Most people with HIV gain weight after starting antiretroviral therapy (ART). While some weight gain can be a sign that the treatment is working, too much can lead to health problems. Older ART drugs could cause lipodystrophy, where fat is stored in unhealthy ways, leading to issues like insulin resistance, diabetes, and heart problems. Newer drugs are less likely to cause these issues, but short-term weight gain can still increase the risk of metabolic problems. Studies show that within the first 12 to 18 months of ART, about 37% of people gain 5% of their body weight, and 17% gain 10%. Weight gain is not always bad, especially for those who are underweight, but doctors worry if you gain more than 5% of your body weight. This can increase the risk of fat accumulating around internal organs, leading to metabolic diseases like diabetes. It's important to talk to your doctor if you're concerned about weight gain. They can help you manage it through diet, exercise, and possibly changing your medication. Regular health checks can also help monitor any potential issues.