ART

Checking for HARD BELLY

(and helping to keep it in check)

HARD BELLY can be difficult for you to accurately describe and can be mistaken for general weight gain or obesity. Talk to your healthcare provider about what you’re feeling and ask them to check for HARD BELLY.

Your healthcare provider can check for HARD BELLY in a few simple ways, including:

Feeling your abdomen (belly) for firmness

Measuring your waist and hips circumference

Calculating waist-to-hip ratio (waist circumference/hip circumference)

If you have trouble managing HARD BELLY on your own with exercise and a healthy diet, ask your healthcare provider about EGRIFTA SV™, which has been shown to reduce HARD BELLY in people living with HIV who have lipodystrophy.

An approved strength of tesamorelin for injection with the same efficacy and safety of tesamorelin 1 mg/vial. The 2 mg/vial is more concentrated than the 1 mg/vial, and the recommended daily dose is 1.4 mg.