If you’ve spent any time scrolling through TikTok or X lately, you might have encountered a peculiar panic gripping corners of the gay internet: the fear that PrEP could give you a potbelly. The rumor allegedly started after a social media comment claimed celebrity DJ John Summit had “PrEP belly,” and from there it spiraled across the chronically online spaces of gay culture like wildfire.
The problem is that the panic itself reveals something far more troubling than any actual side effect ever could.
What PrEP Actually Is (And What It Isn’t)
Let’s start with the basics. PrEP stands for pre-exposure prophylaxis, and it’s genuinely one of the most significant public health tools in modern history. The medication is extraordinarily effective at preventing HIV infection in at-risk populations and has dramatically reduced transmission rates of a virus that devastated generations of LGBTQ+ people. During the height of the AIDS crisis, hundreds of thousands of Americans died from HIV-related illnesses. The fact that we now have a tool that can essentially eliminate that risk is remarkable.
Medical professionals have been remarkably clear on this point: there’s no evidence that taking PrEP causes significant abdominal weight gain as a common side effect.
Dr. Isaac Dapkins, an internal medicine HIV specialist and chief medical officer for the Family Health Centers at NYU Langone, explained the actual science to Them. The older version of PrEP, known as Truvada (TDF/FTC), actually showed a modest weight-suppressive effect in earlier studies. But here’s the catch: that effect likely came from mitochondrial dysfunction, meaning the drug was essentially depleting the energy-producing parts of our cells. That’s not a feature we want.
Newer versions of PrEP do show the potential for minor weight gain as a side effect, but according to Dapkins, that weight gain “may be similar to weight trends seen in comparable populations not receiving PrEP, although some groups, including women and non-white patients, may experience greater changes.”
In other words? The side effect profile is basically unremarkable. Some people might experience temporary bloating or digestive discomfort when first starting the medication, but these symptoms are generally mild and fade within a few days to weeks.
The Real Issue Isn’t Medical
But the actual science doesn’t really matter here, does it? That’s what makes this whole situation so revealing.
Gay men are constantly told, both implicitly and explicitly, that our value is tied to how successful, desirable, and optimized our bodies appear. That’s not new. What feels new is that some people are genuinely hesitating to take medication that could literally save their lives because they’re worried it might blur their abs. That’s a level of aesthetic prioritization that would’ve seemed incomprehensible a generation ago.
During the height of the AIDS crisis, queer activists risked everything fighting a government that cared little that gay people were dying in droves. They begged for access to any treatment, any hope, any tool that might help. And now, just a few decades later, we have one of those extraordinary tools at our fingertips, and parts of the internet are treating it like a casual lifestyle choice.
The distortion of priorities here is staggering. We’ve moved from “we need this medication to survive” to “but what if it affects my appearance?”
When Misinformation Has Real Consequences
Here’s what makes this genuinely dangerous: misinformation around PrEP doesn’t just exist in a vacuum of silly internet discourse. It has real consequences. People might genuinely avoid taking medication they need because of something they read on social media. A joke about “PrEP belly” could be the reason someone decides not to protect themselves from HIV infection.
Dr. Dapkins noted that for most patients, “the substantial reduction in HIV transmission risk will outweigh the potential concern about weight gain,” but he also emphasized that this should be discussed thoughtfully between patient and clinician, without judgment.
That nuance matters. Real conversations about health outcomes should happen in clinical settings, not in the comments section of TikTok videos. And when unfounded rumors spread faster than actual medical information, that clinical conversation becomes harder to have.
A Question of Values
The “PrEP belly” panic isn’t really about side effects. It’s a symptom of something much deeper in gay culture: a slow erosion of values around health and community care in favor of aesthetics and individual optimization.
Gay culture has always revolved, in part, around visibility and sexuality. But somewhere along the way, health and being decent to each other started feeling secondary. We’ve become a community that’s increasingly obsessed with the appearance of wellness rather than actual wellness itself.
That’s not universal, obviously. But it’s visible enough that a baseless rumor about a medication’s side effects can send significant portions of the internet into a tailspin. It’s visible enough that people will genuinely consider risking their health over the prospect of a slightly rounder stomach.
A generation ago, we would’ve celebrated PrEP as the miracle it actually is. We would’ve viewed access to it as a hard-won victory. Instead, we’re scrutinizing our midsections and worrying about how we look taking it.
The question isn’t whether PrEP causes belly fat. The question is what it says about us that we’d even ask.
