A recent study conducted by the Cleveland Clinic found that bariatric surgery is more closely associated with a decrease in the progression of chronic kidney disease in individuals with obesity compared to treatment with GLP-1 drugs for diabetes. Participants who underwent bariatric surgery had a 60% lower risk of kidney impairment progression and a 44% lower risk of kidney failure or death. The surgery reduces the size of the stomach by about 80%, resulting in reduced food intake and metabolic changes that decrease hunger. These changes help resolve obesity, which is a major cause of kidney disease and diabetes.
Obesity is a condition that places stress on the body’s organs and increases the risk of type 2 diabetes. Type 2 diabetes, especially when blood sugar control is poor, can negatively impact kidney health. Bariatric surgery is not typically the first choice for individuals with obesity and kidney disease, but it is becoming more common for those with severe obesity, particularly if they also have diabetes. Insurance coverage for surgery in the United States typically requires a BMI between 35 and 40 with no other medical conditions. According to experts, GLP-1 treatments do not produce the same beneficial metabolic changes as bariatric surgery, but they can still help manage diabetes and weight, which benefits kidney function without the need for surgery.
Surgery, such as a gastric sleeve, alters metabolism by removing cells in the stomach that produce hormones responsible for hunger sensations, such as ghrelin. By reducing hunger and changing the hormone balance in the body, surgery can lead to sustained weight loss and improvement in overall health. Surgeons may also reroute digestion during a bypass procedure, further changing metabolism. These metabolic changes can protect the kidneys by controlling factors that may damage them, such as diabetes. Studies have shown that weight loss surgery is more durable than medications for maintaining weight loss over time, with long-term success rates as high as 80%.
In addition to the benefits for chronic kidney disease, bariatric surgery has been shown to be more effective in promoting long-term weight loss compared to traditional methods such as diet and exercise. Success with diet and exercise alone is typically low, with long-term success rates ranging from 2-5%. In contrast, the long-term success rate with surgery is significantly higher, at around 80%. While the long-term success of GLP-1 drugs is still being studied, experts believe they may offer benefits that fall between diet and exercise and surgery in terms of weight loss maintenance. Ultimately, weight loss surgery can provide lasting results for individuals with obesity and related health conditions, including diabetes and chronic kidney disease.
