Many people with HIV have Hard Belly

When HIV is under control, you can focus on healthy aging and managing issues that may get in the way. For many people with HIV, one of those issues is having Hard Belly.

Hard Belly is a different kind of fat and it can have many different names, such as excess hard abdominal fat, hard belly fat, lipodystrophy, visceral adipose tissue, visceral adiposity, etc. But no matter what it’s called, Hard Belly is not “regular” fat.

Unlike regular fat, which sits just under your skin, hard belly fat is found deeper and surrounds organs. Hard Belly may be hard to recognize during a routine exam with your healthcare provider. But body measurements can help.

Find out more on healthy aging

Healthy Aging with HIV

When HIV is under control, you can focus on healthy aging.

Find out how you can lead a healthier lifestyle.

How do you measure up?

To check for Hard Belly, ask your healthcare provider to:

Feel stomach for firmness

Feel your stomach for firmness

Measure waist and hips

Measure around your waist and hips (see below)

Calculate waist to hip ratio

Calculate your waist-to-hip ratio

Your healthcare provider may consider:

  • Your medical history
  • Your BMI (body mass index)
  • Your HIV therapy regimen
  • A CT scan (may give a clearer picture)

Measuring your waist circumference

The Centers for Disease Control and Prevention (CDC) and healthcare professionals recommend the following:


  1. Stand up straight and place a measuring tape around your middle, just above your hip bones.
  2. Measure at the level of the top of the hip bones and in line with your belly button.
  3. Keep the measuring tape horizontal around your waist.
  4. Do not compress the skin, but keep the measuring tape snug around your waist.
  5. Breathe out before measuring.


  1. Measure at the widest portion of the buttocks, making sure the measuring tape is horizontal.

Every person is different, so it is important to talk to your healthcare provider about Hard Belly.

CT scan of stomach showing hard belly

CT scan of stomach area with Hard Belly

How much is too much?

Waist circumference

  • Men: ≥37.4 in (95 cm)
  • Women: ≥37 in (94 cm)

Waist-to-hip ratio*

  • Men: ≥0.94
  • Women: ≥0.88

*Waist-hip ratio = waist circumference ÷ hip circumference

If your measurements are equal to or higher than these, you may have Hard Belly.

Get additional information from your HCP

Look Deeper

Talking To Your Healthcare Provider