According to Jennifer O. Lam, PhD, MPH, and colleagues, excess weight gain is a significant concern for individuals with HIV (PWH) undergoing antiretroviral therapy (ART), but the precise role of ART in BMI changes remains unclear. In their retrospective study comparing PWH initiating ART with demographically matched individuals without HIV (PWoH), data from electronic health records were analyzed. The study involved 8256 PWH and 129,966 PWoH. Adjusted models revealed that PWH experienced a greater average annual BMI increase in the first two years after ART initiation compared to PWoH. This increase was observed across all ART classes, including integrase strand transfer inhibitors (INSTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and protease inhibitors (PIs). Notably, BMI increases among PWH initiating INSTIs were observed irrespective of baseline BMI. However, BMI changes beyond two years postART initiation were similar between PWH and PWoH. These findings underscore the importance of monitoring weight and cardiometabolic health in individuals with HIV initiating ART