Body fat redistribution syndrome

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Body fat redistribution (BFR) syndrome, also called fat derangement, is a condition where fat shifts around the body. It often causes fat loss in the face and fat gain in the belly and neck. BFR is most common in people with HIV/AIDS who take antiretroviral therapy (ART). Signs can include a fat pad at the back of the neck, extra belly fat, and thinning of fat under the skin on the face, arms, legs, and buttocks. These changes can affect appearance and may lead some people to skip or stop treatment. Severe BFR can cause sleep problems such as sleep apnea, headaches, stiffness, and discomfort from pressure on internal organs, as well as a general feeling of being unwell. Fat loss can also cause buttock pain when sitting.

BFR is linked with other health issues like high cholesterol, high triglycerides, insulin resistance, high blood sugar, diabetes, gout, and heart disease. The exact relationship between BFR and these problems isn’t fully understood. There isn’t one official definition of BFR; different people show different patterns, including fat gain in some areas, fat loss in others, or both. Gender, age, and how much weight someone had before starting therapy can affect how severe the changes are. BFR is different from lipodystrophy, which means fat loss only. Treatments focus on managing symptoms (for example, cosmetic procedures) and may include changing HIV medicines away from protease inhibitors to other drugs.